Metatarsal Stress Fracture

When too much stress is put on the foot, as in running and jumping sports, the center shaft of the bones of the forefoot is very susceptible to stress fractures (break in bone). This is because of repetitive stress on the bone. This injury is more common if osteoporosis is present or if inadequate running shoes are used. Rapid increase in running distances are often the cause. Running distances should be gradually increased to avoid this problem. Shoes should be used which adequately cushion the foot. Shoes should absorb the shocks of the activity.

DIAGNOSIS

Usually the diagnosis is made by history. The foot progressively becomes sorer with activities. X-rays may be negative (show no break) within the first 2 to 3 weeks of the beginning of pain. A later X-ray may show signs of healing bone (callus formation). A bone scan or MRI will usually make the diagnosis earlier.

TREATMENT AND HOME CARE INSTRUCTIONS

  • Treatment may or may not include a cast, removable fracture boot, or walking shoe. Casts are used for short periods of time to prevent muscle atrophy (muscle wasting).

  • Activities should be stopped until further advised by your caregiver.

  • Wear shoes with adequate shock absorbing abilities.

  • Alternative exercise may be undertaken while waiting for healing. These may include bicycling and swimming, or as your caregiver suggests.

If you do not have a cast or splint:

  • You may walk on your injured foot as tolerated or advised.

  • Do not put any weight on your injured foot for as long as directed by your caregiver. Slowly increase the amount of time you walk on the foot as the pain allows or as advised.

  • Use crutches until you can bear weight without pain. A gradual increase in weight bearing may help.

  • Apply ice to the injury for 15 to 20 minutes each hour while awake for the first 2 days. Put the ice in a plastic bag and place a towel between the bag of ice and your skin.

  • Only take over-the-counter or prescription medicines for pain, discomfort, or fever as directed by your caregiver.

SEEK IMMEDIATE MEDICAL CARE IF:

  • Pain is becoming worse rather than better, or if pain is uncontrolled with medications.

  • You have increased swelling or redness in the foot.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.