Rehabilitation After Metatarsal Fractures: Common Concerns

Questions about rehabilitation for fractures of the second, third, and fourth metatarsals?

Hello Dr.
Lee, two months ago I injured my foot, resulting in multiple fractures of the 2nd, 3rd, and 4th metatarsals.
After six weeks of being in a cast, I have now completed two weeks of rehabilitation.
I have a few questions I would like to ask, thank you!
1) In the first week after the cast was removed, I felt no discomfort when pressing on the bones of the top of my foot.
However, starting this week, in the second week, I have experienced slight soreness and pain when pressing on the same area.
Is this a normal phenomenon caused by rehabilitation therapy and walking exercises, or could it indicate that the bones have not healed? Today, during my follow-up appointment, the orthopedic doctor said that the X-rays looked normal, but the pain upon pressure suggests that healing may not be complete.
Since I did not experience pain when pressing in the first week after the cast was removed, I am feeling a bit confused now.
2) Can I walk without crutches at this point? Currently, I am using crutches to assist with walking, as the physical therapist is concerned about putting too much weight on my foot.
However, the orthopedic doctor said that I could walk without crutches.
I would appreciate your advice on this matter.
Thank you for taking the time to respond! Thank you.

Ms. Shi, 30~39 year old female. Ask Date: 2020/08/21

Dr. Li Yanheng reply Rehabilitation

1.
The pain is likely caused by instability due to soft tissue injuries such as ligament and tendon damage after starting to practice walking.
Once the bones have healed, you may undergo prolotherapy for the ligaments and tendons to enhance stability.

2.
Whether or not you can bear weight needs to be assessed by your physical therapist based on your specific condition; it cannot be answered online.

Reply Date: 2020/08/21

More Info

Rehabilitation after metatarsal fractures can be a complex process, and it's understandable to have concerns during your recovery. Let's address your questions one by one, and I'll provide some additional context regarding the rehabilitation process for metatarsal fractures.

1. Pain upon Pressure: It's not uncommon to experience some discomfort or pain in the area of a metatarsal fracture after the removal of a cast. The initial absence of pain when pressing on the area could indicate that the surrounding soft tissues were still healing and that the bone was beginning to stabilize. However, the onset of pain during the second week of rehabilitation could be attributed to several factors.
First, as you begin to engage in rehabilitation exercises and start walking, the increased activity can lead to soreness in the muscles and soft tissues surrounding the fracture site. This is often a normal part of the healing process, as your body adjusts to weight-bearing activities after a period of immobilization.
Second, while your X-rays may show that the bone is healing well, the presence of pain upon pressure could indicate that the bone is still in the process of healing or that there is some residual inflammation in the area. It's essential to communicate with your healthcare provider about this pain, especially if it persists or worsens. They may recommend modifying your rehabilitation exercises or adjusting your activity level to ensure that you are not overloading the healing bone.

2. Use of Crutches: The decision to use crutches or to walk without them should be based on your comfort level and the advice of your healthcare provider. If your doctor has indicated that you can start walking without crutches, it may be a sign that your fracture is healing adequately. However, if you still feel unstable or experience pain while walking, it may be wise to continue using crutches until you feel more confident.

It's important to listen to your body during this phase. If you experience pain while walking without crutches, it may be beneficial to use them for a little longer. Gradually increasing your weight-bearing activities while monitoring your pain levels can help ensure that you do not jeopardize your recovery.

Additional Considerations for Rehabilitation
- Physical Therapy: Engaging in physical therapy is crucial after a metatarsal fracture. A physical therapist can guide you through exercises that promote strength, flexibility, and balance. They can also help you develop a personalized rehabilitation plan that takes into account your specific injury and recovery goals.

- Gradual Progression: It's essential to progress gradually in your rehabilitation. Start with gentle range-of-motion exercises and gradually increase the intensity and duration of your activities as tolerated. This approach helps prevent re-injury and promotes optimal healing.

- Pain Management: If you experience pain during rehabilitation, consider discussing pain management strategies with your healthcare provider. They may recommend over-the-counter pain relievers or other modalities to help manage discomfort.

- Monitoring Healing: Regular follow-ups with your healthcare provider are essential to monitor the healing process. They may perform periodic X-rays to assess the status of the fracture and ensure that it is healing correctly.

- Long-term Outlook: Most individuals can expect a full recovery from metatarsal fractures with appropriate rehabilitation. However, it's essential to be patient, as healing can take time, and everyone's recovery timeline is different.

In summary, while some discomfort during rehabilitation is normal, it’s crucial to stay in close communication with your healthcare provider and physical therapist. They can help you navigate your recovery and ensure that you are progressing safely. If you have any further concerns or if your symptoms change, do not hesitate to reach out for medical advice.

Similar Q&A

Rehabilitation Tips for First Metatarsal Fracture Recovery After Surgery

Hello, I would like to ask about my condition. I sustained a fracture of the first metatarsal with a closed fracture and joint collapse after a car accident on November 2nd. I had surgery on December 5th, and the doctor has now removed the cast. I would like to know about rehabil...

Dr. Hong Ximing reply Orthopedics
Foot fractures can lead to joint stiffness post-surgery. It is advisable to consult a rehabilitation specialist for appropriate rehabilitation methods. However, the rehabilitation process can be challenging and requires perseverance.

Effective Rehabilitation Strategies for Fractured Metatarsals After an Accident

Since your accident at the end of this month, you have been experiencing soreness, tightness, and pain daily in your fractured second and fourth metatarsals. What rehabilitation should you pursue?

Dr. Zhou Jianwen reply Rehabilitation
First, confirm that the fracture site is properly stabilized before beginning rehabilitation.

Rehabilitation Tips for Recovery After a Fifth Metatarsal Fracture

Description: A fall down the stairs resulted in an oblique fracture of the fifth metatarsal in the left foot, which also exhibited displacement. Following the doctor's recommendation, surgery was performed, and absorbable bone screws were inserted. It has now been five weeks...

Dr. You Dianqi reply Orthopedics
Each person's recovery situation is different. It is recommended to consult your primary physician or seek an evaluation from a rehabilitation specialist. Thank you.

Rehabilitation After First Metatarsal Fracture Surgery: What to Expect

Due to a car accident, I underwent surgery for a fracture of the first metatarsal bone. The procedure was named: "Open reduction and internal fixation of the left foot tarsometatarsal joint dislocation with fracture." The reason for the surgery was the dislocated fractu...

Dr. Chen Yongxue reply Orthopedics
Heel pain is temporary and related to a period of not walking properly. Please apply heat therapy frequently. Stretching, as tolerated, will help improve the condition. The absorbable bone screws do not need to be removed. Thank you.