Initial Therapy Exercises

• According to PhysioRoom.com, metatarsal fractures typically result from direct trauma, excessive rotational forces or overuse. As a result, initial therapy exercises will need to focus on little to no weight-bearing on the affected limb as the bones continue to calcify and heal properly. Therapists will introduce manual therapy around the ankle and plantar (bottom side) of the foot to minimize inflammation and pain while also promoting increased ROM within the smaller metatarsal and tarsal joints. Due to the complex anatomy and movement within the foot during normal walking, maintaining proper laxity within the foot itself is critical to proper limb functionality. Ice therapy via the use of a cryo cuff or air cast will also typically be administered early in treatment.
  
  

Mid-Therapy Exercises

• Treatment plans for metatarsal fractures can differ greatly depending upon the severity and area of the fracture and will need to be adapted to better serve the patient in the mid-therapy stages. According to FootPhysicians.com, stretching and strengthening exercises can continue six to eight weeks into therapy, again focusing mainly on the promotion of flexion and extension within the ankle. Therapists will normally introduce increased weight-bearing exercises, but patients will still be required to walk with the assistance of a flexible boot or air cast to minimize the risk of further bone injury.
  
  

End Therapy and Discharge

• At the time of therapy discharge, patients should typically have full use of the affected foot and be able to walk completely unassisted for extended periods. However, patients may still be unable to partake in any running exercises at the time of discharge. Therefore, the physical therapist will prescribe a home exercise program to further promote increased strength within the surrounding leg muscles vital to foot stabilization during full running cadence. Patients may also require follow-up X-rays to monitor the level of bone repair within the metatarsal at the discretion of the orthopedic surgeon or therapist.