Metatarsal Stress Fracture? Is Your Foot Trying to Tell You Something?
Do you have a pain in the middle or ball of your foot that just isn’t going away or is gradually getting worse, even at rest? It could be a metatarsal stress fracture.
What is a metatarsal stress fracture?
A stress fracture is a small crack or break in one of the bones of your body. Stress fractures are often called hairline fractures. They can be a sign of overuse and overloading of the bone and are different to a broken bone caused by a sudden injury.
The five metatarsal bones are the long bones that connect your toes to the rear of your foot. They can be susceptible to stress fractures because of the repetitive forces going through the foot when walking, running and jumping. The second metatarsal bone is the most commonly affected because of its anatomy. Stress fractures can make up to 20% of all sports injuries.
Symptoms of a metatarsal stress fracture
Pain that starts with activity and gets worse the longer you exercise
Pain that doesn’t go away after stopping the activity
Pain that is present even when resting
Swelling
Pain that is located over the bone
Symptoms often start gradually, may not stop you from exercising, and in the early stages will go away with rest but over time will become more painful. The whole foot may be sore, but there is often one area that is most painful, such as the area over or near the bone.
What causes metatarsal stress fractures?
These fractures are caused by repetitive motions that put pressure on the bone, which causes the bone not to have enough time to recover. They start as an inflammation on the bone surface (stress reaction), like a bone bruise. Repetitive impact causes microfractures, which consolidate into a stress fractures
Some common causes of metatarsal stress fractures are:
Increasing the type, frequency or intensity of an exercise too quickly.
The second toe being longer than the first.
Tight calf muscles.
A training program that does not include sufficient rest.
Suddenly changing the surface you train or work on, such as running on the road rather than a treadmill, or standing on concrete floors all day.
Footwear that does not provide enough cushioning or shock absorption, has become worn out with use or exercising barefoot.
Sports most associated with metatarsal stress fractures include running, basketball, tennis, dance and gymnastics. Medical conditions that may predispose to stress fractures are osteoporosis, vitamin D deficiency, bunions, high-arched rigid feet or flat feet, and body composition.
How do you treat metatarsal stress fractures?
The good news is that metatarsal stress fractures tend to heal well but a correct diagnosis is essential to ensure that it can be treated early. This is usually done by obtaining a thorough history of the symptoms and examining the foot. The inability to hop on the affected foot or pain when a tuning fork is placed over the affected bone can diagnose a stress fracture. A foot x-ray or MRI may also be requested to monitor the bone healing.
Treatment will usually involve:
Relative rest
Icing of the affected area
Anti-inflammatory medication
Immobilisation of the foot in a stiff soled shoe or moon boot.
Alternative exercises such as swimming, and cycling until the stress fracture is healed.
The stress fracture may take 6-8 weeks to fully heal. The podiatrists at JS Podiatry can help with footwear selection, correction of biomechanical issues, and a return-to-exercise program to help prevent stress fractures from returning.