Fractured 5th Metatarsal experience

Greetings all,

Over Christmas I managed to snap my 5th Metatarsal in a Snowboarding accident. The accident happened just before NYE in Chamonix and resulted in this pretty mess
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It matters not how I did it which was far more rubbish than you might imagine, but more to the point how long it’s taken me to recover and I wish to offer up my advice to anyone as unfortunate as myself to experience such a rubbish and debilitating break in their foot.

To give you some perspective about my physical state, I’m a keen gym go-er and keen cyclist. I was training for the Caledonia eTape until the injury and was in Base 2 of my training working up to 12 hours or more on the bike at that point. Being very active and training around 2 hours a day, 6 days a week meant that this injury presented me with some pretty big challenges physically and mentally.

6 days after the fracture I had the foot operated on by Eoin Baldwin who did a fantastic job in re-attaching the splintered bones with two fixing screws. That was the complicated bit out of the way, the rest was down to me and my body’s healing process.

In Jan ’12 it was pretty cold in the UK, no more than normal, but still, cold. After getting up in the morning I had real trouble keeping my foot warm in the bootie cast that I had on. It was far from painful and I stopped taking the codeine based painkillers 1 day after the Op. It simply wasn’t hurting enough for me to want to take them.

Sadly, 2 days after the Op, I came down with the Flu which was kindly given to me by one of my holiday buddies. That was horrid, being club footed and Flu’d up all at the same time was one of the most rotten feelings ever. 4 days later I was starting to feel human (albeit club footed) again.

No-mans land ensued. I was signed off from work but still completely mentally able. 12 days after the Op, I returned to work – a couple of days earlier than recommended, but I was going nuts and had a lot of work on. I struggled after the journey to work to keep the foot warm still. After a 07:30 get up, by 10am my foot would be uncomfortably cold and I’d try my best but would fail in trying to warm the thing up until I got home and had a bath with one foot hanging out the side.

As soon as I was back to work, I was back at the gym too. I’ve read elsewhere that other people have completely avoided all exercise to ‘let the body do the healing process’. I honestly disagree with that. This implies that they think their body can only do one thing at once, or it takes power away from the healing process by your body doing anything else. For example your body has 100% of ‘healing power’ and by doing Strength Training on your remaining functional parts of your body, you are detracting from that 100% ‘healing power’ by diverting some of that healing toward the applied stresses of Strength Training.
Assuming you are eating ‘well’ taking into account you are what you eat and you’re eating ‘enough’ which I think would be easy if you’re doing Strength Training with limitations i.e. your lower body is out of action thanks to an injury like this then for me there is no reason to lay back and sit still for months waiting for a bone to fuse.

I’ve ranted briefly on this as I had ALOT of arguments with people telling me I shouldn’t be going to the gym whilst I had the injury. Notably, none of these people were people who, without being harsh, were people that ate ‘well’ or had a good physique or good relationship with food or exercise so their advice fell on ears which were not tuned in to their concern.

I will stress though that you should not attempt any lower leg exercises. I did.
Leg Extensions using the Leg Extension machine were the only exercise I felt comfortable using both my legs so as not to train only one leg and cause imbalance.
I suggest you avoid these too as although there’s no direct stress on the foot in any shape or form, after my news which I’ll talk about in a moment, I suggest disengaging your temptation to use your lower body at all for the time being.

Some 20+ days after the Op, I visited the Hospital for a follow up x-ray only to have the Surgeon stand in front of the light box and utter ‘Oh’. That short noise was the last thing in the world I wanted to hear.

 

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That ‘Oh’ was the realisation that somehow I’d managed to pull the repair apart so the two fixating screws were although aligned but holding the bone with quite a degree of separation again.

It was one of the worst things I’ve ever heard and was very very upset and depressed for a couple of days.
Because the up down and side to side alignment was actually okay meaning the functional operation of the foot was looking okay, the decision was to leave it be for a while and see how it was looking in another 2 weeks. Now, just to mention here, there was expected to be some fusing already, which there wasn’t either because I’d split it or simply it hadn’t started.
The problem with the 5th metatarsal is it’s a small bone, it’s also about as far away from your heart as you can get in your body, and is on the outside of your foot with a relatively small amount of blood flow.
These are all facts that worked against me.

