Fractured Metatarsal

[RefereeX]

Probably shutting the stable door after the horse has bolted here, as I completed my first match on Saturday post injury... but... inspired by @KentRef to start a thread... I'm wondering if any medical experts or on the off chance someone has had similar can offer some advice...

I was out running in the dark mid December, landed funny and turned my ankle. My right foot went down on the outside of the foot basically. I thought it would just be a sprained ankle but I had a big egg appear on the side of my foot further forward than the ankle and the pain was in my foot, not my ankle. I went to get an x-ray after a day of hobbling around and was told I'd fractured the base of my 5th metatarsal

As a keen runner who was targeting a 2:50 marathon in April and also a level 3 referee... this wasn't ideal obviously.

I was given a 'beckham boot' and told to wear it for 6 weeks. Full disclosure and at the risk of sounding like a moron... I wore it for 2 weeks and then it felt fine to walk without it. I was at the stage where i only got pain if I put my full weight on the front right hand side of my foot. Even during the 2 weeks I had the boot on I took it off to do some cycling at the gym to try and maintain my fitness level.
4 weeks after injury, it felt okay to do a gentle run, but after 2 gentle runs I had a lot of pain in the other side of my foot which made me think I'd adjusted my gait subconsciously, so I stopped the running and waited 2 more weeks, then some horrible illness kept me off it for almost another week.

I also got another x-ray which I was told no further action was required on.

I then returned to running. relatively pain free. But then after a couple of runs I noticed swelling and discomfort where the fracture was again. And basically that's been the case since. I can do a couple of days worth of good intensity exercise no problem, but then I have to rest for a couple of days while the swelling and pain goes.
I got through my first match back on Saturday with no issues on a very soft pitch, then ran just over 15km at 3:52/km yesterday, so fairly high intensity, but this morning I couldn't do a recovery run because my foot needed resting.

My question is, is this as a result of trying to come back too soon / not following doctors advice properly, or is this a case of this is something that's gonna take a very long time to settle down and I'm just going to have to manage it for a while? Dr Google said I could have discomfort and swelling for up to a year post-injury, but nobody from our NHS has told me anything like this.

 

[es1]

as someone who is always far too eager to return to action too early...you've 100% done the same. Get it rested man, follow the advice, it's not worth it...if you come back too early you run the risk of developing more serious chronic issues if things aren't allowed to heal properly...

I'm very much a hypocrite typing this as i've been playing racket sports with an elbow injury for 6 months and not followed any advice...

 

[RefereeX]

as someone who is always far too eager to return to action too early...you've 100% done the same. Get it rested man, follow the advice, it's not worth it...if you come back too early you run the risk of developing more serious chronic issues if things aren't allowed to heal properly...

I'm very much a hypocrite typing this as i've been playing racket sports with an elbow injury for 6 months and not followed any advice...

Haha, while I agree that on the face of it this is the obvious answer, what I don't want is to be in a position where actually it is just something that's gonna settle down over time but won't go away just by resting yet I rest for ages and in 10 weeks it's still exactly the same.

I got through my football match fine, so I don't see any reason why I can't at least see out the season, get a couple of observations in etc to help me for the annual merit table (if not the current season's) and then maybe see if I think it needs that rest after April.

 

[Archer]

Time to take Ol' YellerX out back.

 

[es1]

Haha, while I agree that on the face of it this is the obvious answer, what I don't want is to be in a position where actually it is just something that's gonna settle down over time but won't go away just by resting yet I rest for ages and in 10 weeks it's still exactly the same.

I got through my football match fine, so I don't see any reason why I can't at least see out the season, get a couple of observations in etc to help me for the annual merit table (if not the current season's) and then maybe see if I think it needs that rest after April.

is that worth the gamble though? what if by doing this you end up being out for 3 or 4 months later in the year?

are the merit tables influencing your decision making here...?

 

[RefereeX]

is that worth the gamble though? what if by doing this you end up being out for 3 or 4 months later in the year?

are the merit tables influencing your decision making here...?

No. My keenness to return to sport and not lose my fitness level is. I've lost about 10 secs per km on my distance running already!

I guess at the moment I fear wasting time waiting for the pain / discomfort to go away when in reality it won't, it's just something that will only go very gradually and I could have just carried on and managed it more than I fear putting myself out longer by overuse.

 

[RefereeX]

Time to take Ol' YellerX out back.

Feel like I'm missing something obvious here but you're gonna have to explain this one to me

 

[Archer]

Feel like I'm missing something obvious here but you're gonna have to explain this one to me

Well, spoiler alert for a mid-50s book/film...

Spoiler

Beloved and adorable adopted former-stray golden labrador ('Old Yeller') goes on adventures, scrapes and japes with young lad Travis, but then catches rabies and Little Timmy Travis has to take his father's gun, plus the dog, out back to... err.. do the deed. AND EVERYONE CRIES FOREVER

 

[es1]

No. My keenness to return to sport and not lose my fitness level is. I've lost about 10 secs per km on my distance running already!

I guess at the moment I fear wasting time waiting for the pain / discomfort to go away when in reality it won't, it's just something that will only go very gradually and I could have just carried on and managed it more than I fear putting myself out longer by overuse.

hmmm...tough one. Get yourself to a physio and listen to what they say would be my advice.

 

[Kent Ref]

Get well soon.

 

[ARF]

My question is, is this as a result of trying to come back too soon

You broke a bone in your foot, and you thought running on it again after a month was a good idea? And then refereeing and running 15k in under an hour in the space of one weekend two months afterwards?

If it's still swelling up and so painful you can't even do a recovery run today, then you need to stop. Do some non/light impact stuff to keep your fitness levels up, but you need to look after it better or you're going to end up reinjuring it, and putting yourself out for even longer.

