Metatarsal Fracture

What is Metatarsal Fracture

Metatarsal fracture is a break in one of the five bones that connect the toes to the rest of the foot. This may also be called a forefoot fracture. A metatarsal fracture may be:

  • A crack in the surface of the bone (stress fracture). This often occurs in athletes.
  • A break all the way through the bone (complete fracture).

The bone that connects to the little toe (fifth metatarsal) is most commonly fractured. Ballet dancers often fracture this bone.

What are the causes?

A metatarsal fracture may be caused by:

  • Sudden twisting of the foot.
  • Falling onto the foot.
  • Something heavy falling onto the foot.
  • Overuse or repetitive exercise.

What increases the risk?

This condition is more likely to develop in people who:

  • Play contact sports.
  • Do ballet.
  • Have a condition that causes the bones to become thin and brittle (osteoporosis).
  • Have a low calcium level.

What are the signs or symptoms?

Symptoms of this condition include:

  • Pain that gets worse when walking or standing.
  • Pain when pressing on the foot or moving the toes.
  • Swelling.
  • Bruising on the top or bottom of the foot.

How is this diagnosed?

This condition may be diagnosed based on:

  • Your symptoms.
  • Any recent foot injuries you have had.
  • A physical exam.
  • An X-ray of your foot. If you have a stress fracture, it may not show up on an X-ray, and you may need other imaging tests, such as:
    • A bone scan.
    • CT scan.
    • MRI.

How is this treated?

Treatment depends on how severe your fracture is and how the pieces of the broken bone line up with each other (alignment). Treatment may involve:

  • Wearing a cast, splint, or supportive boot on your foot.
  • Using crutches, and not putting any weight on your foot.
  • Having surgery to align broken bones (open reduction and internal fixation, ORIF).
  • Physical therapy.
  • Follow-up visits and X-rays to make sure you are healing.

Follow these instructions at home:

If you have a splint or a supportive boot:

  • Wear the splint or boot as told by your health care provider. Remove it only as told by your health care provider.
  • Loosen the splint or boot if your toes tingle, become numb, or turn cold and blue.
  • Keep the splint or boot clean.
  • If your splint or boot is not waterproof:
    • Do not let it get wet.
    • Cover it with a watertight covering when you take a bath or a shower.

If you have a cast:

  • Do not stick anything inside the cast to scratch your skin. Doing that increases your risk for infection.
  • Check the skin around the cast every day. Tell your health care provider about any concerns.
  • You may put lotion on dry skin around the edges of the cast. Do not put lotion on the skin underneath the cast.
  • Keep the cast clean.
  • If the cast is not waterproof:
    • Do not let it get wet.
    • Cover it with a watertight covering when you take a bath or a shower.

Activity

  • Do not use your affected leg to support your body weight until your health care provider says that you can. Use crutches as directed.
  • Ask your health care provider what activities are safe for you during recovery, and ask what activities you need to avoid.
  • Do physical therapy exercises as directed.

Driving

  • Do not drive or use heavy machinery while taking pain medicine.
  • Do not drive while wearing a cast, splint, or boot on a foot that you use for driving.

Managing pain, stiffness, and swelling

  • If directed, put ice on painful areas:
    • Put ice in a plastic bag.
    • Place a towel between your skin and the bag.
      • If you have a removable splint or boot, remove it as told by your health care provider.
      • If you have a cast, place a towel between your cast and the bag.
    • Leave the ice on for 20 minutes, 2–3 times a day.
  • Move your toes often to avoid stiffness and to lessen swelling.
  • Raise (elevate) your lower leg above the level of your heart while you are sitting or lying down.

General instructions

  • Do not put pressure on any part of the cast or splint until it is fully hardened. This may take several hours.
  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. These can delay bone healing. If you need help quitting, ask your health care provider.
  • Do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you may take showers.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if you have:

  • Pain that gets worse or does not get better with medicine.
  • A fever.
  • A bad smell coming from your cast or splint.

Get help right away if you have:

  • Any of the following in your toes or your foot, even after loosening your splint (if applicable):
    • Numbness.
    • Tingling.
    • Coldness.
    • Blue skin.
  • Redness or swelling that gets worse.
  • Pain that suddenly becomes severe.

Summary

  • A metatarsal fracture is a break in one of the five bones that connect the toes to the rest of the foot.
  • Treatment depends on how severe your fracture is and how the pieces of the broken bone line up with each other (alignment). This may include wearing a cast, splint, or supportive boot, or using crutches. Sometimes surgery is needed to align the bones.
  • Ice and elevate your foot to help lessen the pain and swelling.
  • Make sure you know what symptoms should cause you to get help right away.

Metatarsal Fracture Rehab

After you break one of the long bones in your foot (metatarsal fracture), it is important to regain your flexibility, coordination, strength, and balance. This is especially important if you had a cast or boot.