This leads to my first piece of advice.
KEEP YOUR FOOT VERY WARM! Never let the foot go cold.
Cold = No blood flow. No blood flow = No healing.
Do whatever you have to do to keep your foot warm at all times. This includes your Thigh and Lower Leg as they’ll be supplying the blood to your foot. Long Johns, super big socks and over sized slippers are all good things. In emergency perhaps some chemically activated hand warmers stuffed into your foot may help. Make this your personal priority.

My second piece of advice
Do nothing that puts your foot under any pressure until your surgeon advises you otherwise
I cannot state how important this is.
Getting up out of bed puts pressure on your trailing foot, be careful! Getting up from being one legged in front of the fridge and unknowingly the supporting (broken) foot that’s out behind you is put under top side pressure to help with the one legged get up.
Falling over, which I did too many times and hated every one.
Not using any lower leg gym equipment, no matter what muscles you think you are aren’t working. It simply isn’t worth the risk or a re-op or a situation like mine with a mis-aligned bone.
I cannot state how difficult it is to exist with only one foot on the ground for months at a time.
I cannot explicitly state which moment cause my repair to separate. There were plenty (too many) moments including the falls which put far too much pressure on my foot and it could have been any of them.

Lastly, Do Exercise!
Do Upper Body strength training. Unless you have one of those upper body cycling things you’re not going to be able to do any cardio, so simply engaging your upper body will stop you going nuts and keep some resemblance of your physique.

After three months I’m out of casts and actively load bearing without crutches now, but I’m awaiting my next x-ray to see the state of the repair and will update this post when I have that aswell as thoughts on muscle loss and diet during that recovery period.
In the meantime. Good luck if you’re going through this too!

Ciao! x

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11 comments on “Fractured 5th Metatarsal experience

  1. Help help help….. Same thing happened to me whilst dancing. I live in Kuala Lumpur and I was dancing when it happened. There must have been a weakness there as it snapped and shattered so mine is pinned, plated and all the little bits of bone wired together. I still can’t weight bare which is driving me insane and its 9 weeks since injury. The thing that is annoying me equally to the fact I can’t walk is everyone telling me that I should be up and about now. I am following my surgeons instructions to the letter but getting very frustrated now. Please tell me you have some words of wisdom …

    • Hey Katy,

      I’m really sorry to hear about your accident! It sounds like a really complex break that you have too.

      All I’ll say is, be very careful of the foot. IGNORE peer pressure, it’s so hard when people are giving you their opinions not to take it to heart and not to do things that you don’t feel comfortable doing.
      I really struggled as everyone has an opinion, but no one knows apart from you and your surgeon or doctor.

      Trust me, you do NOT want another operation to re-align all those bones if you can possibly help it. So keep be very very careful.
      Get sports massages on your leg and foot and work around and as close to the injury as you can to keep the fascia free and flowing with blood, do everything you can to keep the part of the body used but not under pressure. It will help the recovery no end if you keep movement.

      DO MOVE. Don’t go stale but be careful. I used an Aircast SP Walker which was a great boot and was so relieved to be out of a cast. Get out the cast and into one of those as soon as possible.

      For your benefit, apart from slight aches every now and again, I’m back to doing EVERYTHING I did before the break, so it WILL get better but it’s a really slow healer especially if you’re not lucky enough to be Rooney or Beckham and have daily reviews, treatment, improvements because you’re worth 10’s of millions of pounds on the pitch.

      I hope that helps somewhat, and I wish you the speediest and most successful recovery possible.

