• Metatarsals are the long bones in the feet.  1st ray is the metatarsal in line with the big toe.  The 5th metatarsal is the metatarsal in line with the little toe.

  • Fractures of the metatarsals can be stress fractures or related to a single traumatic incident.

Signs & Symptoms

Stress fractures:

  • Gradual onset of pain

  • Local tenderness specific to the metatarsal

  • Pain which over time worsens with activity

  • 2nd metatarsal most commonly affected

Traumatic incident fracture:

  • Sudden pain

  • Audible snap or crack

  • Related to traumatic accident

  • Inability to weight bear

  • Swelling

What Causes It?

  • Excessive pronation

  • Shorter 1st ray compared to 2nd metatarsal

  • Trauma such as an ankle sprain

  • Sports including ballet, running

How to Self Manage

  • R.I.C.E. protocol

  • Seek an assessment and diagnosis, as rest from activity may be required

  • Rest from aggravating activities (4-6 weeks)


  • X-ray, bone scan, or MRI are the optimal investigations for a suspected metatarsal fracture

  • Surgery and immobilisation may be required for an unstable traumatic fracture (especially for the 2nd and 5th metatarsals).

How Physio Helps

  • Assessment of the metatarsals for bony damage

  • Biomechanical review of the foot and lower limb

  • Prescribe an individualised plan of management

  • Acupuncture

  • Referral for investigation (x-ray, bone scan, MRI) scan for confirmation of diagnosis

  • Referral to an orthopaedic specialist for advice on management

  • Prescribe use of an aircast to reduce pain initially

  • Referral to a podiatrist for biomechanical review and orthotic prescription

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Sammy Margo Physiotherapy

444 Finchley Road



Email: physiophysio@hotmail.com

Tel: ​020 7435 4910​​​
Fax: 020 7435 0461

Web: sammymargophysiotherapy.com


Disclaimer: Information made available by AskPhysio (Sammy Margo Physiotherapy) is provided for guidance only and should not be considered as medical recommendations or advice.  AskPhysio is not responsible for errors or omissions in the information. Please consider what the best options for your healthcare are, based on the urgency of your condition and nature of your condition. Please consult a GP or Healthcare Specialist to discuss any specific concerns that exist prior to using the information provided.