Early treatment is crucial to a speedy recovery and will help relieve pain promptly. Limitation of activity is not enough to decrease load through the metatarsal. Immobilization with post-surgical shoe at least can be done but more preferably with the use of a removable cast boot or CAM walker for a three to four week period of time preferable. The goal of treatment is to decrease the torsional load through the metatarsal to allow adequate osteoblastic bone healing response at the site of injury.

CAM Walker Used During Recovery

Once your physician has determined it is time to get out of the walker treatment must be continued with proper footwear. The next step of the treatment in the recovery of a metatarsal stress fracture is getting into a shoe and orthotic combination that will work similarly to the CAM boot but on a smaller scale. The shoe and orthotic will work like a cast to reduce motion to the metatarsals allowing them to further heal without having the constraints of the bulky CAM boot.

The right shoe should have the following features that will help stabilize the foot:

• Lacing or velcro straps for a snug fit
• Internal shank to support hindfoot and midfoot
• Strong heel counter to reduce excessive medial-lateral movement
• Sturdy midsole material to guard foot against excessive flexion (shoe should not bend in half)
• Forefoot rocker to distribute pressure evenly during gait

All features work together to prevent excessive loading to the healing metatarsals and are shown the images bellow.

 Features of Appropriate Metatarsal Stress Fracture Recovery Shoe

The use of a functional orthotic provides additional motion control to the foot as the metatarsals heal. A functional orthotic is constructed of semi-rigid plastic which will help reduce the motion of the foot. The shoe and orthotic combination works similarly to a cast while still giving the patient freedom of motion and comfort during daily activities during recovery time.

Top and Internal View of Functional Orthotic

Delayed or poorly managed stress fractures can cause loss of supportive function of the metatarsal after healing and lead to stress fractures in the adjacent metatarsal bones. The CAM boot and shoe-orthotic treatment has proven to be reliable and will have you going about your normal daily routine in no time.