Range of Motion After Foot Fracture

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I fractured my 5th metatarsal four and half weeks ago. It was not displaced and not a Jones fracture. I went in today for my third follow up appointment. Today's x-rays showed that the fracture is filling in nicely. It wasn't completely filled in, but there was definitely new bone growth since my last appointment 2 weeks ago. My orthopedist said I should start walking in my air cast boot and crutches with minimal weight bearing today and work my way up to 100% weight bearing by the time I see him at my next appointment in two weeks.

In my elation about being able to begin the process of walking again, I completely forgot to ask him about range of motion exercises with my foot and ankle. My ankle is very weak after 4+ weeks in the boot. He squeezed my foot today and moved it around today and I was terrified that it was going to hurt, but it didn't hurt! What have others experienced with range of motion after a foot fracture? Should I be working on rotating my foot, flexing my foot and moving my toes over the next couple of weeks leading up to my next appointment?

Thanks in advance for your help!

Anna

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  • Posted

    Hi Anna,  It sounds like you are going GREAT!  When I got out of my cast I went into a boot (I don't know what an air cast boot is) and started doing range of motion exercises without the boot on.  Besides the ones that you mentioned I also leaned the end of my foot to the right and left like a metronome (just the foot not the leg too), sole of the foot in (outside foot edge on the ground-just like how I twisted it) and out (inside foot edge on the ground), and writing the alphabet with my toes.  Now that it's been 9 weeks for me since my break I'm in PT and they added exercises for strength with bands and also balance.  They also are letting me ride an exercise bike and I have an ASO brace for my ankle.  It allows me to fit my foot, with the brace on, into my shoes.cheesygrin  Oh, my doctor also said that water aerobics would be great but I haven't been in a swim suit for YEARS.  I know water aerobics it good for you because it has both boyancy, making exercise easier, and resistance, making the exercise more effective.  Good luck! Dev's Mom
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    • Posted

      Hi Devsmom,

      Thank you so much for your feedback and additional suggestions for range of motion exercises. Also, the ankle brace is a great idea! I need to look into that. I believe water aerobics would be great, but I'm not crazy about the idea of wearing a suit in public. I may need to look into that, however, as well. It's amazing, because sometimes I look at my foot and try to make it move in certain directions, and it's almost like it isn't attached to my body! I really have to really think about making it move the way it's supposed to.

      Another question for you. When you started walking in your boot, did you have any pain? I'm being very careful not to overdo it as I start walking again, but I also don't want to be so slow about it that this process takes months instead of a few weeks. It's a bit more scary than I had imagined it out would be! My orthopedist told me to "let pain be your guide. If you feel pain, stop." Yesterday with one step I took I felt a sharper pain, so then I backed off and was pretty light on my foot. Today I feel some dull aching across my foot at times, but no sharp pains yet. Overall, I've been a bit timid about walking. What was your experience?

      Also, how much did you walk? Right now I'm doing laps walking around the main floor of my house 6 to 8 times a day, but then I resume my spot on the couch with my foot elevated. I want to be sure that I'm doing enough to make progress! I don't want to get in a rut where I end up being a couch potato. I am normally very active and I'm so ready to resume my normal activities. My husband and I have three kids, ages 16, 15 and 12. I love taking our two big dogs on daily 4 to 5 mile walks. My husband and I have planned a trip to Alaska with our kids in early July and we were planning to do several day hikes of 5 to 8 miles each. We may need to scale it back a bit if my foot can't take it, but my orthopedist says I should be in pretty good shape by early July if everything continues to go as well as it has. I'm really focused on healing as quickly as possible so we can enjoy most, if not all, of our hikes in July.

      I hope your healing continues to progress well! With summer just around the corner, I hope you are able to get out and about and enjoy it!

      Anna

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    • Posted

      Having computer problems so will send all that I can get into the message.  When I went into the boot I had 3 week till my next Dr visit and had not been weight bearing at all.  I had a walker (no crutches) and the first week I used the walker to carry half of my weight with my arms and half with my R foot.  Second week I walked with all weight onnn 
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  • Posted

    I have been having computer problems with the patient website. I hate computers.  Must be my age.   BTW, my fracture was a Jones fracture with 3 breaks.

    When I went into the boot I had 3 weeks till my next Dr visit and had not been weight bearing at all prior to that time.I also was kind of scared about weight bearing even though my foot usually didn’t hurt much.

    The doctor wanted me to wear the boot all the time, even to bed so that I would not be tempted to walk without it if I got up in the middle

    of the night. I had a walker (no crutches) so the first week I used the walker to carry half of my weight with my armsand half with my R foot. Second week I still used the walker, but wanted my foot to carry all of my weight 

    so I walked kind of normally, that is weight bearing equally on both feet and I let the walker simply move with me walking for balance and safety.  Third week I eliminated the walker and just walked as normally as I could with the knee high 

    boot on. I did have some trouble with the boot being about an inch higher than my left foot. The first night in the boot was horrible it hurt my foot so much I couldn’t sleep and wanted the cast back.  

