Metatarsal Stress Fracture
The metatarsals are the long bones in the foot which connect to the toes. A stress fracture can occur through overuse or poor foot biomechanics.
What are the Symptoms of Stress Fractures?
- Foot metatarsal pain which comes on gradually.
- Pain is located towards the mid/front of the foot.
- Pain is aggravated by weight bearing activities such as walking, running or dancing.
- Pain to touch the bone at the point it is broken.
- Swelling is often present.
- An X-ray will often not show the fracture until two or three weeks after it has started to heal.
Stress Fractures
Metatarsal fractures can be either an acute fracture or a stress fracture. They can be fractured through impact for example a vicious football stud (acute fracture), or through a more gradual onset, where repetitive impact causes a stress fracture.
This usually will involve the second, third or forth metatarsal bones. Stress fractures to the metatarsals are the second most common location for a stress fracture, after the Tibia.
The most common position for a metatarsal fracture is the second metatarsal, especially in those whose second toe is longer than their big toe. It is also more common in those who overpronate with the first metatarsal in a dorsiflexed position as this places greater load on the 2nd metatarsal.
Stress fractures in the other metatarsals are less common, although they do occur.
Causes of stress fractures include:
- Over use!
- Too much training, too soon without enough rest!
- Overpronation
- Oversupination
- They are common in army recruits (often called a march fracture), runners, ballet dancers and gymnasts.
Treatment
- Rest from weight bearing activities as much as possible.
- For those whose job requires them to weight bear, a walking boot may be used.
- The rest period should normally be around 4 weeks to allow sufficient healing.
- Recommence activities only once all pain on touch and walking have cleared.
- Start with a very slow return to activity and a gradual build of duration and intensity.
- If the stress fracture may have been caused by abnormal foot mechanics such as overpronation or oversupination then orthotics may be required to correct this.
