Physio exercises for a broken 5th metatarsal

[bess]

Hi there,

Very glad to have found somewhere I can get an answer (I hope), having spent about an hour trying to find info online.

I acquired an undisplaced fracture in my left 5th metatarsal about 3.5 weeks ago, and after spending a couple of weeks in a back-slab cast, I'm now allowed by my doctor to try a little weight-bearing on that foot if I'm on the flat at home.

I'm being very gentle, but I note that the muscles leading down into my little toe and the 4th toe on that side have kind-of seized up. Gentle massage across the top of my foot at the base of my toes has actually caused bruising for very little pressure (he went nowhere near the break - just tried to stop the cramp in them by gently moving the toes!).

Anyway, I may have to wait some time to get into the physiotherapists at our local public hospital, as we're on a pretty low income, so I thought I would try to find some gentle exercises to help get the foot working again, without hurting the foot near the break.

Does anyone have any suggestions? I can't find anything online except a few general foot-strengthening exercises (grabbing marbles/towel and moving them with toes etc.) and some of them seem like they might do more harm than good.

Thanks in advance!

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[physiobob]

Hi Bess, sorry to hear about your fracture. Those ones can be nasty and to be honest you are still very early in the fracture healing process and to much exercise won't be good for it at this stage. The towel and marble exercises are nice but not for a few weeks yet. You need to have a fracture clinic review to see the state of the bony union as this is a notorious area for delayed healing.

Perhaps a first step to ease out some of the cramping sensations would be to move the foot and toes about in a warm foot bath. Also some massage to the shin and calf would be useful as the outside and calf areas of your legs are where the muscles that attach to your foot reside.

Gentle reflexology away from the fracture site might also be useful for pain. For now continue to take it slow and get back to the fracture clinic for a review if it is on offer.

Best of luck

[bess]

Thanks Bob!

Your advice is very much appreciated. The doctor said from my x-ray last week that the point I broke (right up the very back tip) is knitting very nicely, and even since my last message, walking (well, limping!) around on it gently is hurting less and less.

Since I haven't been able to afford (or borrow) a weight-bearing boot as suggested by the doctor, I've resorted to taking most of my weight on the heel as I get around the house or the office. She expressed concern that the muscles should start to rehabilitate ASAP and didn't want me to stay in the back-slab any longer. Without the suggested boot, though, I've had to improvise!

As of yesterday, things started to loosen up a little, and hurt a lot less. Without putting weight on the foreparts of the foot, I've been going through the motions of rolling the foot forward and up (as you do when you walk normally - I hope this makes sense!), but without putting any real pressure on it (by the time I lift the foot, I've got all my actual weight on the good side). This *seems* to be allowing the toes to loosen up a bit and get used to operating the way they should again.

It doesn't hurt, but is it a really bad idea? Last night, it was aching a bit, but wasn't even swollen when I took my sock off to go to bed, which really surprised me! It's like it's allowing the fluids to circulate a bit better.

The physios I have dealt with in the past have always said it should be okay if it's not hurting, so I've tried to think laterally. Being a mum with a 20-month-old toddler (who has been cared for these past nearly four weeks by either my parents or Daycare so I could get better), I need to regain some mobility ASAP, although I don't want to rush in and cause more damage.

Sound sensible?

Thanks again for your thoughts. The foot-spa will be coming out tonight, and towels/marbles are off the agenda!

[kevpol77]

I broke my fifth metatarsal about 11 weeks ago in what the dr called a 'watershed area'. Apparently the lack of blood flow to this spot has slowed the healing substantially. After 9 weeks in a fibre glass cast I've been in a walking boot for 2 weeks and schedule to go back to the dr for more x-rays in 4 weeks.

I was wondering if there were any techniques (e.g massage, magnets, hot/cold water baths, exercises) I could do in the meantime to try and increase circulation to that part of my foot and speed up the healing process?

[physiobob]

All sounds sensible. As long as symptoms are reducing gradually, and not increasing, all it on the mends. Hot/Cold bath do stimulate the shunting of blood to the area which is useful. But to hot over a fractured area and it might just provoke pain so go easy if this is an option. Perhaps the most important thing is to wear suitable footwear that has a good absorbing/cushioning sole. Running trainers for example would be better than flats. Also their usually higher heel height causes the foot to land as if on a slight ramp (decline) which should reduce the force on the base of the 5th metatarsal as the mid-foot contacts the ground.

Best of luck (to both of you)