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

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.

 

 

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