Runners push off from
their toes, putting great stress on the metatarsal heads. The 1st metatarsal
or stress fracture is isually immune to fracture because it is much thicker
and stronger than the others. The 5th metatarsal is relatively immune because
the major force of "toeing off" comes from the first 2. The 2nd, 3rd
and 4th metatarsals are usually susceptible because of their thin diaphyses.
Stress Fracture Symptoms, Signs and Diagnosis
Patients usually present with fore foot pain, often during a long or intense
workout, which disappears within seconds of stopping exercise. On successive
exercising, the metatarsal pain returns earlier than previously, ultimately
becoming so severe that it may prohibit exercise and persist even with the patient
lying in bed. Palpating the swollen area causes pain at the facture site. An
x-ray usually is not sensitive enough to diagnose the stress fracture until
a callus forms 2 to 3 wk after the Metatarsal stress fracture injury.