Anyone ever had metatarsal stress fracture?

Two weeks til the Brighton marathon and I think the pain on the top of my foot may be a metatarsal problem. Just wondering if anyone out there has any experience of this - how to diagnose, what to do.


  • See a doctor ?
  • I'd imagine a doctor's going to be useless as there standard (and quite understandable) response will be "rest it, and if there's no improvement in 2 weeks, come back again"

    An xray won't really help as the stress fracture itself probably won't show up until a few weeks after the event when new bone growth should be visible. If it is an mt stress fracture then there's bugger all you can do apart from rest and wait for it to heal (which will be more than 2 weeks). 
    Can you still run at all?, if so it might just be nerve irritaion on the top of the shoe caused by them being too tight. Try loosening the laces or removing the lacing over the problem area.



  • Thanks Ian,

    I ran 20 miles on it at the weekend, but its flared up a bit since with some swelling. I'll see how it goes this week and then try a light run with laces loosened as you suggest. Hopefully it will ease off..

    Cheers, Nigel

  • I've had a metatarsal stressfracture and extensor tendonitis (both at the same time!!!) and a pressure point over the tendons, so see if any of the following helps:

    1) If you go to your GP s/he might try the point pressure test from underneath your foot. If you hit the ceiling when s/he does this, it's probably a stress fracture. The cure is 6-8 weeks of rest, wearing a solid-soled shoe (if you can get it on) for support. Note: many stress fractures don't show up on X-ray. I doubt you've got a stress fracture, however, since you're talking about having run 20 miles and only had it "flared up a bit" - I was practically non-weight-bearing with mine.

    2) If it's extensor tendonitis, rest alone won't help (mine was not helped at all by the rest time to let the metatarsal stress fracture repair) but physiotherapy will. Try self-massage of the muscles on the front side of the leg to the side of the shin bone - work your way up towards the knee and feel where the muscle is tight (if you use both hands, to massage/press on both legs at the same time, you'll probably find an area which is tender on the side with the foot pain and not on the other side - that's the area you need to work on), also the calves (muscles work in pairs, so if you had a hamstring strain, I'd be suggesting nmassaging your quads as well as your hamstrings). Recovery takes time, but does occur with appropriate treatment. A few sessions from a physiotherapist or good sports massage may be very useful if self-treatment doesn't seem to be working.

    3) For a pressure point, try the following: get a piece of chiropodist's felt and cut it to about an inche per side larger than the painful area. Now cut a hole out the middle, the same size as the painful area. Tape the felt onto your foot (micropore, zinc oxide tape or whatever) before each run - that should keep the pressure off the tendons. I've found this really useful previously. (Use tape to stick it on so you can reuse the same bit of felt repeatedly, which you can't do if you use the felt's own sticky backing).

  • Thanks Debra - no tenderness in lower leg so probably not tendonitis. I will try the pressure point treatment when I next run. Think I will go see a physio - hope you are right and it is just inflammation.

  • Yes, seeing a physio might help put your mind at rest even if it is just pressure. Pressure sensitivity seems to be quite common, and it's so easy to fix! Another test - run a short distance (even just around the room) barefoot. No pain? And the same distance with shoes on, some pain? Sounds like pressure sensitivity to me. Note: this can take a while to settle, due to stuff associated with the pain nerve pathways (they get sensitised). Some people find that just lacing their shoe more loosly, or changing the lacing pattern, helps, or than some brands of shoe cause the pressure and others don't.

  • Yup, have had this. I'd suggest seeing a podiatrist not a physio? Mine confirmed it was a stress fracture by feel but made me go for an x-ray to rule out any complications.

    I think the advice might depend on which metatarsal it is - 5th heals less well, 1st and 2nd bear the brunt of weight bearing load etc so treatment may differ.

    Using a felt pad in your shoe may exacerbate the problem if it's a lacing problem?

    Ultimately I would guess that managing 20 miles and not being crippled is a positive sign, but equally you could be at the tipping point and further running causes damage.

    Have you built up miles quickly, changed footwear etc?

    If it is a stress fracture no running at all for 6-8 weeks and a low build up after that. You will feel fine before 6 weeks and be tempted to run, but that will set you back to the beginning and you'll have to start the clock again image

    Hope it turns out to be something minor.
  • Oh, and ice and elevate in meantime in case just soft tissue? Can't think that would do any damage if it is a stress fracture, but clearly I don't know that for a fact!
  • Nigel, sorry to hear you are suffering this close to Brighton.

    I am also marathon training and about 5 weeks ago, started suffering with mild pain on the top of my foot after I changed trainers.  I put it down to that and carried on running through the pain.  After a 16 miler, it swelled up and was very tender to the touch, like you, I thought it might be a stress fracture or tendonitis.  It wasn't.  It was just a stiff joint and with some massage from physio, it relieved itself within a couple of week. I had been doing too many miles on tarmac and the new shoes tipped it over the edge so I did more running on trails not tarmac.  Go see a physio or podiatrist, put your mind at rest. 

  • Thanks folks - lets see what the physio says today, hopefully I'm just over-reacting

  • Nigel, how did you get on?

    I'm in a similar situation with a week to go until Leeds Half Marathon and a little niggle that started a week ago has flared up and made me think it's a (4th) metatarsal stress fracture

    I ran 10 miles on it fine on Thursday, hurt a little at times but not serious.  Rested all day Friday felt fine.  1 mile jog Saturday and it's hurting every time my foot lands so I ducked out of my 11 mile run for fear of further injury.  1 mile jog to test it again last night and it got worse the further I went, but varies depending on how my foot lands

    It's sensitive to pressure from the top but only if you really press down on it

    So - facts are that I can run, but with pain.  I can walk fine.  So do I run with some kind of padding or accept I need a few weeks off?

    I've got tons of race entries already paid for throughout May, and am only just over my last injury that kept me out all March (ankle deltoid ligament tear).  Just getting back towards PB form image

    Any advice much appreciated thanks!

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