Question
Dear Dr. Bodart,

Three weeks ago I fell down after a jump in ballet class.  I immediately knew something was wrong, iced it, and went to the ER.  After X-rays, I found out that I had a displaced fracture on the shaft of my fifth metatarsal.  The ER doctor called in an orthopedic surgeon to confirm, and he suggested to have surgery because of the amount that it was displaced.  About 5 days later after the swelling went down, I had the surgery where they put in a plate with 6 screws.  

For the past 2 weeks I have been working from home, keeping my foot elevated almost all the time, and using crutches around the house.  Overall, the pain levels and swelling have decreased except for a tingling feeling when I move my foot in certain ways.  The doctor said I could start walking on my heel, but I'm hesitant to put any weight on my foot.  He advised me not to put full weight on my foot for 4 weeks.  

I was hoping that you could give me advice on how to transition from complete non-weight bearing to regular walking.  Would it be beneficial to start using an Aircast Walker boot for partial weight bearing?  Could I start using that at the 3 week mark with crutches and then slowly transition to without crutches by the 5 week mark?  I have read that using a stationary bike is also helpful in the recovery process.  At what point do you think it would be ok to use the bike?

I look forward to your response.  Thank you in advance.

Answer
Hi, Tiffany,

So sorry to hear about your injury!  I'm glad you got it checked out right away.  I would definitely do your best to stay off it for the four weeks as directed, because it typically takes 4-6 weeks for a fracture to heal.  Resuming activities too quickly can disrupt the healing process.  A walking boot can be very helpful during the transition to normal walking, although I would check with your surgeon about using it (definitely with crutches during the third week, if that's what you choose to do) in the time period that you have suggested.  It's definitely more bulky than a surgical shoe and would probably be much harder to walk on your heel in a boot, but once you can begin putting weight on it, the boot does give some overall support to your foot.  It might put too much pressure on the 5th metatarsal overall, however, so I'd ask your surgeon.  My recommendation for the bike is to wait until your doctor tells you that the bone is totally healed and you can walk in sneakers without pain.  Again, too much motion can disturb and prolong the healing process.

I hope this helps, and may you heal quickly with as little pain as possible.

Wishing you health, happiness, and peace,
Dr. Bodart