How to Return to Running After 5th Metatarsal Fracture

A metatarsal fracture can be a runner’s worst nightmare! There’s no way to avoid causing pain when you run, since you land directly on your metatarsals with every step.

The best thing to do is rest your foot until it’s healed. If you resume running too soon, you risk damaging your feet more severely. It’s frustrating, but starting slowly is the best way to do it!

Here’s our advice on how to return to running after a 5th metatarsal fracture. The 5th metatarsal is the one most likely to be injured as it’s the least protected.

There are many different types of 5th metatarsal fractures, but these recovery and return-to-running tips are the same regardless of where your metatarsal has been injured.

Let’s have a look at 5th metatarsal fractures and how to get back to running after healing from one.

What Is a 5th Metatarsal Fracture?

A 5th metatarsal fracture is a crack or break in the 5th metatarsal bone. This is the long bone leading from the ankle to the toe, on the outside edge of the foot.

This is one of the most common foot injuries in runners, but it can happen to anyone.

A 5th metatarsal fracture can occur as a result of overuse or high arches—stress fractures—or trauma to the foot.

Symptoms

Depending on the severity of the fracture, you may have varying symptoms. The first sign you may notice is that you will most likely feel pain and discomfort when walking.

This may also come with bruising, swelling, and tenderness on the outside edge of your foot. You may feel or see these anywhere along the outer edge, from just in front of the ankle bone to almost up near your toe.

The pain will usually get worse with exercise and should ease a little but not necessarily disappear when you rest your foot.

Wearing your shoes or even tight socks may cause the pain to worsen as well.

The 4 Types of 5th Metatarsal Fractures

There are four types of 5th metatarsal fractures. Each one is in a different place on the 5th metatarsal, but all require treatment.

  • Head/neck fractures—closest to the toe, often as a result of stubbing your toe or other direct trauma.
  • Jones fractures—near the back of the bone. This is the hardest type to heal.
  • Dancer’s fractures—in the middle of the metatarsal bone, diagonal or spiraling through the bone.
  • Avulsion fractures—the most common type, closest to the ankle. A part of the bone is pulled off of the tendon.

How Can You Get A 5th Metatarsal Fracture?

The most common way for a 5th metatarsal fracture is trauma to the foot. In most cases, this happens when the ankle suddenly rolls inward and pulls hard on the tendon attached to the 5th metatarsal.

The tendon is extremely strong, which can cause the bone to crack or break under the tension.

While this can happen to anybody, especially when walking or running on uneven ground, it’s more likely to happen to those with high arches.

A 5th metatarsal fracture can also occur due to overuse, such as the repetitive motion of the feet pounding on the ground when running—especially if your form is incorrect or you aren’t wearing shoes with enough support.

Other trauma, such as a car accident, fall, or dropping a heavy object on your foot, can also lead to a 5th metatarsal fracture.

How Do You Treat A 5th Metatarsal Fracture?

It’s always best to see your doctor if you suspect that you may have a 5th metatarsal fracture. They will be able to advise you on the best course of action.

Until you can go to the doctor, you should treat your foot with the RICE principle. Rest your foot and avoid doing any activity that increases your pain. Ice your foot for 10 to 20 minutes as soon as you can after the injury, 3 to 4 times throughout the day.

If you have compression socks, you may use them to increase circulation in the area so that healthy, oxygen-rich blood can flow to the injury site and start the healing process. You can also elevate your foot above your heart if possible.

Your doctor may recommend or perform any of the following treatments:

Immobilization

Your doctor may recommend immobilizing the foot with a walking boot to prevent unnecessary movement as the bones heal.

Typically, this will be recommended in cases where a minor fracture isn’t displaced. Crutches may also be used to take your body weight off the injured foot.

Bone Stimulation

Bone stimulation is mostly used to treat Jones fractures. This is done using a device that stimulates the bones to speed up healing. It’s pain-free and research suggests that it helps relieve pain and improve range of movement.

Surgery

If the bone is displaced or hasn’t healed after other treatment, your doctor may suggest surgery as a last resort.

5th Metatarsal Fracture Recovery

As a runner, full recovery is important. If you return to running after a 5th metatarsal fracture before it’s fully healed, you run the risk of damaging it more severely.

Follow these tips to ensure your foot heals properly so you can get back to running as soon as possible.

Take a Break

As frustrating as it may be, staying off your feet is necessary for a 5th metatarsal fracture to heal properly.

If you return to activity—even light activity—too soon, it can extend your recovery time and delay you getting back to running at full capacity.

It’s also wise to take as much weight off your foot as possible. You can use crutches—or crutch alternatives—to take your weight off the foot entirely until it’s healed.

