3 Simple Metatarsal Stress Fracture Rehabilitation Exercises

What is a metatarsal?

Metatarsals are the bones of the foot. There are 5 metatarsals in each foot and these bones are located between the ankle and toes. 

What is a metatarsal stress fracture?

A metatarsal stress fracture is a very thin crack within one or multiple metatarsal bones. This fracture will develop from an overuse injury. The repetitive force from activities involving a lot of running or jumping can cause microscopic damage to the bone. If you partake in these activities daily, the body may not have enough time to heal between exercise sessions. This then causes the stress fracture.

Risk factors and causes of stress fractures

A metatarsal stress fracture is caused by overuse, usually from an excessive weight bearing activity such as running, jumping, sprinting or dancing. The stress fracture may occur from starting one of the above listed activities, or due to making a change such as an increase in activity, intensity or change in training conditions. An example is running for longer distances or partaking in exercise sessions more frequently within a week. Risk factors for metatarsal stress fracture involve: not wearing supportive shoes, training on hard surfaces, osteoporosis or obesity. 

Symptoms of stress fracture

  • Painful swelling 
  • Tenderness or pain on palpation/touch
  • Pain when walking
  • Inability to walk/weight-bear on the affected foot

Pain may only occur during activity and go away with rest. However, if left untreated pain may become constant. 

You will need to see your GP/podiatrist to get a diagnosis of a fracture. 

Early rehabilitation tips 

This will involve resting and avoiding whatever activity caused the fracture to begin with. If walking is causing pain, you may need crutches to help you mobilise and reduce the amount of weight on your foot. 

You will want to elevate your foot to help decrease swelling. Be sure to ensure your foot is elevated above the level of your heart. Do not use ice to reduce the inflammation/manage pain, as ice will cause further injury to the surrounding muscles by causing them to tighten. Take anti-inflammatory medication to manage pain instead. 

Metatarsal stress fracture rehabilitation exercises

Only begin these exercises when an Exercise Physiologist tells you it is safe to do so. This may usually be 4-8 weeks after your injury has occurred.  

Gastrocnemius/calf stretch

Stand next to something you can hold onto for balance, such as a chair, table or wall.

  • Step forward with one leg.
  • Lift your toes into the air, keeping the heel of your foot on the floor.
  • You should feel a stretch in your calf. 
  • Hold this for a minimum of 30 seconds. Swap legs.

Soleus/deep calf stretch

  • Stand with your feet shoulder width apart. 
  • Take one step back with your affected leg and bend the knee of that leg, lowering yourself as much as possible whilst keeping the entire foot (especially the heel) on the floor. 
  • You should feel a stretch in the back of your calf. 

Ankle range of motion

This exercise to maintain the motion and mobility within your foot. 

  • You can do this exercise whilst seated or lying, with your leg hanging off the edge of the sofa/bed.
  • Begin by moving your ankle back and forth, which is the movement of pointing your toes up and down. 
  • Stop if you feel any pain. 
  • Perform 10-20 repetitions.

If that exercise is too simple, you can also perform the harder version:

  • You can do this exercise whilst seated or lying, with your leg hanging off the edge of the sofa/bed.
  • Imaging your big toe as a pen, write each letter of the alphabet in the air. 
  • Make sure the movement comes from the ankle and not the knee or hip. 

Toe scrunches

This exercise is to strengthen the intrinsic muscles of the foot.

  • Begin in standing, with your affected foot placed on a hand towel. You should be on a flat, smooth surface such as a wooden floor or tile.
  • Using your toes, extend them to grab the towel and then curl your toes to crinkle the towel.
  • You are attempting to grab as much of the towel as possible. 
  • Complete 10 repetitions, 3 times a day. 

If you would like more advanced metatarsal stress fracture rehabilitation exercises or if you have any difficulty with the above, book in to see an Exercise Physiologist. 

See an Exercise Physiologist

Exercise physiologists are experts in providing metatarsal stress fracture rehabilitation exercises. They use exercise as therapy, in other words, prescribe exercise as ‘medicine’. They will assist with preventing injury, managing injury, and improving physical functioning. Their therapy is ‘hands-off’ as they provide you with appropriate exercises and stretches individualised to your needs. Their aim is to prevent future re-injury by building your strength and tolerance. 

If you would like a personalised rehabilitation exercise program, book in to see our friendly and experienced Exercise Physiologist at Urban Health HQ. You can make an appointment today or contact us by calling 0411 563 391 or emailing kristen@urbanhealthhq.com.au

Published by Urban Health HQ

We are a health and fitness centre offering Occupational Therapy, Exercise Physiology, Personal Training and Group Fitness classes.

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