Metatarsal Fracture

Bone and Joint Conditions· Also known as: broken metatarsal, fractured metatarsal, metatarsal breakUpdated Oct 2026

Reviewed by Andrew Schox, BSc(Hons) PGradDipPod MPod, October 2026

At a Glance

A metatarsal fracture is a crack or break in one of the long bones in the middle of your foot. It is common: about 35 per cent of foot fractures involve these bones, and the bone on the little toe side is the one most often broken. The main signs are pain, swelling and tenderness over the bone, and trouble walking or putting weight on the foot. Most breaks where the bone hasn't moved out of place heal without surgery, usually within about 4 to 8 weeks, with the right care.

What is it?

A metatarsal is one of the long, thin bones in the middle of your foot. You have five of them, one behind each toe. A metatarsal fracture is a crack or break in one of these bones.

The break can come from a sudden injury. It can also be a stress fracture, which is a small crack that builds up over weeks from repeated impact. The bone on the little toe side of your foot (the fifth metatarsal) is the one broken most often.

Who does it affect?

Metatarsal fractures are common. They make up about 35 per cent of all foot fractures and about 5 to 6 per cent of fractures seen in primary care (for example, at a GP clinic). One estimate is about 6.7 in every 10 000 people.

Between 45 and 70 per cent of metatarsal fractures involve the fifth metatarsal. After that, the middle metatarsals are broken next most often, then the first one, behind the big toe.

In the general population, these fractures are more common in women. Among athletes, they are more common in men. Children get them too. Stress fractures are especially common in people who do a lot of repetitive weight-bearing activity, such as athletes and army recruits.

Signs and symptoms

The usual signs are pain over the broken bone, swelling, and tenderness when you press on it. Some people get bruising. Standing or walking is often painful or difficult, and putting weight on the front of the foot can make the pain worse.

With a fifth metatarsal fracture, the pain is usually on the outer edge of your foot.

A stress fracture can feel different. It may come on gradually, with pain only during activity at first. This can go on for several weeks before it becomes constant.

What causes it?

Most breaks come from a sudden, forceful injury. Common examples are a heavy object falling on your foot, kicking something hard, a fall from standing height, a sporting injury, or a twisting injury at the ankle. Breaks in the middle of the foot are less common and usually come from crush injuries or car accidents.

Stress fractures build up over time from overuse. This can be repeated impact on the bone, or a jump in training without enough rest. Soccer is linked with fifth metatarsal fractures. Long-distance running and recruit training are more often linked with fractures of the second or third metatarsal.

Several things can raise your risk of a stress fracture:

hard, intense training that you haven't built up to gradually
shoes that don't suit your sport or activity
changing to minimalist shoes (very thin, flexible shoes) without giving your feet time to adapt
foot shape, such as high arches, although not every study agrees on this

A heel that tilts inward (hindfoot varus) is much more common in people who have had a Jones fracture. It is thought to make that fracture more likely, and to make it more likely to break again after surgery to fix it. Taking corticosteroid medicines, missed periods and thin bones (osteoporosis) can also play a part, so your practitioner may ask about them.

These risks are best known in athletes and army recruits, and they may not apply in the same way to everyone.

How is it diagnosed?

Your practitioner will ask how the injury happened, whether the pain came on suddenly or gradually, and where it hurts. They will look for bruising and swelling, press along the bones, and check whether you can walk. A common check is whether you can take four steps.

An X-ray is the standard test. It usually includes three views of the foot: from above, from the side and at an angle. If the X-ray isn't clear, or the injury is complicated, you may need a CT scan or an MRI scan.

Your practitioner will also check the bones next to the broken one. Breaks often happen in neighbouring metatarsals together. They will look closely at the Lisfranc joint, a joint in the middle of your foot where the metatarsals meet the midfoot. Signs of a Lisfranc injury include bruising on the sole of the foot after a crush injury, tenderness in the midfoot, pain when the midfoot is squeezed, and not being able to bear weight. If your practitioner suspects one, you will need more detailed imaging.

Treatment

Most fractures where the bone hasn't moved out of place are treated without surgery. It isn't yet known which approach is best for each type of fracture, so plans vary. Follow the plan your own clinician gives you.

Looking after it at home

Don't try to treat a foot you think may be broken by yourself. Get it checked first.

Once you have a plan, stick to it. Agree with your clinician exactly how much weight you can put on the foot, because this differs between fractures. Keep your cast, boot or shoe on as instructed, and watch for the warning signs listed at the end of this page.

Injuring or immobilising a leg raises the chance of blood clots. Ask your treating team what you can do to lower your risk while your foot is in a cast or boot. Smoking makes healing harder, so quitting smoking or vaping improves your chance of a good result.

