I run regularly and recently noticed a small swelling in my instep. Because it was causing me pain when I walked I had an X-ray which showed a small fracture of the fifth metatarsal. I don't remember hitting it so how did it break?
The metatarsal bones are five long bones which link the ankle bones (tarsals) to the bones in the toes (phalanges). The largest metatarsal joins the ankle and the big toes and bears most of the weight going through the foot.
The other four bones are smaller and more fragile and are easily broken when put under excessive stress.
The fourth and fifth metatarsals are more prone to injury because they are smaller and have a reduced blood supply.
Stress fractures are very common in athletes, including those who run regularly, as well as in soldiers and dancers. They account for about 60 per cent of all bony foot problems.
Is this the same sort of injury that footballer Wayne Rooney suffered?
From what I've heard, Rooney fractured the fourth metatarsal of his right foot as a result of a fall during a recent match with Chelsea.
This type of acute fracture is common among footballers with David Beckham, Michael Owen and others suffering the same injury.
In fact, I believe Rooney suffered a similar fracture during Euro 2004. Some fractures require surgery to repair them while the majority heal with conservative treatment. The word is that he should be up and running in about six weeks.
I want to go back to running when this problem has settled but how can I avoid it happening again?
Uncomplicated stress fractures usually heal in three to four weeks, but you must ensure that you do not exercise during the recovery period so the bone can heal completely. Rest, cold packs, pain killers and elevation of the foot should help to promote recovery.
Remember that excessive training and inadequate rest periods between training sessions can precipitate a stress fracture, so pace yourself when you go back running. Try not to run on hard surfaces such as concrete or paving. Listen to your body and don't overstretch yourself.
If you experience acute pain in your foot, stop running and go to see your doctor.