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.
![](https://www.rehabontheroad.com/wp-content/uploads/2020/09/Metatarals-129x300.png)
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.
Rehab
Range of Movement
![](https://www.rehabontheroad.com/wp-content/uploads/2020/09/Ankle-a-z-151x300.png)
![](https://www.rehabontheroad.com/wp-content/uploads/2020/09/Calf-Stretch.png)
![](https://www.rehabontheroad.com/wp-content/uploads/2020/09/Toe-RoM.png)
Strength
![](https://www.rehabontheroad.com/wp-content/uploads/2020/09/Toe-Walking-222x300.png)
![](https://www.rehabontheroad.com/wp-content/uploads/2020/09/Picture8-2-300x152.png)
![](https://www.rehabontheroad.com/wp-content/uploads/2020/09/Picture7-2.png)
Balance (Proprioception)
![](https://www.rehabontheroad.com/wp-content/uploads/2020/09/Picture10-191x300.png)
![](https://www.rehabontheroad.com/wp-content/uploads/2020/09/Picture13-228x300.png)
![](https://www.rehabontheroad.com/wp-content/uploads/2020/09/Picture14-1-206x300.png)
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