Foot Care 101: Metatarsal Stress Fractures

How did I get a fracture?  I didn’t do anything to hurt my foot?         

“I was late for the plane, so I grabbed my carry-on bag and ran like heck to make the flight.  I was the last passenger on.  But when I got on the plane, I realized that my foot hurt.  It’s been hurting now for about 2 weeks.”  This is a familiar conversation in my office.  A benign event, like running for a plane, often is enough stress to result in a metatarsal stress fracture.

What is a metatarsal stress fracture? 

The metatarsal bones are the bones that extend from the arch to the toes.  The metatarsal bone is soft on the ends (metaphyseal bone) with a long tubular center (diaphyseal bone).  When load is applied to a bone, particularly the hard diaphyseal bone, that load is called strain.  When strain becomes so great that the bone fails, we call that stress.  Therefore, a stress fracture occurs when load applied to a bone results in a small break in the diaphyseal bone.

Symptoms of metatarsal stress fractures

• Pain with initial weight bearing
• Pain that increases with the duration of time on your feet
• Pain most commonly found in the 2^nd and 3^rd metatarsals
• Focal, palpable pain on the dorsal (top) of the foot
• Localized swelling specific to the dorsal foot
• Swelling and redness, but no bruising found

Confirmation of a stress fracture with plain x-ray can be difficult in the first 3-4 weeks following the onset of pain.  The stress applied to the bone results in a fracture that is initially indistinguishable on x-ray.  The confirmation of a stress fracture is often made with x-ray 4-6 weeks following the onset of symptoms.  At 4 weeks, the initial bone callus (healing tissue at the fracture site) will begin to calcify at the site of fracture.

Treatment of metatarsal stress fractures

Most metatarsal stress fractures will heal in a matter of 4-6 weeks.  But you can help expedite that healing process by using a stiff sole.  Many physicians will treat metatarsal stress fractures with a walking cast, but a still sole will often suffice.  The key is to avoid the use of a soft, flexible sole.  Additional treatment recommendations include;

• Stiff sole like a clog or men’s wingtip
• Carbon Fiber Spring Plate
• Forefoot Compression Sleeve

I find the Carbon Fiber Spring Plate to be the most effective tool for metatarsal stress fracture management.  Carbon fiber Spring Plates are very thin and very light.  They fit easily into shoes and provide the rigidity needed to expedite healing.

For more information on metatarsal stress fractures, be sure to visit our knowledge base pages on metatarsal stress fractures.

Jeff  

Jeffrey A. Oster, DPM 

Medical Advisor
Myfootshop.com  

Updated 3-11-2021

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