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Re: 5th Metatarsal Avulsion Fracture Experience [sentania] [ In reply to ]
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glad to hear everything went smoothly. keep your head up.

this is week 7 of recovery for me. was i diagnosed with 2 sfx in 4th and 5th metatarsal. i thought id never make it, but im running 3 times a week now. enjoy the holiday season (and the vids). you'll be back at it as soon as your body is ready.

recover well

-jason

Toro Performance
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Re: 5th Metatarsal Avulsion Fracture Experience [sentania] [ In reply to ]
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Best wishes for your recovery.

maybe she's born with it, maybe it's chlorine
If you're injured and need some sympathy, PM me and I'm very happy to write back.
disclaimer: PhD not MD
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Re: 5th Metatarsal Avulsion Fracture Experience [sentania] [ In reply to ]
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+7 days

Things are good. No pain at all anymore, occasionally though I can "feel" the screw. Odd feeling. Biggest problems right now are keeping my tows warm, crutches suck, and I can't drive.

First post-Op on Wednesday to get the dresses changed and the stiches out (? - can't remember if that's this Wednesday or the 30th). Go back on the 30th for another follow-up and to get a walking cast.

Also, I didn't mention it last week, but Dr. prescribed a bone-stim, and my insurance approved it, so I'm slapping that on 3 to 6 hours a day.

Did the hand cycle at the YMCA on Saturday and Sunday.
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Re: 5th Metatarsal Avulsion Fracture Experience [sentania] [ In reply to ]
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+44 days after surgery

Well I've survived two weeks in a splint, 4 weeks in a hard cast, and was just "sentanced" to 3 weeks in a boot.

The pictures taken today show that healing is evident in the fracture - with some progress still needed until "healed". But in the boot I was cleared for partial weight bearing and stationary cycling. But any healing is better than no healing - as that could result in another surgery or me doing something stupid.

I won't be able to cycle hard, but as soon as I dig out a platform pedal atleast I'll be able to do that. It will be better than the hand cycle and more motivating than it.


No pain at all any more, just occasional feelings I can best describe as "Wow, it feels like the screw is in the middle of my foot" that I mostly attribute to weather/cold feet etc.

No numbness either - just a hairy, pathetic, skinny leg and foot. At least with the boot I can fix the hairy part ;)
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Re: 5th Metatarsal Avulsion Fracture Experience [sentania] [ In reply to ]
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Thanks for the update Scott - will be running soon enough ;-)

____________________________________
Fatigue is biochemical, not biomechanical.
- Andrew Coggan, PhD
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Re: 5th Metatarsal Avulsion Fracture Experience [sentania] [ In reply to ]
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Hang in there. I just had my screw out last week, and once the stitches come out, look out! You'll be in the same place soon.

Astounding how such an apparently minor injury can have such a huge impact, isn't it?
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Re: 5th Metatarsal Avulsion Fracture Experience [sentania] [ In reply to ]
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Broke mine at Clearwater and still not able to run. Was not an avulsion so I did not have a pin or screw inserted.

2 more weeks and I see the doc again. Hopefully will finally be able to do light running.

Best of luck with the spinning. I found recumbent bikes at the gym to be the easiest with the boot.
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Re: 5th Metatarsal Avulsion Fracture Experience [sentania] [ In reply to ]
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+63 days.

Still in a boot. Still @ partial weight bearing, easy cycling and hanging out with my bone stim.

I'm not experiencing any pain right now. There is a region of numbness surrounding the incision, with the incision being quite sensitive. I'm also quite pleased with the appearance of my foot - when I first started with the boot my foot was quite misshapen - it looked like I had just gotten off of a 36 hour plane flight... in the last couple of days it's starting to look more like my foot. The only odd spot yet, is a region around the incision that is like a bump... I'm not sure if it's scar tissue, swelling or what, but it doesn' t hurt (it actually corresponds fairly closely to the area that is numb.

More x-rays on wednesday. On the scale of hope, it would be awesome to start riding without the boot, start the long progression towards running again (i.e. take a nice walk around the block) and thinking about swimming. I'll settle for continued progress and being allowed a setup that will let me drive.
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Re: 5th Metatarsal Avulsion Fracture Experience [sentania] [ In reply to ]
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+79 days

Last appointment was 2/17. X-rays looked good - initially when I first saw them it looked like not much improvement from the time before, but the doc zoomed in a bit and did some contrast stuff and it looks great. It's not totally closed, but it's very close - about the size of the tipe of your mouse pointer - compared to what it was initially it's tiny. The doctor was a bit suprised that it wasn't totally filled in after 8 weeks, but was happy that it was continuing to progress. Next appointment is 3/17 - he expected things to be closed up by than, and I can start thinking about running. He also said that if the fracture wasn't fully closed than - we can talk about returning to running as long as I am asymptomatic - because it's likely that between the screw and any fibrous material the fracture is stable, and after 12 weeks it may just be "done".

