As the name implies, a stress fracture occurs when a bone is overloaded by acute or chronic force, resulting in a small crack. They most commonly develop in the second and third metatarsals in your foot, because these bones tend to be longer and thinner than adjacent metatarsals. This is also an area of heavy load when you walk or run, so the second and third metatarsals are highly susceptible to fracture if you’re not careful.
Below, we take a closer look at the causes, symptoms and treatment options for second and third metatarsal fractures.
Causes And Symptoms Of Second Metatarsal Fractures
As we mentioned in the introduction, excessive force on an area of your foot is the most common cause of a stress fracture, but that stress can come in a number of different forms. It can be the result of too much activity and not enough rest, ramping up your athletic workload too quickly, or changes to your activity environment that result in increased stress, like running on pavement instead of a cushioned track surface. Overuse injuries are the most common cause of a stress fracture.
Other factors that can increase a person’s likelihood of developing a stress fracture include Vitamin D intake, footwear choice, osteoporosis progression, your weight, your gait or athletic form, and your age, as bone starts to replace itself more slowly as we get older.
Symptoms of a second or third metatarsal fracture include:
- Localized pain
- Pain that alleviates with rest and worsens with activity
- Swelling on the top of the foot
- Tenderness at the toe
- Bruising or discoloration
Diagnosing And Treating Third Metatarsal Fractures
If you are experiencing any of the above symptoms, or you have reason to believe that you may be suffering from a metatarsal stress fracture, you should set up an appointment with your primary care physician or a foot and ankle specialist. They’ll begin by asking you about your symptoms, conducting a physical examination and by seeing if you can perform a few simple movement tests. They may then confirm the fracture and its exact location with the assistance of an X-ray.
If you’re dealing with a metatarsal stress fracture, your doctor will walk you through some simple treatments. The goal of treatment is to provide an ideal environment for the bone to heal without facing additional stress. This will involve a healthy dose of RICE, which stands for Rest, Ice, Compression and Elevation. Your doctor will also want to make sure you avoid continuing to stress the area, so they may advise footwear changes, activity avoidance or a protective walking boot. Anti-inflammatories can also help to calm inflammation and swelling.
The vast majority of stress fractures heal fine with non-operative methods, but if your metatarsal fracture is unlikely to heal with conservative methods, surgery may be required. The goal of surgery is to hold the bones in a specific location so that healing can run its course. This is known as internal fixation, and it’s typically performed with the help of surgical hardware like pins, screws or plates. After surgery, you’ll follow many of the non-surgical treatment protocols to continue to provide the area with the right healing environment.
Most stress fractures take anywhere from 6-8 weeks to fully heal, but some may take longer if you continue to stress the area or rush back to full activity too quickly. This is why it’s oftentimes helpful to sync up with a professional to ensure you’re pursuing the right treatment and safely increasing your workload as treatment progresses.