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Metatarsal stress fracture

Also referred to as:
March Fractures • Fatigue Fractures • Insufficiency Fractures

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What is a metatarsal stress fracture?

The metatarsals are the long bones which run between the toes and the midfoot. They are the longest bones of the feet and can take a lot of stress when we are very active, carrying a lot of weight, or if we wear inappropriate footwear.

Stress fractures are tiny cracks that form in bones as a result of stress. When multiplied, these tiny cracks become a larger problem and can cause pain, swelling, dysfunction and damage.

Normal bones can develop stress fractures from overuse and excessive or repetitive loading, however abnormal bones, in people with osteoporosis (low bone density) for example, can develop stress fractures even from normal daily activities.

There isn’t usually a single or specific injury involved with stress fractures. Unlike for example, a metatarsal fracture when you drop something heavy on your foot and break a bone, or an avulsion fracture where you twist the foot and a tendon pulls part of the bone away, causing a fracture. This is most common on the styloid process (The base of the 5th metatarsal)  which is the little bump halfway down on the outside of your foot.

A Jones fracture is another fracture in this area which is more on the neck of the 5th metatarsal. These can be caused by repetitive stress or from trauma or injury.

How can I help myself?

If you start to develop pain in your foot and you think it may be a stress fracture, then think about the sort of activities you have been doing and look at the footwear you have been wearing to check if it is suitable. Replace any worn out footwear.

Resting may help to prevent the problem from developing into something more serious and can allow healing. Pain and swelling may be the initial warning signs you need to look out for. If you are wearing thin soled footwear or higher heels, or if you have taken up new activities or are running or walking more, then you need to try and avoid these things to see if the pain and swelling reduces.

If the problem is more serious, or you had a specific injury or trauma, then you need to seek appropriate medical care quickly.

You also need to be cautious if you have conditions such as osteoporosis or if you have diabetes or other medical conditions that could impact healing and cause numbness (neuropathy) in your feet. This may mask the development of stress fractures. In people with neuropathy (especially diabetics), microtrauma and stress can lead the development of a Charcot foot.

The following links may be of interest:

POLICE therapy

Anti-inflammatory and pain relieving medication

When to see a podiatrist for a stress fracture?

It is a good idea to get a podiatrist to check your foot if you suspect any form of fracture because they can advise on short, middle and long term management of the problem.

They may recommend a period of total rest or immobilisation with a boot. They may also recommend imaging to confirm the diagnosis.

They can also assess your foot mechanics and see if you need footwear changes, foot orthoses or other devices to try and help offload the problem areas and prevent recurrence.

If you book an appointment, it is a good idea to take the footwear that you wear day to day.