    I loosened the strap around my ankle, took some advil, and cried.  The second night I decided to remove the hard plastic L shaped insert that covered the front 

    of my leg (below the knee and down my shin, L at my ankle, and down the top of my foot to the end of my toes).  That helped but I still had to loosen the strap around my ankle.

    After 3 weeks in the boot I was very used to it and was so glad to be able to get around, if someone could drive me somewhere I walked and walked as much as I could.  But, like you when I sat down I also elevated my foot.

    It was either walking around doing chores , grocery shopping, out with friends, whatever OR foot up!  By the time I went to the doctor and had no clue what the next step would be so I was shocked when he told be that I didn’t need anything. 

    You might be there now because you were doing so good.  I wasn’t prepared for that news and didn’t have shoes to put on and left the Dr. In my boot with that ASO brace in my purse.  At first I was scared to walk without the boot and I think

    I put the brace on too tightly because walking hurt more in the brace then out of it.  I think that was because the brace didn’t let my ankle bend forward as much as it should for a normal walking gait.  The physical therapist said I didn’t really need 

    the brace except that it would be a good idea to wear it if I was walking on uneven surfaces like hiking!  I’ve been wearing it gardening and to my 2 X’s weekly “senior” exercise classes.  As far as how much did I walk.

    I walked until I was done with what I wanted to do or was too tired out.  It was not miles a day like you were used to and it was not like I was used to with 4 X’s weekly exercise classes.  My before fall 3 X’s weekly step aerobic class might have equaled 3-4 miles.  

    Now not at all so much activity.  Weight up 5 lbs.  Grrr  The changes I’ve seen walking “normally” ha ha again is that my foot swells up and is a sunburned color.  I still elevate my foot during the day when I’m sitting and sleep with it on a pillow too. 

    Sometimes it’s pretty normal looking and other times fat and red.  It’s a mystery.  I don’t consider were the breaks occurred to be painful.  Except for the 3 or so days after the fracture I didn’t  have too much pain. 

    Sometimes I feel a bit of a throbbing more on the top of my foot and I ignore it during the day and take Advil at night so I will sleep OK.  I really think at this point it’s my ankle and big toe that hurt more than my foot. 

    My toe hurts when I push off to step forward and my ankle with the normal bend also walking forward.  Because of this I have to concentrate to be able to walk (with some pain) with a normal gait.  

    If I don’t think about it I find myself leaning more to the left side when I’m on my left foot and then swinging my right foot forward with a bit of an outward curve rather than totally straight forward movement.  

    If I swing the right foot I don’t have to bend my ankle forward or push off from my big toe.  The PT said the xrays show arthritis in that toe.  Didn’t bother my before.  

    I think you should keep up with the stretching exercises, follow Doctors orders, go to PT and do their strength exercises and see what happens.  You may very well be able to hike on your vacation as much as you would like. 

    Get GOOD supportive hiking shoes and don’t push yourself.  

    I’m sure they have lovely spas in Alaska.  How about a relaxing massage and facial with some wine while the others hike??  

    Take care and be glad you’re active and youthful and not pushing 70 like me this year.  Regards,  Dev’s Mom

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    • Posted

      Devsmom,

      Thanks so much for sharing your experience with me. It's good to be able to share experiences and know that my experience is similar to those of others.

      I've been working on my range of motion exercises with my foot and ankle over the last two weeks and it has improved quite a bit. It's been almost 2 weeks since my last orthopedist visit when I started weight bearing. The orthopedist had said to try to be 100% weight bearing by my next appointment, which is tomorrow. I've managed to move to one crutch, so 75% weight bearing, but I likely won't be ready to walk with just the boot and no crutches by tomorrow's appointment. It shouldn't be long, though. I really struggled moving from two crutches to one. My ankle is so weak and, on top of that, I think I also had developed a bit of plantar fasciitis, because every step I took felt like I was walking on Legos or like there was a screw in my boot! I even checked at one point to see if a rock had ended up in my boot. No rock. I ended up looking up some physical therapy exercise videos for plantar fasciitis online and it's gotten better. The ankle is still weak and is going to take some work!

      I'm hopeful that I'll be ready for my shoes soon - if not tomorrow, then sometime this week. As soon as I'm given the green light to transition to shoes I am going to do as you suggest and invest in a very good pair of shoes.

      Also, I seem to have the same lingering swelling issues that you are experiencing. I wish the swelling would go away. My foot usually looks fairly good first thing in the morning, but it swells up and gets pink once I start walking on it. My entire foot swells, including my toes and ankle. I'm hoping this goes away in time.

      I wish you continued healing and a swift return to your pre-injury activity level!

      Anna

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