Most fifth metatarsal fractures, except a Jones’
fracture where the shaft and base of the bone meet,
are treated symptomatically. This means your physician
prescribes whatever non-surgical treatment is needed
to ease your pain. You usually can bear some weight
on your foot right away as you can tolerate the
pain. Depending on your pain, you may need to use
crutches at first. As your pain decreases, your
weight bearing can increase. Everyone is put on
a slightly different schedule, but in general, it
takes about six to eight weeks to heal a fifth metatarsal
fracture. During the first few days, your physician
may recommend resting with your foot elevated above
the level of your heart to keep swelling down. If
your fracture is preventing you from walking, your
physician usually immobilizes your foot and ankle
in a removable brace called a cam walker. A cam
walker is a removable hard plastic boot, made with
nylon straps that fasten around your calf and foot.
Most cam walkers have an adjustable hinge at the
ankle that can be set to allow the range of motion
your physician prescribes. The sturdy bottom of
the cam walker is rocker shaped, which enables you
to walk. Most patients wear a cam walker for two
weeks and then go into a cast shoe. This open-sandal
shoe has a hard, plastic bottom that does not bend.
When wearing the cast shoe, your foot does not flex
when you take a step, which takes pressure off your
fifth metatarsal. If you are not in a lot of pain,
your physician may skip the cam walker and instead
put your foot into a cast shoe. Treatment is a gradual
process of weaning yourself from the cam walker,
to the cast shoe, and then back into normal shoe
wear. v=PAT&doc_id=29" target="_new">William
G. Hamilton, M.D., team physician for the New York
Knicks and New Jersey Nets.
Most people do not need formal physical therapy
to recover from a fifth metatarsal fracture that
has not required surgery. Before you return to normal
shoe wear, your physician usually instructs you
to steadily increase your weight bearing exercises.
As pain permits, begin with short walks one to two
weeks after the injury while wearing your cam walker
or cast shoe. The key is to avoid pain. Do not walk
distances that cause discomfort in your foot. After
a few weeks, you may be able to ride a stationary
bicycle with your cast shoe on to help improve your
fitness. Upper body workouts and swimming also can
increase your cardiovascular fitness. As pain decreases,
slowly increase the duration of your walks. A safe
way to increase your workouts is by 10-percent increments.
For example, if you walk one mile on Saturday, continue
walking one mile for about a week, and do not go
further than 1.10 miles on the following Saturday.
If your workout causes pain, decrease its intensity
or duration. Your fracture usually takes about six
to eight weeks to heal before you can return to
normal shoe wear. Most patients can return to sports
and activities about ten weeks after the injury.
Test your foot strength before returning to strenuous
activities. You should be able to run, jump, and
cut side-to-side without pain. If your foot continues
to hurt, speak with your physician before returning
to activities, as you may need further treatment.
v=PAT&doc_id=29" target="_new">William
G. Hamilton, M.D., team physician for the New York
Knicks and New Jersey Nets.
To prevent complications after a fifth metatarsal
fracture, it is important to make stretching and
strengthening exercises part of your everyday routine.
A strong and flexible foot will be less likely to
suffer reinjury. Though it is hard to avoid accidents
that cause traumatic injuries to your foot, you
can be cautious during your training and activities
to avoid drastic increases in the duration or intensity
or your workouts. Your fifth metatarsal should heal
and return to full strength, but if you feel pain
return, especially after a period of overuse or
high intensity training, you should visit your physician
as soon as possible.
Finding a shoe with the proper shape and support
for your foot can help prevent abnormal foot strain.
Your athletic shoes should have good shock absorption
in the heel, good flexibility, and sturdy materials
to prevent side-to-side motion. Try to minimize
the time you spend walking in unpadded dress shoes
or boots. If your physician has prescribed orthotic
inserts, you should continue to wear them in all
your shoes. Based on your activity level, shoe inserts
may wear out within six months and need to be replaced.
v=PAT&doc_id=29" target="_new">William
G. Hamilton, M.D., team physician for the New York
Knicks and New Jersey Nets.
