From a reader:
“I fractured my fifth metatarsal and, after attempting to heal naturally for a couple weeks, I ended up getting it fixed surgically, with a titanium plate. Ten weeks after the injury occurred, I finally was able to walk again, using a cam boot and cane. I have no balance issues, but the pain was pretty severe. I’d say it ranged from 7 or 8/10 at first, and now, a week later, it’s around 5-6.
I’m wondering if you have a sense of when my foot will feel normal again? As in being able to maybe take a jog, or chase my cat?”
How long the pain lasts can differ from case to case, but from these descriptions, several ideas come to mind. However, anything I say here is obviously trumped by your podiatrist, who has seen you and directed your care.
You say that you are now at 11 weeks post-op, and you only began mobilizing the foot/ankle last week. My guess is that the area of the heel, where the achilles tendon anchors, has become tight and somewhat adhesed. This creates inflammation in the area. Also, I would bet that the soleus muscle has an active trigger point which needs to be deactivated, and that the muscle needs to be mobilized and rehabilitated.
The reason that I say the soleus muscle, in particular, is that the referral zone for the soleus is nearly unique to that muscle. It looks like this (see TrP1 in the diagram):
Keep in mind, 10 weeks (2.5 months, roughly) is a LONG time for your foot to be immobilized. Muscle / connective tissue that has been damaged begins to heal, literally, overnight. Unfortunately, when there is bony tissue fracture or damage that requires immobilization, the soft-tissue takes a backseat to healing the bones completely, which results in the soft-tissue being pretty darned stiff and sore when you begin to re-mobilize.
Here’s what I recommend to those who present with this type of complaint:
- Heat the foot and calf with a hot water/epsom salt soak for 10-15 minutes to dilate the blood/lymph vessels and reduce swelling in the joints.
- Use a rolling pin (yes, that’s right, like for pastry) to roll across the soleus muscle and compress the trigger point (“X”, above, for TrP1). You can also use the Tiger Tail, a cool new tool I learned about:
- Use a tennis ball or other compression ball (not too small or hard!) to roll the foot and heel on, to massage it.
- Take the foot, ankle and calf through a more challenging series of motions, such as “drawing the alphabet, A-Z” with the foot.
- If still sore, either use an ice pack or a lidocaine cream on the heel (only, not the ankle or calf, and please clear with your podiatrist first):
The ice or 4% lidocaine will temporarily deaden the superficial sensory nerves, and hopefully lessen the soreness.
I also recommend walking on a soft surface (such as sand or with your body supported in water) very slowly and barefoot to maximize mobility and minimize impact and weight-bearing to the heel.