Metatarsal Stress Fracture

A metatarsal stress fracture refers to a condition in which one of the metatarsal bones is affected with an incomplete crack. There are five metatarsal bones in the foot which are located in the forefoot.

Weight bearing activities such as running and jumping apply pressure to the metatarsal bones of the foot and several muscles attached to these bones. When the muscles associated with these bones contract, the respective bones experience a pulling force. When forces are too excessive, beyond what the metatarsal bones can withstand, the bones will gradually get damaged. This damage progresses to a stress fracture. Usually the second metatarsal bone, which is next to the big toe, is affected in a metatarsal stress fracture.


Metatarsal stress fractures usually develop with time due to excessive weight beating activities such as running, jumping, sprinting or dancing. Stress fractures of the metatarsals often occur after a recent increase in weight bearing activity, change in intensity or training conditions such s footwear, form, techniques, surface etc. Sometimes, this condition may occur due to trauma form landing from a height on a hard surface.

Signs and symptoms of metatarsal stress fractures

Patients with metatarsal stress fractures usually suffer from pain in the forefoot, which increased due to impact activity such as from jumping, running, standing on toes or sprinting. Pain decreases with rest. Symptoms may also affect other areas of the foot that are not affected by the injury. Sometimes patients may experience discoloration or swelling at the site of the fracture.

In more serious cases, standing or walking alone can exacerbate symptoms and cause pain to flare up. Pain and discomfort may cause the person to limp while moving from one place to another. Patients may also suffer from pain while resting. Other symptoms of metatarsal stress fractures include night aches, pain when firmly touched or pain while squeezing the forefoot.

Contributing factors

The following factors may be associated with the development of metatarsal stress fracture. If you suspect that any of these may be linked to your fracture, these will need to be evaluated by your physiotherapist and treated.

  • Excessive training – on hard or uneven surfaces
  • Poor posture of the feet – due to high arches or flat feet
  • Poor balance
  • Poor biomechanics
  • Muscle weakness
  • Ankle joint stiffness
  • Poor flexibility of the calf muscles
  • Poor running technique
  • Poor gait
  • Inappropriate footwear – such as tight shoes or high heals
  • Being overweight or obese
  • menstrual disturbances
  • inadequate nutrient intake from diet
  • Discrepancies in leg length


Physiotherapy may promote healing and enhance the flexibility and strength of the structure involved. Moreover, physiotherapy techniques will also prevent further injury and ensure positive outcome from treatment.

  • Soft tissue massage
  • Joint immobilization
  • Rest – use of crutches
  • Dry needling
  • Electrotherapy
  • Foot taping
  • Modification of activity – allowing adequate rest and avoiding aggravating activities
  • Using a cast, a protective boot or a foot brace
  • Appropriate footwear
  • Gait correction
  • Biomechanical correction – with the use of a metatarsal raise or orthotics
  • Exercises to enhance flexibility, strength and balance
  • A gradual return to physical activity

Your physical therapist may suggest performing the following exercises after treatment or surgery:

  • Foot and ankle : Up and Down

Move the affected foot and ankle up and down. Do this as far as possible, making sure you are comfortable and experience no symptoms such as pain. Repeat 10-20 times. Only continue if you feel no pain.

  • Foot and ankle: In and out

Move the affected foot an ankle in an in and out motion, provided that you are comfortable and feel no pain. Repeat 10-20 without any symptoms

  • Foot and ankles: Clockwise and Anti-clockwise

Move the foot and ankle in a clockwise and anticlockwise motion – in a circle as large as possible – without any pain. Repeat 10-20 times without any symptoms

It is imperative at Happy Physio that we treat and fix your problem, rather than simply treating the symptoms. If you would like to discuss your condition with one of our health professionals, please do not hesitate to contact our friendly administration team on 9272 7359. Our access to the latest technology and experienced physiotherapists, exercise physiologists and massage therapists will assist you in feeling happier and healthier as soon as possible.