5th Metatarsal problems (Any advice welcomed)

HI there,
I am currently immobilised with a broken 5th metatarsal for the 3rd time in 3 years. Both previous times the hospital sent me away supposedly fit after maximum of 8 weeks despite a constant pain during the whole 3 years i have had this problem. I have returned to hospitals and doctors offices many times complaining of pain to be told many different excuses (e.g. growing pains! I have size 12 feet so no more growing!) when I myself knew the problem was more serious and have been dismissed every time with only a bandage.

On the 15th April 2012 I turned on the ball of my foot walking down stairs and heard a snap, I went to the emergency room to be told the exact same spot on my foot had broken again. I am still suffering from pain and poor movement in my right foot, even though I was told by the doctor that the healing time would be 6-8 weeks. Its now going on the 14th week and there is still pain. On the last x-ray I was told that the bone has only started to heal yet they sent me home in a tube bandage and said to go back to work and leisure activities (I'm a football coach in my spare time).

I have recently went to see a specialist and they have said that the problem is in a stiff calf muscle so my ankle cannot bend enough when I walk, causing stress on the metatarsal. They said that because I lead with the outside of my foot when I put my foot down then it is always the 5th metatarsal that gets the most stress. From people I know who are from a medical background they thought that a bone that has had a previous break and healed properly is stronger than a normal bone.

I am just worried about my future because I am only 21 and don't want this to haunt me for the rest of my life. It has hindered my working and social life and I am desperate for the problem to be resolved. Many people have said about surgery on my foot but I wanted ANY advice because it is a big decision and can have impacts in future times.

Thanks (sorry for the long post) :)

Hello, sorry to hear you have broken the 5th meta tarsal for the 3rd time. I think you should ask yourself (which you seem to have done) why it snaps. I assume it is a stress fracture and this will continue to happen again and again unless you get it examined properly why this is happening. The reasoning that it snaps because of tight Calf muscles seem to me a guess and I would like to see any research support for this claim. That it can have to do with the loading of your foot is most plausible though. Which means that at soon as you are on your feet again you need to get referred to a physiotherapist for biomechanical assessment of the ankle function (have you sprained this ankle in the past on several occasions?) . Maybe even better get yourself referred to a Podiatrist for this sort of assessment. With size 12 feet, are you tall, are you heavy built? If so this could compromise the loading. Poor foot biomechanics have a tendency to cause problems. E.G is your 2nd toe longer than your big toe? are you over pronatin excessively? are you putting all your weight on the outside of your feet? and so on.
Your friends might be right that a bone becomes stronger after a fracture but this most likely only true in the short term and even if this would be true in the long term (which would mean that more and more force would be needed to fracture the 5th metatarsal) the biomechanics is the clue and you might have to compromise in choice of footwear and insoles.
Hope this helps.

Hi,

In addition to the advice above, if this is the 3rd fracture in 3 years you should ask about getting it pinned with a plate. It would not effect your movement as the plate would be placed on the shaft of the bone and not across a joint. A course of physiotherapy afterwards should get your movement and strength back.

Also, do not take anti-inflammatories as these will slow the healing process of bone.

Hope this helps.