Well, my tri season is shot this year due to a 5th metatarsal avulsion fracture that was fixed with surgery (ORIF).
I’m currently 8-days post-op and see the Dr. on Tuesday for the first followup. Right now I’m in a split/cast and non weight bearing for an expected 3 weeks, then the Dr. is planning for a walking boot for 7-10 weeks. The 7-10 weeks seems pretty long, but I’m willing (but maybe not able;) ) to stay the course to ensure the best recovery.
My question is to some of the Ortho/Podiatrist out there about expected recovery, specifically cycling restrictions. The way I see it, and obviously I’m not ‘informed’, is that a fracture typically takes 6-8 weeks to heal so I would expect to be able to return to cycling after that kind of time frame. I can accept that running may take a longer time due to the inherent trama cause to the foot by running.
What I don’t get is why/what trama cycling would cause. In all honesty, I don’t see why I can’t cycle as soon as the Dr. puts me in the walking boot and removes the weight restriction. Since everything is pinned/plated/screwed in place, and my cycling shoes are as firm/rigid as the walking boot is, how would cycling be a problem in recovery. I understand that pre-operative the tension caused by the ankle flexing on the tuberosity would have delayed/prevented successful healing, but wouldn’t the pins/plates/screws provide the needed stability now?
As I mentioned, I’m trying to be a patient-patient, but I’ve got a very technical, engineer’s kind of thought process and need to understand “why-not” versus “just don’t do it”.
I am not a podiatrist but here is my experience. In Dec of 2013 I had a bunch of bone removed from my right big toe due to lack of motion and pain it was causing. It did not help so in March 2013 they went in again and cut out more and put screws in it to fuse. She told me it was weight bearing and put me in a boot. After about two weeks I would ride a bike but wear the boot for 8 weeks. There was still some discomfort. It kept getting worse and went back to get it checked again. The fusion did not take. I highly suspect it was because of my bike riding. I just got operated on it again. This time they cut the whole joint out and took bone out of my hip to make the two the correct length and have screws and plate holding it together and have my leg in cast for 8 weeks.
Feet are very finicky. My advice is let it heal or you could be out two years instead of one like me.
Do you need surgery? Yours look more displace than mine back in 2012 so keep that in mine. I was swimming the next week and cycling by week three. Running started in week 9 and I was up to 30 miles per week (running) by week 12. An x-ray would probably still show a fracture but I’m not experiencing much pain (none really) so I’m not pushing a surgery.
I purchased a ultrasound bone stimulator online (ebay) to help with blood flow. Also, by week three I ditched the walking boot (Hoka’s are the same height by the way if you want to even out your hips) and purchased some super-stiff mountaineering boots (stiff enough to take a full cramp-on). This gave more mobility than the “boot” yet was just as supportive and protective. I was walking up to 60 minutes in these boots by week 6.
Couple of things: first, most 5th met avulsion fractures are not fixated/ORIF (unlike a Jone’s fx). They usually heal eventually. Having said that and seeing perhaps a hundred of these, I’m glad your surgeon was more aggressive since I find these heal better/faster in the typical type-A athlete this way. As for the stiff shoe vs. stiff boot, the part you are “missing” in the control of the ankle joint. That piece that was avulsed off was because of traction of the insertion of the peroneus brevis tendon. This would not be isolated with cycling, though it would be pretty low stress between the force of pushing on a pedal, a stiff shoe, and a plate with locking screws. Discuss carefully with your surgeon since only he/she knows how tight/close the repair went and how aggressive they might want you to be.
First of all, how did you do this? And second, how’s it going?
I stepped on a rock, rolled my left foot and broke my 5th metatarsal (avulsion) 3 years ago just 5 days before Ironman CDA. The recovery was very long. But I didn’t have surgery so you might be back faster. I was out from June to September with any kind of biking or running. Truly sucked.
I rolled my ankle running and broke the bone. It was an avulsion fracture as well.
Timeline:
2/24 - injury
3/11 - first Dr. visit & xrays
3/12 - CT scan - Dr goes on vacation
3/25 - Dr. followup, schedule surger
3/27 - Surgery, plate + 6 screws including Tendon re-attachment. Non-weight bearing from this point forward
4/21 - Transition to walking boot - Started to bike at this point with the walking boot and modified platform pedals.
5/6 - Transition to ankle brace - Started to bike with regular road shoes & pedals
5/29 - Out of the brace and standard riding, no running yet
6/10 - First casual run with ankle brace and basically back to normal.
