What is a Metatarsal Stress Fracture?
A metatarsal stress fracture is a small crack or severe bruising within one of the five long bones in the foot (metatarsals), often caused by repetitive stress or overuse. Unlike acute fractures that result from a single injury, stress fractures develop gradually over time and can significantly impact mobility if left untreated.
What are the Causes of a Metatarsal Stress Fracture?
Stress fractures are typically the result of repeated mechanical stress on the bone. Common causes include:
- Overuse from sports such as running, basketball, or dance
- Sudden increases in activity without proper conditioning
- Improper footwear lacking support or shock absorption
- Biomechanical issues like flat feet or high arches
- Poor bone health due to low bone density, osteoporosis, or nutritional deficiencies
- Training on hard surfaces or uneven terrain
These factors can combine to exceed the bone’s ability to repair itself, resulting in microfractures.
What are the Symptoms of a Metatarsal Stress Fracture?
The symptoms of a metatarsal stress fracture tend to worsen gradually with continued activity. They may include:
- Localized pain in the midfoot or forefoot, especially during weight-bearing
- Swelling or bruising on the top of the foot
- Tenderness to touch over the affected metatarsal
- Pain that improves with rest but returns during activity
- Difficulty walking or limping in more advanced cases
Early recognition and treatment are key to preventing a more serious injury.
How is a Metatarsal Stress Fracture Diagnosed?
Diagnosis begins with a physical examination and review of the patient’s activity history. The area of tenderness and pain during weight-bearing are key clues. While initial X-rays may not reveal the fracture, advanced imaging such as MRI or bone scans can confirm the diagnosis. In a sports medicine setting, evaluating biomechanics and training patterns is also essential.
What are the Treatment Options for a Metatarsal Stress Fracture?
Treatment typically focuses on nonsurgical care and activity modification. Options may include:
- Rest and activity restriction to allow bone healing
- Immobilization with a walking boot or stiff-soled shoe
- Ice and elevation to reduce swelling
- Physical therapy for strengthening and return-to-sport planning
- Gradual return to activity
Surgical intervention is rarely needed unless the fracture fails to heal properly. With early care, most athletes can expect full recovery.