Treatment from your podiatrist

If the bone has moved only a small amount (less than 10 degrees of bend and 3 to 4 mm of shift), treatment without surgery is the usual choice. The options include:

A cast shoe with protected weight bearing for 4 to 6 weeks. This suits fractures where the bone hasn't moved, and some breaks of the second to fourth metatarsal that have shifted sideways.
Taping, a cast or a brace. You take no weight on the foot for 3 weeks, then put weight on it for another 3 weeks.
A short-leg cast, a cast boot or a stiff-soled shoe. This is used for stress fractures of the shaft or neck of a metatarsal.

A fifth metatarsal break at the bony bump near the middle of the foot (the tuberosity) is also treated without surgery if the bone hasn't moved.

Stable Lisfranc injuries can also be treated without surgery. You can usually put weight on the foot as it allows, with check-ups every 1 to 2 weeks.

Other options

Up to 1 in 10 stress fractures fail to heal. If yours doesn't, you should be reviewed by a specialist, and you may need surgery.

Surgery

Surgery is kept for fractures where the bones have moved out of place or are unstable. For a fifth metatarsal break at the bony bump, it is considered when the bone has moved more than 2 mm, or when more than 30 per cent of the joint between the metatarsal and the outer midfoot bone (the cuboid) is involved. Unstable or displaced Lisfranc injuries still need surgery to fix them.

Recovery

Healing time depends on which bone is broken and how. Stress fractures of the shaft or neck of a metatarsal are expected to heal in 6 to 8 weeks with a short-leg cast, cast boot or stiff-soled shoe.

If pain carries on beyond the healing time you were given, go back for another check. A stress fracture that hasn't healed needs reassessment.

Healing is harder if you smoke. Quitting smoking or vaping improves your chance of a good outcome.

Preventing it

You can't prevent every injury, but you can lower the risk of stress fractures. Build up your training gradually, and avoid sudden jumps in how hard or how long you train. Wear supportive shoes that suit your sport.

If you want to switch to minimalist shoes, give your feet time to adapt. If you have had a Jones fracture, ask your practitioner to check the tilt of your heel, because it is linked with the fracture coming back.

When to see a podiatrist

When to book

Book an appointment with your podiatrist if you have pain in the top or outer side of your foot that comes on with activity and has lasted several weeks. Book one too if you are being treated for a fracture and the pain hasn't settled by the time your clinician expected the bone to heal, or if you want advice on shoes and building your activity back up. If pain and swelling in your foot haven't eased within three days, see your GP soon.

When to get help sooner

Call your local emergency number if bone, tendon or a joint is showing through a wound, if there is heavy bleeding, or if your foot or toes suddenly turn cold and pale or blue. Call it too if you have sudden sharp chest pain, fast breathing, or breathlessness when resting, because these can be signs of a blood clot in the lungs.

After a foot injury, you need urgent medical assessment if you have any of these: tingling, numbness or loss of feeling in your toes or foot; a foot at an odd angle or an unusual shape; severe pain with a foot you can't use; or a foot you think may be broken. You also need it if you have diabetes and have hurt your foot in any way. See your GP today, or go to an urgent care clinic or the nearest emergency department. Don't wait to see if it settles.

If you are in a cast or boot, you also need urgent medical assessment if you have increasing pain that your prescribed pain relief doesn't control, pins and needles or numbness, a sudden increase in swelling or tightness, or burning pain in the muscle or new weakness. These can be signs of pressure building up inside the muscle (compartment syndrome). The same applies if your leg becomes painful, swollen or tender while your foot is immobilised, because this can be a blood clot in the leg.

Frequently asked questions

What is a Jones fracture?

A Jones fracture is a break in the fifth metatarsal (on the little toe side) at the point where the wide end of the bone meets its shaft. A break at the bony bump at the base of the bone is called a pseudo-Jones fracture. A break in the shaft within 1.5 cm of that bump is a third type. Treatment depends on which spot is broken.

Can children break a metatarsal?

Yes, it is a common injury in children. It is usually caused by a sudden forceful injury, such as a heavy weight dropping on the foot, kicking a hard object or a sporting injury. Children with an injured foot that may be broken need the same prompt check as adults.

Why do I need repeat X-rays?

A broken bone can slip out of position after treatment starts, even when it looked fine at first. Follow-up X-rays let your clinician catch this early and see how the bone is healing. Some midfoot injuries that look stable at first can also shift later, so keep your check-ups.

When can I get back to sport?

It depends on the bone, the type of break and how it heals, so ask your podiatrist before you start again. For stable midfoot (Lisfranc) injuries treated without surgery, most athletes were back in sport within 6 to 10 weeks. Your clinician can help you plan a gradual return once the bone has healed.