Metatarsal stress fracture
What is it?
A crack (fracture) in one of the long bones (metatarsals) of the foot. The second metatarsal is the most common bone to fracture as it is typically the longest bone in the foot.
Symptoms
The main symptom is pain at the top of your foot, especially over the fracture. The pain usually develops gradually and is very tender to touch. You may also have pain at night when you are resting.
Causes
Stress fractures are overuse injuries. When you run, your feet are put under continual stress as each foot strikes the ground. This can cause areas of weakness to form in the bone leading to stress fractures.
You're more likely to have a stress fracture if you have:
- recently increased your training routine
- poor movement in your foot (biomechanics)
- tired muscles
- a poor diet
- reduced bone density (osteoporosis)
Treatment
A sports medicine professional, such as a sports medicine doctor, can diagnose and treat a foot bone stress fracture. He or she may use an MRI, X-ray or bone scan to asses the extent of the damage.
Treatment usually involves resting your affected leg. You may need to use crutches and a special boot to protect the damaged area of bone. The majority of stress fractures heal after six weeks of rest.
Taking painkillers such as ibuprofen will help to reduce pain and swelling. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.
Putting ice or ice packs on the injured area until the swelling goes down will also help. Don't apply ice directly to your skin as it can give you an 'ice burn' - place a cloth between the ice and skin.
A biomechanical assessment and foot orthotics (special insoles worn inside your shoes) may also help to prevent the injury from coming back.
Do
- Rest from all running and high impact exercises.
- Keep up your cardiovascular fitness by swimming or cycling.
- Build up to long distances gradually when you start training again.
Don't
- Continue exercising as you usually do. This will weaken the bone further and may lead to a complete break in the bone.
Peer reviewed by David Toy, MCSP, Bupa Sports Medicine physiotherapist
Publication date: June 2009
