Why is the base of the 5 th metatarsal so susceptible to fatigue fracture?
“Firstly, this is a susceptible metatarsal. It is on the outside of the foot, so that naturally there would be an increased incidence of fractures as a result of inversion injury (as described above). However, it is the repetitive nature of the loads applied to the Metatarsal beyond the body’s capacity for healing which leads to the development a frank or ‘complete’ stress fracture. “The sensation of aching and soreness along the outer aspect of the foot is critical, since this represents ‘overstress’ or fatigue of the bone prior to going on to a complete stress fracture. Typically, this soreness occurs following a game, and dissipates by the following day. If the exercise continues without protecting the metatarsal, the stresses also continue, and then the soreness begins earlier in the game, a condition we refer to as the ‘crescendo effect’ of stress. Changing activities or protecting the foot at this stage may prevent a true stress fracture from occurring. “In summary then, it is th
