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Foot Care 101: Metatarsal Stress Fractures

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

Metatarsal Stress Fracture

“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 2nd and 3rd 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;

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.


Dr. Jeffrey Oster
Jeffrey A. Oster, DPM

Medical Advisor

Updated 3-11-2021

Leave your comment
11/29/2018 5:59 PM
I've been wrapping my foot with Ace Bandage but I want something that will feel more comfortable in my shoe. I saw that your forefoot sleeve has grade 2 compression and I'm wondering if that will be enough. Thank you.
11/29/2018 8:05 PM
Hi Mike,<br>
I think you'll find the overall compression and the thinness of the <a href="/forefoot-compression-sleeve">Forefoot Compression Sleeve</a> to be far superior to an Ace Wrap.  The Forefoot Compression Sleeve can fit easily under a sock so that you'll be able to wear a regular shoe.  With a metatarsal stress fracture, the stiffer the shoe the better in that it'll act as a brace.  That being said, the combination of both The Forefoot Compression Sleeve and a stiff shoe is optimal in treating metatarsal stress fractures.<br>
Grading of compression is always hard to be accurate with due to variations in the size of the foot in relationship to the Compression Sleeve.  But I think it would be fair to say that The Forefoot Compression Sleeve's compression would be comparable to OTC support hose (15-20 mg/hg pressure).<br>
Hope this helps.<br>
<a href="/jeffrey_a_oster_dpm_cv">Jeffrey A. Oster, DPM</a><br>
Medical Director<br>