Overview

A Metatarsal Stress Fracture is a common injury impacting athletes and is caused by an incomplete crack in one of the metatarsal bones of the forefoot.

Weight bearing activity places weight through the metatarsal bones. When the pulling forces placed on these bones through the attached muscles becomes excessive, damage to the bones can gradually occur or can be caused by a sudden force that can result in a Metatarsal Stress Fracture. The second metatarsal (closest to the big toe) is most often impacted, as this is the bone that absorbs the most pressure during movement.

Metatarsal Stress Fractures are often caused by contact sports, and can be experienced by athletes, dancers and runners. With appropriate care management, most people recover fully from a fracture of this type within three to nine months.

Causes

The most common causes of this condition are:

  • Excessive weight bearing activities such as running, sprinting, jumping or dancing.
  • A second toe being longer than the first.
  • Poor quality footwear that doesn’t provide enough support.
  • Landing on a hard surface from a height.
  • The foot being stepped on or kicked, or having something dropped onto it.
  • Not allocating enough rest time between activities or suddenly increasing the
  • intensity of their exercise programs.
  • When the foot rolls inwards excessively during walking or running, which results in the lower leg also turning inwards.
  • When the metatarsal bones weaken due to weakening of the bones through conditions such as osteoporosis.
  • When nerve sensation in the feet is weakened due to neurological issues such as diabetes.
  • Tightness in the calf muscles.

Symptoms

A person with a Metatarsal Stress Fracture will often experience a progressive pain in the front foot that gets worse when undergoing activities which bear weight on the foot such as walking and running. Swelling and tenderness around the area is often also experienced, with a sharp pain felt when pressure is applied to the metatarsal.

Diagnosis

Dan Everson Podiatry can diagnose a Metatarsal Stress Fracture through an examination of the area along with a bone scan that will provide a precise image of the fracture and can confirm the injury in very early stages. X-rays may be recommended for severe cases or at a later stage of the injury. MRI scanning is occasionally used.

Treatment

People with Metatarsal Stress Fractures must ensure they rest the area as much as possible. Your podiatrist will guide you to the degree of rest required, depending on the nature and severity of your fracture.

Below is a selection of other treatments Dan Everson Podiatry recommends for this condition:

  • Sticking to low impact activities such as swimming, bike riding or running in the water during the healing process.
  • Crutches to avoid weight bearing on the affected foot.
  • Anti-inflammatory medications.
  • A cast or brace for severe cases where a fracture or displacement is likely.
  • Protective footwear with more supportive soles to relief stress to the area.
  • Surgery is rarely but occasionally needed where a screw is inserted into the bone to help it heal.

Prevention

Dan Everson Podiatry recommends the following activities to help prevent Metatarsal Stress Fractures.

  • Kinetic Orthotics can help prevent this condition by reducing the strain on the metatarsal bones.
  • Wear a supportive shoe at all times with appropriate arch support.
  • Athletes should consider and speak with their podiatrist about modifications to their training program. E.g Cross training to avoid overuse
  • Strength training to improve bone density
  • Ensuring sufficient calcium and vitamin D intake

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