![]() ![]() Typically, stress fractures start out as a “stress reaction” in the bone. Metatarsal stress fractures in runners are the result of the repeated load applied to the foot. ![]() They develop slowly with repetitive load on a bone as opposed to a typical fracture that is caused by a sudden twisted or bending force on the bone. What causes a metatarsal stress fracture? They can take several weeks before becoming visible on an x-ray. They are there although you cannot see them. If you bend that branch but don’t break it in half, then you will hear small cracks forming. A simple way to understand stress fractures is to think about a small branch or twig. They are generally small and often do not extend all the way through the bone. Use only as directed.A stress fracture is a hairline crack in a bone. Narcotic pain relievers may be prescribed by your physi- cian for severe pain. Contact your physician immediately if any bleeding, stomach upset, or signs of an allergic reaction occur. Take these as directed by your physician. Nonsteroidal anti-inflammatory medications, such as aspirin and ibuprofen (do not within 7 days before surgery), or other minor pain relievers, such as acetaminophen, are often recommended. Surgery is rarely necessary, although it may be offered for fractures that do not heal after 3 to 6 months despite appropriateĬonservative treatment, such as fifth metatarsal fractures. Physical therapy may be helpful in gradually increasing strength of the muscles and bones after stress fracture and in maintaining cardiac fitness while waiting for the bone to heal. Bone stimulators, which provide electrical currents to the bone, are attempted infrequently. After rest, gradual return to activity is recommended. Menstrual, nutritional, and metabolic abnormalities need to be appropriately identified and treated to help healing and prevent recurrence. This may be done with special hard-bottom shoes, orthotics, or taping techniques. Some physicians allow activity at a level below that which causes symptoms, while having extra support for the foot. Occasionally crutches may be recommended to protect the bone while it heals. Initial treatment consists of medications and ice to relieve pain and relative rest from the activity that caused the fracture. Repeated stress fracture, not necessarily at the same site (occurs in 1 of every 10 patients) Risks of surgery, including infection, bleeding, injury to nerves (numbness, weakness, paralysis), and need for further surgery Progression to complete and displaced fracture This condition is usually curable, with appropriate treatment, within 6 to 12 weeks.įailure to heal (nonunion), especially with stress fractures of the upper part of the fifth metatarsal (outer foot) Wear cushioned arch supports for runners with flat feet. Treat hormonal disorder birth control pills can be helpful for women with menstrual period irregularity.Ĭorrect metabolic and nutritional disorders. Gradually increase activity and training. Use proper technique with training and activity. Wear proper footwear replace shoes after 300 to 500 miles of running. Inadequate footwear with poor shock-absorbing capacityĪppropriately warm up and stretch before practice or competition. Poor extremity alignment, including flat feet Sudden increase in the duration, intensity, or frequency of physical activity ![]() Poor physical conditioning (strength and flexibility) Women, especially when there is loss of or irregular menstrual periods Metabolic disorders, hormone problems, and nutritional deficiencies and disorders (anorexia or bulemia) It is also associated with a bone’s ability to heal and may be associated with loss of menstrual period in women.īony abnormalities (including osteoporosis and tumors) This usually follows a change in training or performance schedule, equipment, or intensity. They usually occur when there is an imbalance between bone injury and bone remodeling (healing). Stress fractures are caused by repetitive forces greater than the bone can withstand. Weakness and inability to bear weight on the injured extremity Uncommonly, bleeding and bruising in the foot Vague, diffuse pain or ache and occasionally tenderness and swelling in the foot It can occur anywhere within the metatarsal, although it most commonly affects the lower third of the second metatarsal (next to the big toe’s metatarsal). This is the second most common bone to sustain a stress fracture in athletes. The wear and injury in the bone exceeds the bone’s ability to heal and repair the injury, resulting in a breakdown of the bone, causing a stress or fatigue fracture. A metatarsal stress fracture is a complete or incomplete break in the foot involving one or more of the longer foot bones (metatarsals) caused by intense exercise or repetitive pressure on the extremity.
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