      Big love
      Paul

  2. I believe my chiropractor worsened my stress fracture. I have a tibial stress fracture…causing pain I thought was my knee. The chiropractor said my leg was out of alignment, pulled my leg and whacked the sides of my knee to put things back. I told him this was hurting…but he didn’t stop. The pain got worse, and I had an MRI from the sports doctor and found a severe stress fracture. No more chiropractor for me.

    metatarsal stress fracture

  3. Thank you Paul for this post. I just fractured my right foot 5th metatarsal in a similar location to yours on Sunday Aug 17, and got pinned and plated back together on Aug 22. I am not as athletic as you, but I do strive for an active and fit lifestyle. And so I’m really concerned about lack of mobility and exercise. At the same time, I’m realizing the risks I’m incurring as I try to remain active…. Those momentary balance losses where the bad food touches down, even strain on the non-weight bearing foot as I hold it up and foot muscles flex. My heart broke for you when I saw your bone still separated 20+ days post op, but I was super encouraged to read your comments to the dancer that you are doing everything that you used to do.

    Again, thank you so much for posting your experience and giving me hope.

  4. Wow that break looks exactly like my xray. I thought it was put online it’s so close lol. Well for me… It’s been 8 weeks and it still not healed. The last xray looks the same as the first one. They did not pin it…I have no idea why they just thought it would heal on its own but everybody else seems to be pinned when they had this kind of break. I only have an Aircast. I was never told anything but to only put my heal down after a few weeks and when it starts to heal do the full rolling walk. I had a second xray and was told to go back to specialist because it was not healing and may need to be pinned. So I tried to make an appointment and my specialist was away for 3 weeks so I went to see a different one. He just said it still needs to heal and could be another 4 weeks before there’s any solid bone so to come back again in three weeks for another x ray. Didn’t give me any advice on what to do at all so I just kept off of it as much as I could. I was scared to do anything to hurt it but apparently after my last visit with the main specialist she said that was the worst thing that I could have done cuz its stopping the blood flow needed by walking on it and now osteoporosis and set in. She seemed shocked that nobody had told me any advice and said sorry some people slip through the cracks… thank you so much system! so now I’m in my 9th or 10th week with the bone only just maybe starting to heal so we’ll see again in another 4 weeks and hope for the best. It still hurts really bad to touch anywhere around the break even lightly.
    So yes keep that blood flowing is the main point in all this without too much strain on it.
    thanks for posting this it has helped me for sure
    Debs

  5. I fell and broke my 5th metatarsal on my left foot on Aug 24th, I had a plate and screws placed on Sept 8th, I was in a semi cast for 3 weeks then in a regular cast for 4 weeks. ….all this time I was non weight bearing at all. My surgeon then put me in a

    walking boot (with crutches)and weight bearing as tolerated along with physical therapy 3 x a week. After a week or so of PT, I started feeling better and while still in the boot, I stopped using the crutches( for 2 days …..BIG MISTAKE….I couldn’t bear weight at all due to the pain, I was told that I went from non wt bearing to full at bearing and that this needs to be done gradually. That was about 6 weeks ago, about 3 weeks ago, my surgeon took me out of the boot and I am still doing OR 3 x week but my foot hurts constantly…..the x-Ray shows that the bone has healed.
    This all starts d on Aug 24th and today is Dec 20th……I still have constant pain…..does this ever go away

    • Chery, I’ve heard that it takes a year with our injuries before we really feel better. We all heal differently, but I’m sorry to hear you are still having pain. I broke by 5th metatarsal a week or so before you did, and I have discomfort, but I would not describe what I feel as constant pain. I do feel despair that I’ll never be wholly healed, and insulted my physical therapist the other day when I asked her if anyone ever really gets better. Her response to me was that she wouldn’t have a job if people didn’t. I think we need to just be patient and keep doing the exercises and stretches that our health care professionals advise. I have definitely improved since my original injury, so all I can do is be patient and let me body take the time that it needs to fully heal.

  6. Hello..

    Im a professional dancer, i practise 8 hours a day. I broke my 5th metatarsal just two days ago. When moving is the only thing in your life, this thing seems to be the end of the world.
    Last year i had other foot in plaster cast, and i trained. I did workout, push ups, pull ups, abs.. That was my thing to survive the process. I believe that helped the healing process also and the blood circulation keeps activated.