Still in the boot, but full weight bearing.

Was cleared to start swimming again - no push off's with right left. Continuing to cycle - slowly getting strength back - rode 90 minutes on sunday.


I am starting to feel a bit of apprehension about running - no matter the result on 3/17...how will things feel? how fragile/sturdy is it? etc. Got a big mental block to overcome.
Last edited by: sentania: Mar 3, 10 6:51
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Re: 5th Metatarsal Avulsion Fracture Experience [sentania] [ In reply to ]
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Glad you're healing.

Running will come, I'm sure. I tried running on the treadmill a couple of weeks ago, and it didn't feel great - sort of like the middle of my foot had frozen up. It wasn't pain, exactly, just stiff and not comfortable. I don't have any bone-pain. Just 'frozen-up' stiffness/soreness.

Hang in there - it'll come.
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Re: 5th Metatarsal Avulsion Fracture Experience [sentania] [ In reply to ]
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Scott - my experience with 5th met avulsion fx is that there will be radiographic signs of the fx way past when an athlete can run. The other issue is that there will often be some focal tenderness for a long time as well, so waiting until totally pain free can be frustrating. Something to carefully discuss with your surgeon since he has seen your progression, knows how good the fixation felt/went, etc.

Thanks for the updates!

____________________________________
Fatigue is biochemical, not biomechanical.
- Andrew Coggan, PhD
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Re: 5th Metatarsal Avulsion Fracture Experience [rroof] [ In reply to ]
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That's good to know, thanks for the information.
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Re: 5th Metatarsal Avulsion Fracture Experience [sentania] [ In reply to ]
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+95 days

I had another followup this past Wednesday. The fracture is still there and ugly as hell, but it's continuing to improve and fill-in. BUT my doctor feels that everything considered everything is stable enough to start progressing towards full activity. Next follow up is on 4/7.

So I'm cleared to walk in normal shoes - Goodbye stupid boot - cycling without my boot in normal shoes, and start a progression to be running by ~3/31 or so. Personally - I'd love to start running now - but my right leg is so damn weak as compared to my left, that'd be a bad idea. I'm going to resist the urge to rush things and follow a steady progression towards that. Walking a lot, water jogging, etc to streghen up that leg system and to start reconditioning my joints/etc.

Beyond that swimming is progressing very well, and cycling is also. I did FTP test last night and the result was 255. I'm thrilled with that considering how conservative I started out on the test and the circumstances. Barring any wussification or set-backs - I am comfortable saying I'll be back up to more respectable 280-290 with a few weeks of work. That's very reassuring.

More updates to come when appropriate.
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Re: 5th Metatarsal Avulsion Fracture Experience [sentania] [ In reply to ]
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+112 days (I think)

Not much new since last time. My next appointment/xray is this coming wednesday.

I've did three honest to god runs last week, T/R/Sa. 30 minutes each time. They were hard, but awesome. I'm pacing my self using Daniel's adjusted E-Pace for weight gain, and time off - which puts me at a VDot of 45 for now.

No real pain while running, just soreness and discomfort from a weak lower leg/foot. Had a little extra swelling later in the day after each run, but nothing bad and was solved by a bag of blueberries on the ankle for 15 minutes.

I am planning to try and run a normal frequency this week, but keep them limited to 30 minutes. That plan is pending my foots reaction, pain, and the xrays on Wednesday.

Last week was a great week of training. I did 2x20 on the bike @ 270 watts - so that is coming around nicely. My swim "clicked" on Saturday.

I'm getting very excited to see things starting to come around.
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Re: 5th Metatarsal Avulsion Fracture Experience [sentania] [ In reply to ]
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Things are still progressing well.

No pain while running/walking/general activity, although my priopreception (I think I spelled it right) - is horrible.

I still feel like my foot and especially my ankle still need some strengthening and flexibility work, but so far it's reacted well.

out of the boot on 3/17; walked for 2 weeks - 1 day. Ran every other day for a week. Than ran 6x 30 minutes. Last week I ran 45 minutes + 5x30 minutes.