Ask your health care provider or physical therapist when you can start doing exercises at home. If doing any of these exercises causes pain, stop and contact your health care provider or physical therapist.

Stretching exercises

Exercise A: towel stretch

  1. Sit on the floor with your legs straight out in front of you.
  2. Loop a towel around the ball of your injured foot.
  3. Use both hands to pull the ends of the towel, stretching your toes and foot toward your body. You should feel a stretch in the muscle in the back of your lower leg (calf).
  4. Hold the stretch for 30 seconds.
  5. Repeat __________ times. Complete this exercise __________ times a day.

Exercise B: ankle alphabets

  1. Sit with your injured foot raised off the ground (elevated). You can support your leg on pillows or on a footstool. Make sure your foot has room to move freely.
  2. Move your injured foot to trace each letter of the alphabet in the air. Keep your hip and knee still. Make the letters as large as you can without pain.
  3. Go through all of the letters from A to Z.
  4. Repeat __________ times. Complete this exercise __________ times a day.

Exercise C: calf stretch

  1. Stand with both hands against a wall for support.
  2. Bring your injured foot out straight behind you. Keep the front leg bent at the knee.
  3. Keep the knee of your back leg straight and keep your heel on the floor.
  4. Shift your weight toward the wall, making sure to keep the heel of your back leg down on the floor. You should feel a stretch in the calf of your back leg.
  5. Hold the stretch for 30 seconds.
  6. Repeat __________ times. Complete this exercise __________ times a day.

You can also do this exercise with the knee of your back leg slightly bent for a deep calf stretch. Repeat the same steps but with your knee bent.

Strengthening exercises

Exercise A: marble pickup

  1. Sit in a chair. Put 20 marbles on the floor in front of you. Put a bowl or cup on the floor near the marbles.
  2. Use the toes of your injured foot to pick up each marble one by one and place them in the bowl or cup.
  3. Repeat __________ times. Complete this exercise __________ times a day.

If you have only one marble, place two washcloths on the floor and move the marble between the washcloths.

Exercise B: towel curls

  1. Sit in a chair and place a small towel on the floor in front of you.
  2. Use the toes of your injured foot to grab the towel and pull it toward you. Keep going until you have pulled the whole towel under your foot.
  3. Repeat __________ times. Complete this exercise __________ times a day.

To make this exercise more difficult, put a small weight, such as a filled water bottle or can of food, at the far end of the towel.

Exercise C: resistance band calf strengthening

  1. Sit on the floor or on your bed with your legs straight out in front of you.
  2. Loop a resistance band around the ball of your injured foot.
  3. Hold the free ends of the band with both hands.
  4. Push down on the band with your foot, away from your body. Slowly release.
  5. Repeat __________ times. Complete this exercise __________ times a day.

Exercise D: resistance band shin strengthening

  1. Sit in a chair with your feet flat on the floor.
  2. Loop a resistance band around your injured foot, just below your toes.
  3. Bring the loose ends toward your other foot. Pull the band tight and step on it with your non-injured foot to hold it.
  4. Keeping your heel down, lift your injured toes and foot up toward your shin. Slowly release.
  5. Repeat __________ times. Complete this exercise __________ times a day.

Exercise E: calf raises

  1. Stand behind a chair or at your countertop and use your hands to support you.
  2. Lift up onto your toes and then slowly lower back down.
  3. Repeat __________ times. Complete this exercise __________ times a day.

To increase difficulty, lift your non-injured foot off the ground and rise up just on your injured foot. You can also perform this exercise with your toes and the ball of your foot on a step, with your heels over the step. Lift and lower as far as you can without pain.

Balance exercises

Exercise A: single leg stand

  1. Stand close to a countertop or doorframe to hold onto if needed. Stand only on your injured foot. Don’t let your big toe lift.
  2. Hold this position for as long as you can. Repeat until you reach ______ minutes total.

To increase difficulty, close your eyes or stand on a soft surface like a pillow or couch cushion.

Exercise B: star taps

  1. Stand close to a countertop to hold onto if needed. Stand only on your injured foot with your knee slightly bent. Don’t let your big toe lift.
  2. Keep your upper body still and your weight on your injured foot. Tap the ground as far as you can to the front, back, and both sides with your other foot. Don’t let your knee fall inward.
  3. Repeat all directions __________ times. Complete this exercise __________ times a day.

Contact a health care provider if you:

  • Have an increase in foot pain during or after the exercises that does not improve with rest.
  • Notice new or worsening numbness or tingling in your foot or toes.

Get help right away if:

  • Your injured foot or toes turn blue.
15585

Sign up to receive the trending updates and tons of Health Tips

Join SeekhealthZ and never miss the latest health information

15856