    But this fracture is different. My fracture looks similar as yours, bones has moved far from each other. BUT I DIDNT HAVE ANY OPERATION, and now im thinking that has it been a mistake. I have lots of questions, but non of the doctors have worked with danseurs and dont know how to deal with me.

    Can i bear weight at all? Two days from the accident and i don-t eat the painkillers anymore. Doctor said that i have this cast for 3 months, i dont believe him..

    How are you now? Back in the game?

    Laura

    • Hey Laura,

      Day two eh?
      It was 5 days after the break that I had my op.
      Mostly because was in the mountains in France and was only 3 days into 6 days holiday so was cooped up in the apartment whilst my friends were out on the slopes.
      I then had an appointment with my surgeon the day after I landed back in the UK. He made a procedure available the very next day.

      When you say you didn’t have an operation and it was a mistake, were you advised and you turned it down?
      I’d say talk to a professional podiatrist and do as they advise.

      If you say your fracture is similar to the one pictured, then I would suggest you don’t even attempt to weight bear, but again, talk to a podiatrist. If you’re in the south of the UK, get in touch with http://www.elitepodiatry.co.uk/
      Cast for three months? Well, not necessarily a cast, I’d switch to an Airwalker boot ASAP, but three months sounds like a reasonable time frame. Sorry.

      With all that said, yes, I’m back in the game fully. It’s a rubbish journey and like you I’m a very active person and it’s pretty much my (other) life to be lifting, cycling etc etc. So to have that taken away was incredibly difficult. May I be as bold as to suggest seeing someone about the impending grief – a counselor or similar – as if you’re anything like me, on reflection I could have really done with it!

      Feel free to get in touch, I’m happy to talk.
      Big Love
      Paul

  7. Hi Paul
    I broke my 4th and 5th metatarsal a week ago; surgery is in two days. The break in my 5th is similar to yours, however you surgeon told me a plate will also be inserted. The 4th doesn’t require surgery (I have x-ray pics in my blog).
    As an avid cyclist myself, I’m interested in how long it took before you were able to ride again. Were cleats an issue when you first returned to the bike? Are you a road or mountain biker? I’m both, as well, as triathlon.
    You say you’re also a lifter. I’ve just gotten into Olympic and power lifting, is this similar to what you do? How did you find starting on lower body strength again compared to how you were pre-injury?
    I feel I’m going to go crazy without gym work. I’m trying to wait til after surgery to start doing anything, as the swelling hasn’t subsided a lot yet. I’ll definitely be taking your advise on avoiding all lower body until advised. I guess my pull ups, overhead strength work and maybe swimming will get better!
    Cheers from Australia
    Mel

  8. Thanks for all these discussions. I’m experiencing this life tragedy as well now. It happened at night of my last day during my vacation. I flew back to San Francisco from Phuket with just pain killers. Luckily, it was the last night of the vacation and I traveled in business class this trip so I raised my left foot up high throughout the flight. I went to the ED immediately after landing, and yes, it’s broken like a shark oblique in the middle of the 5th metatarsal bone. It’s been the forth week and I met with my podiatrist the second time without surgery or reduction. From the comparison of the X-rays, I couldn’t see the healing well until the podiatrist pointed it out for me. I was hopeless and helpless for the whole time I’ve been grounded at home during the first three weeks. Now I am using the walking cast — not that different from the first one, but I have a hard sole shoe on it for walking. I have been using the knee scooter and crutches before the podiatrist recommended me to wear bearing as tolerated. I’ll go back to work in three days, hopefully I can feel better and plan to go back to my gym routine 5-6 days a week, 2 hours a day. Again, thanks for all info and comments here. I’m still on the optimistic side of my life, even though I know that it will be very slow healing process. I will keep my foot warm and moving, take collagen and calcium to supply the healthy healing process as possible as I can.

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