I'm planning to run 60 minutes today, and a few 30 minute runs this week. I'm doing saint anthony's this weekend so that will be fun. I don't plan to push the run and have very low expectations, but I'm just excited to be back at it.

If my run fitness returns like my bike fitness has and is - things will be just peachy.
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Re: 5th Metatarsal Avulsion Fracture Experience [sentania] [ In reply to ]
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Glad to hear you are able to race again! I am racing (competing more like it) in St. George next week.

Like others have said, I continue to have some pain from my 5th metatarsal fracture as well. Guess it just takes time. Another suggestion I would have for you is to do a lot of individual leg strength training to make sure both legs are working. I did not do this for the first few months back and it caused several setbacks with IT, hamstring, etc... Every time I tried to up the workouts it seemed I would have a setback. Over the last few weeks I have focused on the strength training and it seems to have helped.

Just my $.02.

Best of luck on your first race back!

Chuck
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Re: 5th Metatarsal Avulsion Fracture Experience [sentania] [ In reply to ]
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I broke my fifth metatarsal and ankle in September 2008. It wasn't a Jones Fracture and I didn't have to have surgery. I was in hard cast for a week and then an air cast for seven weeks. I was limping badly for a couple of weeks afterward and felt good enough to try running on a rat wheel in late January 2009. I assume you are or will be in physio soon? Best of luck to you in your training.
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Re: 5th Metatarsal Avulsion Fracture Experience [lonestar] [ In reply to ]
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Same here, I was in a boot for 6 weeks. Switched from Asics & went to Nike then never had any problems. Of course, 18 years later--I'm using Asics for my latest pair but not having any issues. No surgery needed. But start up slow when you do. Try dirt trails for a while.
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Re: 5th Metatarsal Avulsion Fracture Experience [sentania] [ In reply to ]
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Nice job on recovery.

I started running for a while, but then have stopped for the past couple of weeks - the ball of the same foot has been hurting. Go figure.

My ankle and general foot flexibility are still stiff, and the break site sticks out a bit, but doesn't hurt at all.

Hope this is it, for you.
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Re: 5th Metatarsal Avulsion Fracture Experience [sentania] [ In reply to ]
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Last post for me in this thread as far as updates goes.

~151 days post op.

Just got home from the triple T, done on 7ish weeks of run training, and 10ish weeks of swim and bike training.

Long story short - happy to be back.