Ice & Elevate

Icing your foot regularly helps keep swelling and inflammation down. You can ice your foot 3 to 5 times a day, for 10 to 20 minutes at a time.

While icing your foot, it’s also a great idea to elevate it at the same time. You should lift your foot above the level of your heart, this will help to drain excess fluid buildup and reduce swelling.

Wear Special Footwear

Your doctor may recommend special shoes after a 5th metatarsal fracture. In some cases, you may have to wear a moon boot or a post-op shoe to restrict movement.

However, you may also have to rethink your daily footwear. The best shoes after a 5th metatarsal fracture should have a stiff midsole to restrict flexibility, good cushioning to absorb shock, and enough support for your arch type.

Stay in Shape With Low-Impact Exercises

Even if you can’t run to full capacity yet, you can still stay in shape by choosing exercises that are low-impact and easy on your feet.

Check with your doctor before doing any cross-training. Swimming and aqua jogging are excellent choices as they will allow you to get some good exercise without placing pressure on the bones of your foot.

This will help you keep your fitness level up so that when you do return to running, you are still fit and won’t struggle to get back into it.

How to Start Running Again

Wait for Doctor’s Approval

It’s wise to wait for your doctor’s go-ahead before you attempt to start running after your 5th metatarsal fracture.

Depending on the type of fracture and its severity, the fracture should be sufficiently healed within 6 to 8 weeks. However, this can vary based on several factors, so check in with your medical professional first.

Change Your Shoes

Consider whether your current shoes are supportive enough for your post-fracture foot. Your shoes should have:

  • A rigid outsole to prevent twisting
  • Enough cushion to absorb shock
  • A sturdy heel cup to prevent lateral movement
  • Adequate support for your arches
  • A grippy outsole for safety on different surfaces

If your current shoes don’t offer all of those features, you may want to consider getting new shoes that will both protect and cushion your feet while you run.

This will help stop you from developing another metatarsal fracture due to overuse as your 5th metatarsal will be a weak point.

Do Gentle Foot Exercises & Stretches

Spending 5 to 10 minutes every day doing gentle foot stretches and exercises can help build strength in your foot and keep the muscles, tendons, and ligaments supple and flexible.

This will help increase your range of motion so that when you start running again, your feet are in the best condition to handle the movement.

Also, make sure you warm up properly before you start to run and cool down well when you’re finished.

Start Slow and Gradually Increase Mileage

You won’t be able to start running at the same level as when you stopped. Start slowly and gradually build your way up until you’re back at the level you were

It’s a good idea to start with walking. If you feel no pain, you can start to jog lightly. If you can run for a few miles without any foot pain, you can slowly progress.

Try to progress by 5 to 10 percent per week. For example, if you can run one mile without pain now, try to aim for 1.1 miles next time. If you still feel no pain, try for 1.2 miles the next day.

Don’t overdo it and push yourself too far or you may find that you are set back even further. Rather do less on one day and do more the next day than do too much and have to take a longer break.

You should stop and walk if you feel pain when running. If you feel pain when walking, you are not ready for any activity and should continue to rest your foot until you can walk for at least a mile without pain.

Alternating Walking and Running

Alternating between walking and running is an excellent way to get back into running properly. Start with equal sections of walking and running—for example, 2 minutes of walking and 2 minutes of running.

Gradually lengthen the running and reduce the walking until you can run without any pain. If you feel pain while running, revert back to walking. If you feel pain while walking, stop and rest your foot and try again in a day or two.

Run On A Softer Surface

Running on a soft surface—a running track, trail, or grass—reduces the amount of shock that your feet experience on every step.

This will help ease the impact on the metatarsals. It can reduce pain and increase the ease of your run, so it’s a great way to start getting back into running before going out on the road again.

Take Frequent Rest Days

When you return to running after 5th metatarsal fracture injuries, don’t rush it. Try to run every 2nd or 3rd day at first, to allow your foot time to rest in between sessions.

When you can run every 2nd day without pain or unusual fatigue, you can try running two days in a row.

Listen to your body and be sure to take time to rest and recover if you feel pain or discomfort.

Aleem, I. S., Aleem, I., Evaniew, N., Busse, J. W., Yaszemski, M., Agarwal, A., Einhorn, T., & Bhandari, M. (2016). Efficacy of Electrical Stimulators for Bone Healing: A Meta-Analysis of Randomized Sham-Controlled Trials. Scientific Reports, 6(1).
https://doi.org/10.1038/srep31724 

Smidt, K. P., & Massey, P. (2019, June 22). 5th Metatarsal Fracture (Jones Fracture, Dancers Fracture). Nih.gov; StatPearls Publishing.
https://www.ncbi.nlm.nih.gov/books/NBK544369/