I broke my foot 7 weeks ago - stepped on a rock while running and turned my foot out. I was diagnosed with a fifth metatarsal avulsion fracture. I was in a walking boot for 7 weeks. I took the boot off yesterday and tried indoor cycling. The cycling made my foot burn and then I had pain the rest of the day - felt like the fracture and the tendon were hurting. Today, I tried going for a walk without the boot and that also made my foot hurt a lot. It feels like it hurts on the bottom of my foot.
Does anyone know if it’s normal to have this much pain 7 weeks after the fracture? I felt great in the boot after about 2 1/2 weeks and expected to feel fine when taking the boot off.
Have you asked/discussed this with your treating physician?
No, unfortunately I do not trust my doctor based on prior experience. I need to make an appointment with a different doctor, but it will be several weeks before I can be seen as a new patient (which is how I ended up seeing my current doctor who I could see right away when the fracture first occurred). I felt very good in the walking boot and am really surprised and discouraged at how much any activity hurts now that I’m out of the boot. Icing helps a lot with the pain.
My doctor told me that I could start using my exercise bike ten days after the fracture. Ten days after the fracture I was still in a lot of pain just trying to walk in the boot. The first time I tried using the bike was yesterday, seven weeks after the injury, and I was in pain all day after that even with very low resistance on the bike.
Good news is that 5th met avulsion fractures (assuming this is your correct diagnosis) almost always heal, though they are notoriously slow.
The bad news is that you do need to back off training a bit if painful.
Even after radiographic evidence of healing, many athletes have tenderness in the area for a long time. You can train through this with caution, but this is where you need to have trust in your treating physician (specialist hopefully).
From the time of injury until complete recovery it was about 8 months, though I didn’t “know” it was broken until 2 months after it happened, and then continued to ignore it for another 2 months before I finally made arrangements to get it fixed.
If I had to go back and do it all again, I would have acted on my knowledge that something was wrong with my foot immediately and had surgery immediately as well, though as rroof mentioned it’s best to talk it through with your doc.
Rroof has a lot of good points. I realize you’re in between orthopedic surgeons right now so a great deal of self-care is required. I very much hope I’m wrong, but I think the fracture you might be talking about is this one:
If this is your fracture, please keep off it completely for 6-8 weeks or until you’ve seen for yourself that the entire fracture is healed on an xray of the foot (aka full union). I speak from painful experience. These fractures do heal but their slow healing has a lot to do with inappropriate treatment, i.e. just wearing good shoes. Not many orthopedic specialists appreciate what this fracture is and it can linger for a long time if not treated appropriately. The fracture in an area that doesn’t get a lot of blood supply and will be pulled apart by the tendon in the leg as soon as you put weight on it. Wearing the boot won’t help it heal, unfortunately. Don’t go by pain or lack thereof as you can walk around on this kind of fracture. It will heal, but you’ll need to take very good care of it if you want it to heal fast without surgery. That means crutches. Once full union has been reached, you can slowly ease back in with pool running and dry land walking and then build from there, but prepared to back off if it becomes really bothersome. Rroof is totally right, there may be some residual pain for a long time afterwards, but this too will go away.
I am both a physician and a former athlete who suffered a fifth met head avulsion fracture. My downfall was a walnut. 6-8 weeks in a boot is sufficient time to allow for bone healing to take place providing it was a consistent 6-8 weeks. Not 2 weeks, test run, still pain, resume boot. It should be 6-8 weeks non stop. Now, as the previous poster pointed out, the fifth met head is a watershed area due to blood supply. What this means is it pulls blood from another region rather than having its own dedicated supply. In reality, not all avulsion fractures actually heal. One of two things happen, the bones rejoin or the two fragments heal over and form bone cortex that is separate. If it is the latter, then this some times leads to pain due to rubbing or pinching soft tissues and/or nerves. Mine happens to be a nonunion, though I am lucky and do not have pain. My ortho friend occasionally does surgery purely to remove the fragment. Now, if you did the trusted 6-8 weeks, I would follow the old saying, pain during activity and you’re not ready, pain after the activity, then it’s too much too soon. I started swimming, and then did the walk jog routine. I will admit my foot still hurt for a while as I thought I was not ready but as long as you stick to the above, it’s seemed to be okay. Hope this helps. Either way, when you square out your ortho situation, plain X-rays should be able to tell you if it has healed or not.
Broke my 5th at the mile mark of the Timberman 70.3 in August. Despite moving to a heel-strike the last 12.1 hurt, but apparently did no further harm. Surgeon did a bone graft from my hip since the stem cells will aid heeling in this low-blood flow area. After 8 weeks, 6 of them in a boot or plaster-cast, I was given the all-clear to run.
The point I want to make is that it may be worth considering why this happened, with a view to preventing it in the future. If a DEXA scan shows low bone density, then aside from Calcium, Vitamin D, and load-bearing exercise an Endocrinologist might suggest medications.
Good luck
Just to clarify … the 5th met head is up by the toe (the MTP joint). The typical avulsion fracture that occurs from an inversion injury (traction of the peroneus brevis tendon insertion) is at the BASE (styloid process). FYI.
