Sports Medicine: Apophysitis of the 5th Metatarsal Iselin’s Disease
Iselin’s disease is pain and swelling of the growth plate of the bone that is located on the outside of the foot.
What Is Apophysitis of the 5th Metatarsal Iselin’s Disease?
Iselin’s disease is pain and swelling of the growth plate (apophysis) of the 5th metatarsal. The 5th metatarsal is the bone that is located on the outside of the foot. A muscle called the peroneus brevis attaches to this growth plate at the base of the 5th metatarsal. The growth plate is an area of weakness, especially during growth spurts. Injury to the apophysis can occur because of repeated stress or a specific injury to the outside of the foot. This condition occurs most often in children between the ages of 9 and 13.
What Are the Signs and Symptoms?
- Tender area on the outside of the foot (5th metatarsal)
- Often swelling on the outside of the foot
- Pain with activity, especially running, cutting, and jumping
- Limping due to pain
Increased Risk
- Growth spurts, especially in those ages 9 to 13
- Injury that causes the ankle to roll or direct contact to the outside of the foot
- Sports that require cutting and changes of direction (soccer, basketball, football)
- Poor physical conditioning (strength and flexibility)
- Wearing tight fitting or narrow shoes such as cleats or spikes
How Is Apophysitis of the 5th Metatarsal Iselin's Disease Treated?
- Medicine
- Anti-inflammatory medicines, such as ibuprofen (Motrin® or Advil®) or naproxen (Aleve®), may be recommended. Take these as directed by your doctor or health
care provider. - Other minor pain relievers, such as acetaminophen (Tylenol®).
- Anti-inflammatory medicines, such as ibuprofen (Motrin® or Advil®) or naproxen (Aleve®), may be recommended. Take these as directed by your doctor or health
- Use of cold and heat
- Cold should be applied for 10 to 15 minutes every 2 to 3 hours and after any activity that makes symptoms worse. Use ice packs or an ice massage.
- Heat may be used before doing stretching and strengthening activities prescribed by your doctor, health care provider, or athletic trainer. Use a heat pack or a warm soak. Apply for 10 to 15 minutes.
- Orthopedic aids
- A brace or walking boot may be advised to provide support and decrease pain.
- Rest
- Rest, especially from the activity that caused the problem, will aid in healing. Exercises can also be done at home for more severe cases.
- Exercises
- Exercises to improve flexibility and strength of the muscles around the foot will be important. These can be done at home but often a referral to a physical therapist or athletic trainer may be recommended by your doctor or health care provider.
How to Prevent
- Do correct warm-up and stretching before practice or competition.
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Exercise carefully, avoid extremes.
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Wear properly fitting shoes.
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Avoid fast or extreme changes in training or activity.
- Maintain suitable conditioning, strength, flexibility, endurance, and cardiovascular fitness.
When to Call the Doctor
Call your doctor, health care provider, or the Sports Medicine team at (614) 355-6000 if:
- Symptoms get worse or do not improve in 4 weeks, despite treatment.
- New, unexplained symptoms develop.
Helping Hands Patient Education Materials
Written and illustrated by medical, nursing and allied health professionals at Nationwide Children's Hospital, Helping Hand instructions are intended as a supplement to verbal instructions provided by a medical professional. The information is periodically reviewed and revised to reflect our current practice. However, Nationwide Children's Hospital is not responsible for any consequences resulting from the use or misuse of the information in the Helping Hands.
HH-I-561 ©2005, revised 2022, Nationwide Children’s Hospital
