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August 18, 2021
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MLS athletes with fifth metatarsal fractures have high rate of return to sport

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Major League Soccer athletes who sustain a sports-related fifth metatarsal fracture return to sport at a high rate with low risk for refracture, according to a recent report.

Jonathan A. Stone, MD, and colleagues, used the HealtheAthlete database to identify 21 soccer-related fifth metatarsal fractures in 18 Major League Soccer (MLS) athletes from 2013 to 2017. Outcome measures included return to sport, radiographic healing, refracture and player performance characteristics.

Stone and colleagues found athletes returned to sport in 20 instances (95%) of 21 total fractures. Mean time to return to sport was 11.1 weeks. Among the 18 athletes, four (22.2%) experienced refracture. Mean time to radiographic healing was 8.5 weeks. Researchers also noted that while player performance characteristics declined in the first year of return, performance improved by the second year.

“A substantial number of fractures were in players’ rookie seasons and/or during the preseason and predominantly occurred in players in non-midfielder positions, which may be helpful for screening players and potentially modulating training to decrease repetitive stresses,” Stone and colleagues wrote in the study.

“Professional soccer players are at high risk for foot and ankle stress injuries secondary to training and high-intensity games,” they added. “Athletes should be counseled regarding refracture risk.”