2010 Triple T Race Notes
Friday
The Triple-T prologue always catches me by surprise, despite my background as a sprinter in college swimming – I have a difficult time spinning the engine up to the necessary level. Despite a good warm-up prior to the race, this year was no exception. The swim and the bike went well enough. My plan was to ride the beginning of the ride and the climb just slightly above threshold – get to the turn around and coast back down – than run a mile. The plan worked well and I rolled in a pretty decent time, over a minute and a half back from the winner. Mostly I was glad to get through the race without feeling like I had tweaked any muscles, along with the pleasant surprise of not being completely dusted.
Saturday
The course for Saturday’s first race was changed from the traditional bike course to the Saturday PM bike course due to a tree blocking the road that fell during the storm on Friday night. I think this suited me a bit more as the PM course lends itself to a bit more of rhythm riding – rather than constant up and down cycles.
Even though Matt and I were starting together, the Saturday AM race is an individual TT – since Matt was planning to take it easy on the swim – as soon as we were given the signal to start I left him behind. I went through the swim strong, steadily building into it. Around 5 or 6 hundred meters in I got buzzed by the John Kenny motorboat – I don’t think I’ve someone ever swim that fast in a Tri before. I hit transition in a touch under 20 minutes, and hit my bike. I was able to catch a glimpse of Matt as I doubled back past transition and saw him about a minute behind me.
The Saturday PM course (which we were riding today) – is a long [not]false flat for a few miles, followed by a nice climb, a downhill, a mile or so flat, a nice climb, some rollers, a wicked decent, than a flat section to the turnaround, and then it’s all in reverse. My plan for the ride was to not limit myself at threshold watts, but to limit myself away from insane watts – in short I was counting that my fitness has increased since Saint A’s and my perceived effort combined with a knowledge of what is unrealistic would keep me safe.
I didn’t pass to many people, but was passed by only a couple, I rolled into transition with a split right around 72 minutes – given the hills and the technical nature of the descents average power is pretty meaningless – but my Normalized power was 277 – which is excellent.
Heading onto the run, I was carrying my wife’s Garmin – which I intended to use similar to my SRM on the bike – try and keep things from heading towards insane – and rely on PE. The main goal was to simply get through the run without feeling like I had overexerted myself.
The TTT run course is essentially an uphill trail run for about 2.75 miles, downhill for a half mile, than turn around and run back; Once each for each Saturday race – twice on Sunday. The course itself is hard to describe, but basically each direction of the run course has one climb equal to or worse than Observatory hill on the IMWI run course.
Watching the Garmin I was pretty surprised that my PE was taking me to about 7:30 miles going out, and 6:40’s on the way back yielding a mid-46 for 6.55 miles. Not too bad. I kept waiting for the hammer to fall, but it never did.
Saturday PM
I left the race site Saturday morning with my expectations for the entire weekend already blown away. My bike fitness nearly equal to 2008 and 2009 in terms of FTP – and my run closing down the gap to previous years here. Of course I did have some doubts about my depth of fitness since I was toeing the line with only 7 weeks of run training and 10 weeks of real bike training. But the Saturday PM would help uncover that – I’d either fold spectacularly (and miserable) or I’d hold the line in the sand. Fortunately since the PM race is a team time trial, I would have Matt there to help with any rough spots.
Saturday PM is a unique race format – Bike, Swim, Run. After you’ve done the race, you realize that it’s a much harder format than the traditional one – IMO it’s the way a tri should always be run.
The plan was for me to do most of the wind breaking on the bike since I out split Matt in the AM, and I had brought all my aero toys and Matt was lacking. Matt’s job was to pace me up the hills, and pull through at any key moments or if I popped.
70 minutes after we departed we rolled into transition 100% intact, contrary to 2008 and 2009 where I spent most of the ride suffering in Matt’s draft hoping for the bike to end, I felt as if we had stayed 100% within my fitness. Matt towed me up the hills, and gave me a couple minutes of rest shortly after the turn around as he hauled us up to and past a team up the road.
Matt and I tossed on our wetsuits as quick as we could and headed for the water. Since my run was definitely going to be slower than Matt’s the plan was for me to hit the swim fairly hard and get out onto the run course and let Matt catch up. I got through the swim only a handful of seconds slower than the AM and was leaving transition as Matt came in.
We cruised through the run, again pleasantly surprised. I was waiting for my body to pop the entire run, but it never did. I wasn’t crushing it, but I was holding my own. My run split was actually faster than 2009, and only 3 minutes and change slower than 2008.
I went to bed Saturday knowing we were comfortably in second place OA in the male team division. The first place team was most likely out of reach barring a disaster on their part, and my job for Sunday was to get through the race in one piece.
Sunday
When I woke up on Sunday morning my legs felt sore and tired, but surprisingly ready. The plan for the day was for Matt and me to swim our paces, and for me to wait in transition. I got through the swim without event feeling good – trying to ease into it and use it as a warm-up for the rest of the day.
Matt showed up in transition just behind me and we were out on the bike quickly. Initially the plan was for me to break the wind and pace us through the race at an aggressive Ironman effort with Matt pacing up the 2 climbs on the HIM course, but after 20 minutes or so matt and I settled into 3-4 minute rotations of work. I don’t know how it felt from Matt’s perspective, but sitting in for those 3-4 minutes was a great rest and really made it easy to drive the desired pace when I was in front.
Unlike last year the first loop was ”fairly” uneventful, we made it past the spot of the crash last year without a problem. We did have an interesting moment at the bottom of the Big Run fire road descent, as I went into a right hand turn I realized I had misjudged the angle slightly and ended up riding into the yard bordering it and cyclocrossing it for a bit. Just practice for the Cheq40 I say…
The remainder of the ride was uneventful – we managed to ride a couple minutes faster than 2008 with a 2:58 or 2:59.
The 13.1 mile run was the final test of the weekend. Not only was it going to be a half marathon after a weekend of madness, it was going to be my longest run since last October. My game plan was to use the Garmin to keep away from insanity, and let my PE guide me. I intended to run as if the race ended at 10.5 miles, as that is the point of the run were it is downhill to the finish. I figured I could ring 2.5 downhill miles out of my shattered body – I just needed to make sure I got there.
The first loop went without a problem, I tried to not look at the Garmin often – I was worried that it might start making my brain think too much. My job was to just get my ass to mile 10.5 and then roll downhill – so that was all I tried to focus on. At half way I checked our time and we were right around 52:30 which meant we were on pace for a spectacular run.
Things continued uneventfully until around mile 9 which is a wicked uphill into an aid station and the peak of the run before you plummet to the turn around. I nearly broke on that hill, alarms started going off like crazy in my head. I did my best to ignore them and rewarded myself with a brief couple of walking steps through the aid station and then continued to the top of the run course.
During the downhill towards the turnaround I had a couple doubts about my ability to get back up the hill – fortunately about that time Matt told me to let him know if and when I needed a push. Just a few minutes later I was crusing back downhill past the 10.5 mile mark re-energized and ready to finish.
Matt and I crossed the line with a run split just under 1:47. Which means I faded by less than 2 minutes on the second loop. Best of all Matt and I finished this year, and finished in 2nd OA in the Male Team division.

