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Stress fracture of the metatarsal bones.
Last reviewed: 07.07.2025
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Stress fractures of the metatarsal bones can result from repetitive stress from lifting weights.
A stress fracture does not occur as a result of a single trauma (e.g., fall, blow), but rather as a result of repeated loading. Metatarsal stress fractures (march foot) commonly occur in runners and poorly trained patients who walk long distances and carry heavy loads (e.g., conscripts). The stress fracture usually occurs in the second metatarsal. Risk factors include cavus pes (high arch), shoes with insufficient shock-absorbing qualities, and osteoporosis. These fractures may also be a feature of the female athletic triad (amenorrhea, eating disorders, and osteoporosis).
[ Symptoms of a Metatarsal Stress Fracture
Foot pain that occurs after prolonged, intense work, then quickly disappears with rest, is a typical initial symptom. With subsequent exercises, the pain increases, it appears earlier and can become so severe that performing the exercise becomes impossible. The pain continues even when the patient does not lift weights.
Diagnosis of Metatarsal Stress Fractures
Standard radiographs are recommended, but may show nothing for 2-3 weeks after the injury. Technetium diphosphonate bone scans are often required for a definitive diagnosis. Women with recurrent stress fractures may develop osteoporosis and should have dual-energy X-ray absorptiometry.
How to examine?
Treatment of stress fracture of metatarsal bones
Treatment involves unloading the affected leg using crutches and a wooden "horseshoe" (or any other unloading devices or shoes). The need for a plaster cast is rare. A plaster cast should not be kept for more than 1-2 weeks, as this can cause significant muscle atrophy and slow down rehabilitation. Recovery usually takes 3-12 weeks.