As for the other poster. Your 5th met fracture was NOT an avulsion fracture, but a more serious Jone’s (or really diaphyseal) fracture and most all specialists will suggest screw fixation (as your X-ray showed - will excellent placement I might add)
I am a sports med orthopedist. Agree with above. A Jones fracture (metadiaphyseal fifth metatarsal fracture) and an avulsion of the base are completely different injuries and the treatment of them are completely opposite. Any qualified Ortho should be able to diagnose these apart. If it in fact a Jones fracture and surgery is indicated, I’d suggest you see an Ortho doc that specializes in foot and ankle. Hopefully, you do in fact have the avulsion fracture in which case activity typically is as pain allows.
My doctor said that I could take my boot off at four weeks but, based on what I read online, I decided to be safe and wear it for seven weeks. The first thing I did when taking it off was use my spin bike for the first time since the fracture. Since then, I have had pain and have had to ice several times a day. I wonder if I would not have had pain if I had just walked around and not used the bike. I kept the resistance very low and did not stand on the bike at all, but I did feel a burning sensation in my foot when pedaling.
I will give it a few more weeks and then call a doctor if I am still having pain. Maybe I just need to be patient and give it time to heal.
I had a 5th metatarsal avulsion fx 2.5 years ago. Same deal, running, stepped on a rock and rolled it (actually heard the break). I fully recovered from it in record time (insert sarcasm) of 12 weeks. I didn’t do surgery as my physician felt because the fx was minimally displaced it would heal in a 10-12 week time period. I was allowed to do just about nothing during the recovery. It sucked. My return to running was very slow and gradual and during that time the fx site was very sore. As a matter of fact, even now I still feel very, very faint soreness after a hard workout.
PM me if you want to hear more about it. Sorry you have to deal with this. Good news is, when it heals its as good as new. Unlike my chronic soft tissue injuries in my low back…which I am convinced will never go away…
I’ll add one more testimonial to the list. I had an avulsion fracture of my left metatarsal and my ankle in September 2008. I was on crutches and in a boot for seven weeks. I didn’t need surgery, but I listened to the ER doc when he told me six to eight weeks is the normal healing time for these breaks. I started walking (limping) immediately after the boot came off, and I began running again in January of 2009. I began cycling on a stationary bike as soon as I was out of the boot and didn’t experience any pain. The muscles and other soft tissue needed to begin working again. I don’t experience any pain now.
I had a 5th metatarsal avulsion fx 2.5 years ago. Same deal, running, stepped on a rock and rolled it (actually heard the break). I fully recovered from it in record time (insert sarcasm) of 12 weeks. I didn’t do surgery as my physician felt because the fx was minimally displaced it would heal in a 10-12 week time period. I was allowed to do just about nothing during the recovery. It sucked. My return to running was very slow and gradual and during that time the fx site was very sore. As a matter of fact, even now I still feel very, very faint soreness after a hard workout.
PM me if you want to hear more about it. Sorry you have to deal with this. Good news is, when it heals its as good as new. Unlike my chronic soft tissue injuries in my low back…which I am convinced will never go away…
I’d love to hear more about it, but I have no idea how to send a PM. ETA: Never mind…I just found it!
I broke my ankle in 1997 and it took a year to heal (two surgeries - one to insert pins and plate, the other to remove the pins and plate). Once it was healed, it was 100% fine. I also broke my tailbone and wrist in 2001, but those healed quickly and easily with no problems. My foot feels bad now after seven weeks in the boot and it is frustrating, but I feel better after reading everyone’s experiences and realize it’s probably just going to take some time. I just expected it to feel a lot better at this point.
I am at 8 weeks post fracture now. When I do a lot of walking, I have swelling in the ball of my foot - I end up with a pretty large lump at the base of my second/third toes and it’s painful to walk. Does anyone know why I am having swelling in that area or did anyone experience this with their own fifth metatarsal avulsion fracture?
Hi Beth. I am 7 weeks post fracture and just started walking in an aircast. I can tell you that it is definitely painful! The foot has been without weight for quite some time, as well as elevated, and is experiencing a whole new “world” being used again. The worst part about the fracture, for me anyway, was all the soft tissue damage that takes much longer than the fracture to heal. Keep your head-up and let your pain be your guide!
Sorry about your fracture! I am 9 weeks post fracture now and it feels pretty good. A little soreness and tingling, but nothing bad. I realized that a lot of the pain and swelling I am having is not from the fracture, but I somehow ended up with capsulitis in my foot. So, now I am treating that which is incredibly frustrating because I am basically back to where I started from. Normal activities don’t seem to give me any trouble, but I can’t do any type of workout - not even walking - without swelling and pain. I am going crazy from not being active.
Hi. Sorry to hear you’re still having issues. I still get massive swelling and severe discoloration at times. I also am experiencing decent pain still. I was actually wondering if I have a mild case of crps. 7 weeks later and my last xray showed healing but, definitely still broke. I do not go back for 3 more weeks and am on a bone stim 10 hrs a day as well. This thing feels as if it is never going to heal! I had a hard cast NWB for 4 weeks and a boot with WB as tolerated since. I did notice after they removed the cast severe ankle pain and swelling. I did not notice any pain or swelling there post injury but, definitely noticed out of the cast! I am hoping that I do not have a tear in the tendon but, can not figure out why else it would come out of the cast so painful and swollen. The frustration of this injury stinks. I had huge plans for the race year and now am just hoping l’ll be jogging by march.
