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Metatarsal Stress Fractures


Metatarsalgia and Metatarsal stress fractures

Metatarsal injuries are common in activities that involve running and jumping. Metatarsalgia is a condition in which the ball of your foot becomes painful and inflamed due to the bruising of the bones themselves.

Metatarsal stress fractures occur when the metatarsal bones fracture. They are the second most common type of stress fracture just second the tibial stress fractures.

Metatarsalgia and metatarsal stress fractures in running

Given the excessive forces put through the front of the foot (up to 7x the body weight) during running the metatarsals are a common site of injury. Distinguishing between the two if you are experiencing pain in the forefoot can be difficult. X-rays for stress fractures within the first week of injury often times are useless as the early stages are too faint to detect. Metatarsalgia is more common in the second and third metatarsal bones and the third and forth are more common sites for stress fractures.

Several factors play an important role in increasing your risk of developing forefoot pain and metatarsal stress fractures.

  • Calf tightness
  • Weakness of toe muscles
  • Inadequate vitamin D3

A tight calf while running will cause the heel to lift early driving the forefoot into the ground with excessive force. Take a look at the photo below, the image on the left shows a tight calf and premature heel lift causing high stress to the metatarsal bones into the ground. The image on the right shows a normal flexible calf and normal stress through the forefoot. Individuals with tight calves are 4.6x more likely to fracture their metatarsals than a more flexible calf.

tight calf cause diagram

Tight calf causing metatarsal stress fractures

Metatarsals are also more prone to injury with weakness of the toe muscles. The toe flexors help to prevent excessive stress onto the metatarsal bones when running and help to distribute forces through the foot. Vitamin D plays a crucial role in bone health. Active individuals who enjoy participating in higher impact activities should maintain adequate vitamin D levels to reduce their risk of stress fractures.

Behm Muscle & Joint Clinic – Treating running injuries since 2015

Behm Muscle & Joint Clinic is a chiropractic, rehabilitation and soft tissue clinic located in Bellevue, NE. The doctors have treated many cases of foot pain in runners and non runners alike. Our examination involves orthopedic, muscle length, functional tests and gait analysis to determine the cause of your metatarsalgia or metatarsal stress fracture pain. If you are experiencing pain in your forefoot give us a call at 402-292-1450 or schedule an appointment online.

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