Metatarsal Fractures
What are Metatarsals?
Metatarsals are the long bones in the forefoot. There are five in each foot, one leading up to each toe and forming the metatarso-phalangeal (MTP) joints with the phalanges (toe bones) at the base of each toe. They also form the tarsal-metatarsal (TMT) joints with the tarsal bones towards the ankle.
Metatarsal fractures can be either an acute fracture or a stress fracture. They can be fractured through impact for example a viscous football stud (acute fracture), or through a more gradual onset, where repetitive impact causes a stress fracture.
Stress Fractures
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.
What causes stress fractures?
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.
What are the symptoms of stress fractures?
Foot 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.
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.
Acute Metatarsal Fractures
This is a fracture to the metatarsal bones caused by some kind of violent impact. Often something is dropped on the foot or the foot might be stamped on. Alternatively, a violent twisting or turning motion at the ankle may cause a fracture in the 5th metatarsal in particular. These can include an avulsion fracture, where the tendon of the Peroneus Brevis muscle pulls a piece of the bone away. Or a Jones fracture which occurs at the base of the 5th metatarsal. This area typically has a poor blood supply and so healing may be affected.
What are the symptoms?
Acute pain at the point of trauma.
Rapid swelling.
Inability to weight bear.
There may be deformity in the foot.
Bruising will usually develop within 24 hours
What can the athlete do?
See a Doctor as soon as possible.
X-rays will be taken of the foot to confirm a fracture.
How are they Treated?
If the bones are not displaced then a short cast or boot will be fitted for the first three weeks.
After six weeks the foot should be X-rayed again to ensure it has healed.
More complex or displaced fractures may require surgical fixation.
Jones fractures require 6-8 weeks of non-weight bearing immobilisation.
Once the cast has been removed, a thorough rehabilitation programme should begin to regain full mobility and strength.
A gradual return to sport can then begin!
Products for fractured metatarsals:
Stress fractures in particular are often caused by having the wrong running shoes. Make sure your shoes provide enough cushioning and support for your foot.
Read our article on 'Choosing Running Shoes' for more information.
Our retail site return2fitness.co.uk supply sports medical and training products, including New Balance running shoes.
What are Metatarsals?
Metatarsals are the long bones in the forefoot. There are five in each foot, one leading up to each toe and forming the metatarso-phalangeal (MTP) joints with the phalanges (toe bones) at the base of each toe. They also form the tarsal-metatarsal (TMT) joints with the tarsal bones towards the ankle.
Metatarsal fractures can be either an acute fracture or a stress fracture. They can be fractured through impact for example a viscous football stud (acute fracture), or through a more gradual onset, where repetitive impact causes a stress fracture.
Stress Fractures
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.
What causes stress fractures?
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.
What are the symptoms of stress fractures?
Foot 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.
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.
Acute Metatarsal Fractures
This is a fracture to the metatarsal bones caused by some kind of violent impact. Often something is dropped on the foot or the foot might be stamped on. Alternatively, a violent twisting or turning motion at the ankle may cause a fracture in the 5th metatarsal in particular. These can include an avulsion fracture, where the tendon of the Peroneus Brevis muscle pulls a piece of the bone away. Or a Jones fracture which occurs at the base of the 5th metatarsal. This area typically has a poor blood supply and so healing may be affected.
What are the symptoms?
Acute pain at the point of trauma.
Rapid swelling.
Inability to weight bear.
There may be deformity in the foot.
Bruising will usually develop within 24 hours
What can the athlete do?
See a Doctor as soon as possible.
X-rays will be taken of the foot to confirm a fracture.
How are they Treated?
If the bones are not displaced then a short cast or boot will be fitted for the first three weeks.
After six weeks the foot should be X-rayed again to ensure it has healed.
More complex or displaced fractures may require surgical fixation.
Jones fractures require 6-8 weeks of non-weight bearing immobilisation.
Once the cast has been removed, a thorough rehabilitation programme should begin to regain full mobility and strength.
A gradual return to sport can then begin!
Products for fractured metatarsals:
Stress fractures in particular are often caused by having the wrong running shoes. Make sure your shoes provide enough cushioning and support for your foot.
Read our article on 'Choosing Running Shoes' for more information.
Our retail site return2fitness.co.uk supply sports medical and training products, including New Balance running shoes.
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