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Stress fracture 3rd metatarsal - any advice on healing time please?

Discussion in 'Ask your questions here' started by Fionabadfoot, Jun 4, 2024.

  1. Fionabadfoot

    Fionabadfoot New Member

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    I started developing some twinges in my right foot which I sort of ignored. I used to walk 4 to 5 miles per day and just assumed that my feet were a bit achy because of this. Anyway, about 8 weeks ago, I was walking home from work and developed a terrible pain across the top of my right foot, kind of wear the toes join the foot. I could barely walk and ended up limping home.

    I went to A&E (I'm in the UK) and was x-rayed and told that there was no fracture and that it was most likely a tendinitis, needed rest etc... I went home and for the next few weeks I barely did any walking, I followed the RICE protocol but there was no improvement. The pain was mainly present when attempting to weight bear, particularly on the 'toe off' stage of walking when the toe comes up off the ground. There was a tender area at the base of my 3rd and 4th toe which was also bruised. The whole top of my foot would become swollen by the end of the day.

    After 3.5 weeks I got an appointment at a muskulo-skeletal physio clinic via an NHS self-referral route, and thank god I did as the practitioner more or less immediately said 'stress fracture'. This was then confirmed by x-ray. I was given an Aircast boot and told that healing time was 8-12 weeks. My follow up care would be with the orthopaedic outpatient clinic. The physio implied that I should have a follow up appointment quite soon and that he would get the referral done the same day. I was sent on my way and told to wear the boot for comfort, but to take it off at rest, bedtime etc... I was given no further instruction at this point.

    I've now been wearing the boot for almost five weeks and have my follow up appointment in a week's time - six weeks on from getting the boot, 9.5 weeks from the initial pain. This will be my first appointment with an actual orthopaedic expert!!

    I have looked at healing times for stress fractures of the metatarsal but I'm unsure where I am on the journey given the delay in diagnosis and the initial time without the boot. I can walk around inside the house in normal footwear, okay on stairs etc... but that's just pottering really. When I've tried to walk outside in normal shoes (trainers) I'm still getting pain in the exact same area. It's no longer tender there to touch and no longer swells up, but it's just the weight bearing and walking normally that is still painful.

    Am I expecting too much at this stage? Hoping to get some answers at my appointment next week, but getting impatient!!

    Thanks for reading.
  2. poddoc

    poddoc Guest

    Stress fractures are caused by repetitive loading. For some reason one of your metatarsals is getting more load than some of the others. The healing time will be related to how much load there is on the metatarsal. A boot will not necessarily reduce load each step you take. However, it does make it a lot harder to put in mileage, so it can reduce load that way. You can reduce load on a metatarsal by altering the insole of the shoe. If you have a shoe with a removable liner you can pull it out and look at it and modify it. Often, if one metatarsal has more load than the rest there will be a lot more wear of the liner under the painful metatarsal. You can create "hole" under the painful metatarsal by adding 3-5 layers of moleskin on the left and right side of the worn area of the insole.
    Fionabadfoot likes this.
  3. Fionabadfoot

    Fionabadfoot New Member

    Thank you for taking the time to respond.
    I do feel that the boot has helped and I can walk in it without any pain at all. it has a rocker base which prevents me from putting weight through the affected area. I have walked a lot less than I usually do in it, so hopefully that will have helped too.

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