A metatarsal fracture is a break to one of the five long metatarsal bones in the foot and is usually caused by a direct impact or trauma. It could also be a stress fracture which comes on gradually from overuse. Seeking medical help is key to recovering from this foot injury to ensure the bones heal.

Symptoms

Acute and severe foot pain at the time of injury.
There will likely be rapid swelling.
The athlete may be unable to fully weight bear.
A visible deformity in the foot may be noticed.
Bruising will usually develop within 24 hours.

Anatomy

Metatarsals are the long bones in the forefoot. They are numbered 1 (Big Toe) up to 5 (Little Toe), one leading up to each toe and forming the metatarsophalangeal joints otherwise known as the MTP joints.

Causes

An acute fracture is caused by a direct impact such as having the foot trodden on by a football stud or similar. Alternatively, a violent twisting or turning motion at the ankle may cause a fracture in the 5th metatarsal in particular.

A stress fracture is caused by;

Overuse – Repetitive strain on the bone eventually results in a stress fracture.

Overpronation – where your foot rolls in too much, or flattens.

Oversupination – where your foot has a particularly high arch. This means it is rigid and does not pronate enough to absorb the forces from running.

Treatment

A X-ray of the foot to confirm if there is a fracture and the type of fracture.

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.

Once the cast has been removed, a thorough rehabilitation program should begin to regain full mobility and strength. A gradual return to sport can then begin.

Rehabilitation of a metatarsal fracture may begin at different stages, depending on whether it is an acute fracture or a stress fracture and also the extent and location of the injury.

Acute metatarsal fractures which require complete immobilization in a plaster cast will not begin rehabilitation until after the cast is removed.