This weekend exceeded every one of my expectations for it – I did not expect it to go nearly as well as it did. It’s impossible to describe how much this weekend reaffirmed my love for the sport of triathlon and my motivation to continue the love/hate relationship with it. I have a great deal of excitement for the remainder of the season; I just need to temper the enthusiasm with continued hard work and consistency.
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Re: 5th Metatarsal Avulsion Fracture Experience [sentania] [ In reply to ]
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Great job at the TTT Scott! Sounds like you are back for sure ;-)

____________________________________
Fatigue is biochemical, not biomechanical.
- Andrew Coggan, PhD
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Re: 5th Metatarsal Avulsion Fracture Experience [sentania] [ In reply to ]
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Despite the fact that I said after the Triple T I wouldn't bump this thread anymore, I can't resist the urge to bump it.

I have a few reasons for this:
1> To demonstrate that you can return from injury and a long break to a very high level of fitness in a short period of time.
2> To demonstrate that you can develop a very high level of run fitness without running very fast in training.
3> To toot my own horn - Toot!

http://www.scottbowe.com/...nman-wisconsin-2010/

Summary:
54:27/5:25/3:09 - Going to hawaii; 10 minute PR - all on the run.

Key Facts:
No running from 11/8/2009 until 3/27/2010 (3.5 minutes)
  • I logged less than 90 minutes faster than 7 minute miles in training, and probably less than 3 hours faster than 7:30 - not counting races

No swimming from 12/12/2009 until 2/23/2010
No biking from 12/13/2009 until 1/27/2009 - although until ~2/23 I was pretty limited in what I could do since I was in a boot. Rides were along the lines of 30 minutes @ 100 watts (.3 IF)


Key Take aways:
Breaks are Good.
If you have a major injury - be patient, listen to your doctor - you will be ready before you know it.
When you can start training again - take your time - rushing things will only get you hurt again.
Listen to your body when training and racing - avoid injuries in the first place whenever possible.
Rappstar is going to destroy the world when he starts racing again.
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Re: 5th Metatarsal Avulsion Fracture Experience [sentania] [ In reply to ]
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Very nice post/bump Scott! And another congrats on a stellar IM performance with obviously great bike pacing and smokin' run!

____________________________________
Fatigue is biochemical, not biomechanical.
- Andrew Coggan, PhD
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Re: 5th Metatarsal Avulsion Fracture Experience [sentania] [ In reply to ]
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Thanks for your story and abundant information on this topic.

Yesterday - car packed for IMCDA, go out for a quick "shake out" run for 25-30 mins, BAM! step on a small rock, roll left foot to the outside, nearly fall. Think its a bad sprain so drive from Salt Lake City to Missoula, MT for 7 hours. Pain worsening, get x-ray at ER in Missoula. Busted 5th metatarsal...no mistaking it. ER doc and on call Ortho say because I'm young and healthy I can rehab this in 2-3 weeks (sounds real optimistic) and be running again in 3 weeks. Pull plug on IMCDA, turn around and drive home all night. Crutches and boot. Devastated...
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Re: 5th Metatarsal Avulsion Fracture Experience [JimMoss] [ In reply to ]
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I was afraid of that from your initial post ...

At any rate, get a 2nd opinion from a specialist who treats runners. There is NO way this will heal in 3 weeks. I'm pretty aggressive in treating these in runners (i.e. Charlotte screw fixation right away, etc.) since they heal so slowly. Also, you posted "busted 5th metatarsal". Treatment recs will also change whether it is an avulsion fracture or a Jone's fracture or a midshaft fracture (less likely).

____________________________________
Fatigue is biochemical, not biomechanical.
- Andrew Coggan, PhD
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