5th Metatarsal Fracture

A 5th Metatarsal Fracture is a common injury we see at Harris & Ross.  It requires complete immobilisation and Harris & Ross will then focus on alleviating the stiffness and weakness in the area once healed.  With our help, the symptoms of a metatarsal fracture recovery can be alleviated and we can get you back on your feet. Find out more about the condition and how we treat it here

What is it?

Metatarsals are the long bones of the foot, of which there are 5 running from bones in the middle of your feet (Tarsals) down to your toes (Phalanges). A 5th metatarsal fracture is where a fracture occurs in the one on the outside of your foot.

What causes it to break?

  • For example landing on the foot awkwardly. When the foot and ankle are rolled inwards (inverted) there is increased stress put on the structures on the outer part of the foot and ankle to stop it moving too far. If too greater stress is placed upon the lateral part of the foot and ankle then something has to give. Often it will be the 5th Metatarsal that pays the price as it breaks under the excessive strain and pressure placed on it.
  • Overuse. Repetitive overuse can lead to fracture of the longer mid-section (shaft) of the bone, for instance with Jones’ Fractures.

Common symtoms:

  • Pain and swelling over the outer part of the foot
  • Difficulty weightbearing

Different types of fracture

1) Avulsion Fracture of the Base of 5th Metatarsal

An avulsion is when the tendon pulls a bit of bone off from where it attaches. In this case one of the tendons on the outside of the foot (peroneus brevis tendon) that attaches into the Base of 5th Meta-Tarsal pulls off from its attachment.

2) Jones’ Fracture

This is where the longer mid-section (shaft) of the Meta-Tarsal Bone gets broken. It can happen through an acute injury or trauma, but more commonly is a result of overuse, for example stress fracture.

How are they managed?

Treatment for a  5th Metatarsal fracture will vary depending on how stable the fracture is. The majority are managed with a period of six weeks immobilisation in a boot, non-weight bearing on crutches. In some instances consultants will surgically stabilise them by inserting a screw straight away.

Jones’ fractures will largely require surgical repair.

 How can Physiotherapy help?

Following both fractures physiotherapy is very important. After six weeks in a boot of immobilisation while the bone is healing many other less useful things happen as a result, including:

  • Ankle joint and joints of the foot become stiff
  • Muscles and soft tissues become tight and shortened (calf and muscles on underside of foot especially)
  • Muscles of the foot and ankle become weak
  • Muscles of the entire lower limb decondition
  • Walking becomes abnormal as a consequence of these factors


Treatment focuses on the knock on effects of being immobilised for so long, as the fracture itself should be well healed. The focus is on getting the foot and ankle moving again, getting the muscles strong, and restoring normal movement patterns through exercise, rehab and hands on treatments. Physiotherapy treatment includes:

  • Hydrotherapy
  • Exercises for Strength, Mobility and Balance
  • Gait re-education
  • Ankle and foot joint mobilisations
  • Deep tissue massage
  • Acupuncture
  • Ice and analgesia
  • Podiatry input and the use of Orthoses if appropriate

If you have a 5th metatarsal fracture and would like to make an appointment for an initial physio assessment at our Manchester, Wilmslow, Altrincham or Wigan clinics call Harris & Ross on 0161 832 9000 or click the book now icon below.