 

[RefereeX]

You broke a bone in your foot, and you thought running on it again after a month was a good idea? And then refereeing and running 15k in under an hour in the space of one weekend two months afterwards?

If it's still swelling up and so painful you can't even do a recovery run today, then you need to stop. Do some non/light impact stuff to keep your fitness levels up, but you need to look after it better or you're going to end up reinjuring it, and putting yourself out for even longer.

Maybe what I said was slightly misleading. It wasn't so painful that I couldn't physically do a recovery run, it was painful enough that I didn't want to do a recovery run as I thought the best recovery was to rest the foot for a couple of days

I came across this article about Beckham's fractured metatarsal and in particular noticed this paragraph...

With minor fractures it is more a question of pain than permanent damage to the foot," he said. "It is impossible to say for sure so early, but it could be that, after intense treatment and rest for a few weeks, he may be able to get back to play with painkilling injections.

So is my thought was perhaps that it is just a common thing that the discomfort will be there for months to come, but that as long as I'm physically able to cope with that pain, it won't do any further damage. Although I'm also very aware that pain is usually the bodies way of telling you you're about to cause damage to yourself.

 

[JamesL]

Maybe what I said was slightly misleading. It wasn't so painful that I couldn't physically do a recovery run, it was painful enough that I didn't want to do a recovery run as I thought the best recovery was to rest the foot for a couple of days

I came across this article about Beckham's fractured metatarsal and in particular noticed this paragraph...

With minor fractures it is more a question of pain than permanent damage to the foot," he said. "It is impossible to say for sure so early, but it could be that, after intense treatment and rest for a few weeks, he may be able to get back to play with painkilling injections.

So is my thought was perhaps that it is just a common thing that the discomfort will be there for months to come, but that as long as I'm physically able to cope with that pain, it won't do any further damage. Although I'm also very aware that pain is usually the bodies way of telling you you're about to cause damage to yourself.

The one thing I would be worried about more than the foot is what damage will be done elsewhere with the body compensating subconsciously for the pain. Naturally the body will want to avoid the pain points and this might cause biomechanical issues up the chain

 

[RefereeX]

Yeah a fair point that I hadn't considered and one that was explained well by Will at CORE camp about injuries as a result of muscles working harder to compensate for other muscles etc.

Although I will add, for the duration of the match on Saturday I had zero pain. For at least 12km of yesterdays run I had zero pain, it was only the last km or 2 that it began to feel uncomfortable.

 

[Runner Ref]

The one thing I would be worried about more than the foot is what damage will be done elsewhere with the body compensating subconsciously for the pain. Naturally the body will want to avoid the pain points and this might cause biomechanical issues up the chain

This is basically what happened to me and why I had to in essence ‘retire’.

Started off with a slight lower back problem, was refereeing and lining better than I ever had, so carried on. But……. I could do a game on a Saturday and then midweek, and that was as much physical exercise as I could do. For the rest of the week I could barely walk and was getting sciatica etc.

I had a mixture of 2 bulging discs and a tilted pelvis. Other parts of the body compensated for these and basically then made those parts weaker

Be careful @RefereeX !

 

[RustyRef]

This is basically what happened to me and why I had to in essence ‘retire’.

Started off with a slight lower back problem, was refereeing and lining better than I ever had, so carried on. But……. I could do a game on a Saturday and then midweek, and that was as much physical exercise as I could do. For the rest of the week I could barely walk and was getting sciatica etc.

I had a mixture of 2 bulging discs and a tilted pelvis. Other parts of the body compensated for these and basically then made those parts weaker

Be careful @RefereeX !

Pretty much the same for me as well, at least one of the main reasons why I stepped down from L3. I had knee pain that I continually ignored, that led to me compensating and getting injuries in various other part of my body. The knee pain was eventually fixed by switching to barefoot trainers, but in turn that has led to me damaging my Achilles.

If I'd sought proper help instead of ignoring the knee pain I suspect they'd have worked out my biomechanical issues and I'd be in a much better position now and would probably have had much longer at senior levels. Ironically I am now doing that and seeing a podiatrist this week for a full biomechanical assessment.

My advice would be never ignore pain, get it checked out.

 

[The Gump]

This is pretty simple. You can keep ignoring the medical advice but some point you’ll be looking at way longer “off games” than if you just listened to the medical advice.

I completely understand it both personally (played through a Grade 1 MCL/meniscus tear and it became a Grade 2; gutted through Achilles tendonitis and just about got away with it) and professionally (work with sportsmen & women who get injured a lot).

Reality is ignoring medical advice sometimes works, but way more often than not you live to regret it.

 

[NoFoulsAllowed]

I think the negatives are two fold.

Whilst the fracture is healing you want it to heal in the most natural position as possible.

Say as @JamesL said, you are running weird to compensate the injury. Even if minor. The injury might fuse in a crappy shape.

Meaning surgery.

The swelling is likely because you are damage the fuse and your body is flapping.

 

[RefereeX]

Appreciate all the advice and help. It's not what I wanted to hear mind.

A couple of people saying about ignoring the medical advice but part of the point is that, yes I did ignore the medical advice, but now after that 6 weeks has been and gone a couple of weeks ago I've not been given any medical advice.

Do people think physio is the way to go? I don't really want to shed out £100s of pounds just for someone who also can't really tell me why my foot is swelling, and that it's perfectly normal after this injury if you know what I mean.

 

[Runner Ref]

If it’s still swelling, I’d personally be getting an X-Ray as a first port or call to check the bone has definitely healed.

After that it’s up to you, physio or rest. Money for physio may seem a lot, but if you get it wrong, you could end up like myself & @RustyRef