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The human foot has five metatarsal bones and about 30% of foot injuries are metatarsal fractures. Over the last few years, a number or prominent athletes have had metatarsal fractures, and this has made it a well-known injury. A metatarsal fracture or broken foot can happen as a result of overuse, excessive rotation force or through direct trauma.
Wearing a foot support can minimise the chances of sustaining an injury to the metatarsal bones, especially for those with foot pain or people taking part in sporting activities.
Two common types of metatarsal fracture are:
Acute - Caused through a direct injury such as a fall or sporting accident. This is a sudden traumatic injury. Several symptoms may indicate an acute metatarsal fracture including severe foot pain, bruising and swelling in the foot and difficulty walking.
Stress - Often caused by overuse. Stress fractures can occur when a person increases the frequency, duration or intensity of exercise too quickly. They can also occur when a person exercises when tired or in pain, or even because they are wearing new or inappropriate footwear. A stress fracture may begin as a slight pain in the foot while exercising, which disappears at rest. Eventually the foot pain may become continuous and increase in severity. As the fracture develops, pain may localise to the fracture site and be swollen and tender.
Treatment for a metatarsal fracture is dependent upon its location and the type of fracture. The patient will need an x-ray to confirm if there is a fracture, where it is and if the bones are still aligned.
For acute metatarsal fractures, as long as the bones have remained properly aligned, the foot will be immobilised in a cast. Often a removable cast is used. Weight bearing will be restricted for about 6 to 8 weeks.
However, research suggests that a fifth of metatarsal stress fractures do not heal as quickly or easily. In some circumstances therefore, it may be necessary for the bone to be fixed surgically. The foot may need to be immobilised in a special shoe or cast for several weeks while the fracture heals. It may take some six to twelve weeks until previous activities can be resumed without foot pain.
Pain medication, such as non-steroidal anti-inflammatory (NSAIDs) or paracetamol may be prescribed to minimise foot pain following a metatarsal injury. Ice therapy and elevating the affected foot can also be helpful to reduce pain and swelling.
Physiotherapy may be required to get the foot and ankle moving again after a metatarsal injury, especially for those who have had their foot immobilised in a non-removable cast. Activity levels should be built up slowly to prevent further injury. It may be necessary to wear a foot support until strength and stability has been regained.
There are several ways you can reduce the risk of a metatarsal injury.
Wearing appropriate and supportive footwear is essential. Make sure shoes fit properly and are good quality. When devising a training or exercise schedule, ensure recovery and rest breaks are factored into the programme and that duration, frequency and intensity are gradually built up.
Never ignore foot pain and seek medical advice as soon as possible. Finally, wear a foot support, especially when participating in high impact activities or contact sports.