Seeking advice/anecdotes on best approach to returning to training from a broken foot. 3 weeks ago I fractured the tuberosity of the fifth metatarsal (the bony protrusion on the outside of the foot). Stupidly enough, I rolled the foot off the Welcome mat while stepping out the front door without looking where I was going, Doh!
Have seen varying info on the web with regard to heal time for this injury, anywhere from 4-8 weeks, but my orthopedist is erring on the side of caution and is inflexibly telling me “3 months for this to heal. You can’t start running again for 3 months. We’ll decide at 6 weeks if you can start riding your bike trainer.”
Ugh. So LOTS of pool time and weight lifting. Am hobbling about in one of those ski-boot-like walking casts, fun! Anyway, would like to hear from others who have had similar injuries. What sorts of things did you do to speed recovery? What sort of PT did you undergo? How long before you started back to running, and how long did it take to build the calf muscles back up?
Thanks!
TriBaby (maybe I can do the Big Kahuna at the end of the summer…)
I’m in the very same boat. Broke the same bone last Tuesday (Apr. 5) did IMAZ Sat. and now am in one of those boots.
My doc told me today that a big factor on healing is where the break occurs. Lower towards the toes is more difficult to heal and requires more off time. High is better and can heal within 6 week. Mine is on the high side. He said I can do nothing for 4 week. Does not even wanl me to walk on it in the boot - I gonna use the F’in crutches for 4 - 6 weeks, no weight on the foot. Then start swimming and biking. At 6 weeks new X-rays. Will evaluate thngs then.
I had a stress fracture in my mid-foot closer to the ankle. The bone on the outside of the bottom outside edge of the foot. The fracture was the result of a marathon and the constant pounding I assume. I did little to nothing for nearly a week then began biking on it and running on a treadmill. Oddly enough it pained me more when I biked on it. It was fine up to about 50-60 miles but once I passed that it was hell in a handbasket. However, the runs were a constant ache. I just ended up taping the shit out of it and running and biking on it. I would tape the foot to minimize the amount of rolling in the foot itself. It appears to have worked. It has been a month since the marathon and what was a 10 one week after the marathon, on a pain scale of 1 to 10, is now a 0-.5. I’d say listen to your doctor but do what you can. Know your limitations.
I missed a year of running due to an ankle injury. I thought the doctor was being over cautious but it really did take that long. I ended up just swimming 5-6x a week for a while. Pool running was also a good substitute. It took a few months to get back to where I was pre-injury after I started running again. The positive part was I did a sprint triathlon a year after my injury on one weeks run training and even though it was the slowest 5k I’ve ever done, I almost made up for it with my faster swimming.
Two notes of caution: be careful riding that you’re not over compensating with your good leg and screw that one up with an over-use injury, same goes with running and uneven flexibility affecting your gait. Be careful pushing off when swimming. I found myself shooting off at an angle since I was pushing off with only one leg.
In addition to treating them, I have had one. The post above talking about the location of the fracture making a big difference is correct. (The stress fracture one, however, is quite different.) Non weight bearing for a tuberosity fracture is pretty conservative. The Aircast often helps a lot, but is really for comfort - no real evidence it actually speeds healing. In my opinion this means that when it is comfortable, often 2-3 weeks, you can walk without the aircast and therefore minimize the calf wasting / need for physio to get range of motion. Proprioceptive physio probably useful. It may take that long for running to feel OK. I let people ride a trainer with an aircast on.
One last bit of advice is not to get too worried about the xray appearance - it wil take months to look healed on xray but can be solidly clinically healed long before this.
The post above talking about the location of the fracture making a big difference is correct. Non weight bearing for a tuberosity fracture is pretty conservative. The Aircast often helps a lot, but is really for comfort - no real evidence it actually speeds healing. In my opinion this means that when it is comfortable, often 2-3 weeks, you can walk without the aircast and therefore minimize the calf wasting / need for physio to get range of motion. Proprioceptive physio probably useful. It may take that long for running to feel OK. I let people ride a trainer with an aircast on.
Yes, this is definitely not a Jones fracture (the one that’s farther up toward the toes). Only complication is that the tuberosity actually broke in two spots, but the doctors didn’t seem to think that made it any worse than a single break. I actually saw two orthopedes. The first put me in a stiff-soled orthopedic shoe; the second put me in the walking cast, his thinking being that by immobilizing the ankle, we avoid having the connective tissues pulling on the fractured area, potentially impeding healing. This made sense to me, so I’ve been going with the walking cast, despite the inconvenience. It’s definitely less painful to walk on, anyway.
I’m probably just going to return to the first doc since I already have a follow up appointment with her at the 7-week point. I’ve been wearing the walking cast for a week; guess I’ll compromise and wear it for another two weeks, then go back to the flat shoe so I can minimize the calf atrophy.
Deke, what is “Proprioceptive physio”? Also, since the xrays take forever to really show healing, how do you KNOW when it’s OK to start running?
I would trust your treating physician over advice from strangers. I had a stress fracture in my foot several years ago. My Doc said six weeks. I didn’t ask about the bike because that didn’t hurt much. When I did start running, I did it in sand. That really seemed to help. I also started snowshoeing during that time but it’s a little out of season for that now. Good luck.
It’s OK to run when the doctor says it is, really, as the post above says. Usually though, it’s kind of a length of time thing, plus whether it hurts or not. As far as the ankle immobilisation thing goes, that probably assumes that the fracture is related to the peroneal tendon insertion, which is how some people think the fracture happens. Others like me think that the peroneals are not related to this fracture, and in fact that it’s a ligamentous avulsion (so it doesn’t really matter if your ankle is immobilised).
Proprioception is the mental sensation of where your foot is in space, and is related to reinjury, as if you have this sense imparied, you will tend to go over on it more easily. An injury and immobilisation tend to impair proprioception, hence an important part of rehab is getting this back so you don’t hurt it again.