Metatarsal stress fractures

[tiger physio]

Does anybody know the recommended time period for non weight bearing for third metatarsal stress fractures? Is it simply a case of when pain free walking can be achieved? Also when is it sensible to commence activities such as aquajogging? Does anyone have any experiences to share of quick recovery from such an injury? Any advice would be greatly appreciated. Thanks.

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[neurospast]

Metatarsal stress fractures tend to be one of the fasted healing fractures [Think of Rooney]. 4 weeks should be more than enough of none weight bearing but is depending on the individual: Sporty/ none sporty, age, weight, general health, cause of fracture, alignment of fracture and so on.
But why do you want to have a shortest possible recovery time? What is the race about? Shouldn`t best recovery be the goal [quantity versus quality]?
I would though use a very simple system [ which becomes more simple the more you use it]: Use pain as an indicator. Use the information you get from the referer.[ not following his instruction makes you liable]
Partly weight bearing [ aquajogging] should be used with care and on indication of pain. I am wondering though about aqua jogging which seems to me rather stressful because it is hard to monitor the amount of stress on the fracture site unlike the use of scales and crutches/bars [patient will focus more on his foot]
You have to let your treatment be guided by the pain:
-use of medication might influence the recovery or hide symptoms like pain.
-No increase of pain over time [all sorts of modalities] unless patient has stopped with medication which influences painlevels.
-Sharp pain indicates something different than dull ache or burning pain. Temporarily increase of dull ache and sharp pain is to be expected after exercising.
-Painlevel will increase on movement and/or weightbearing but should go back to earlier level [pre exercise] within 30 minutes [ I am very generous with this figure take 15 minutes but do not stress your patient with this information].
-Try more weightbearing [stress] only if the pain has subdued at former stress level.
-More weightbearing means using more time at a certain level of weight or more weight during the same amount of time.
- guide the patient , they tend to try to much in general and are going to have a set back. Let them inform you about the discomfort they feel. Inform them about guidelines to pain. In other words let them take [joint]responsibility for their progress.

[physio237]

Hi, i'm a student physio and 400m runner who has suffered a stress fracture of the 2nd metatarsal a couple of years ago. I continued running through the pain for a couple of weeks as noone advised me otherwise (I was not a physio student then) and have now got a dropped arch and significant scar tissue under my medial arch. I beieve this was because I altered my running biomechanics to avoid pain in my foot, damaging other structured in the process. Anyway the best thing I could ever have done was aquajogging..why do u have a problem with this? When done in the deep end using an aquajogging belt this is not weight bearing, and should not hurt! I have since seen many other athletes with stress fractures of different lower limb bones who have all been advised to keep up fitnes in this manner untill the pain of weightbearing activities subsides.

[marymn]

Thanks for sharing the info with us!!