We tend not to take the screws out because it confers more strength on the bone. With a Jones fracture, if you put a screw up the middle of the bone and it heals up, I’ve never seen a re-fracture after that. Is that part of your body vulnerable going forward? The one thing that can happen with elite sportspeople is that they try to get back too quickly and that can lead to a recurrent injury to the foot. If they’re managed well, they don’t usually have setback injuries. And finally work on getting them back to full fitness before they’re allowed to get back to playing football. When you’ve first broken it, the physio is simply trying to keep the swelling down, and as the healing progresses, the physios are going to put them through their paces, get some strength back and get the range of motion back in any joints that are stiff. So, you’re likely to see a player in a boot with crutches, which enables them to get from A to B without too much pain. We just treated him in a boot and he was back after about nine or 10 weeks, but he had physio all day every day for about that length of time. I remember John Terry having multiple little avulsion fractures in his foot. And obviously, if they have surgery, then you’ve got to wait for wounds to heal before you can start the rehabilitation process. It all depends on what you have done, but whether there’s an operation or not, they’re usually going to be in a boot with crutches. In these cases you have to put metalwork in and then take it all out, so the recovery from all of that is at least six months. And if you end up having surgery, it’s more likely to be six months, especially if you have a Lisfranc injury that’s unstable. Very few people will be back within three months. But that wasn’t a conventional metatarsal fracture I think he pulled off a tiny flake of bone. When Wayne Rooney had his fracture before the 2006 World Cup, he got back and played within seven weeks. It’s not pain like getting crushed by a bus, but it is the moderate-to-severe pain associated with any significant fracture. And suddenly it goes crack, and it hurts. With a Jones fracture, they may get some symptoms for a few days or even weeks beforehand, thinking, there’s something wrong with my foot, but I don’t know what it is. But they won’t collapse to the ground, they just can’t run around. But for example, with a Lisfranc injury when you pop the ligament and pull off a little piece of bone, often, people will go, ‘Oh, I think something’s happening to my foot’. You’re not going to fracture your foot and not know about it. And that’s when you get Lisfranc injuries. The other injuries tend to occur as a result of twisting injuries or a very heavy fall on the foot. It’s actually very rare for someone to be stamped on and fracture a metatarsal, but it can happen. These also often need an operation because it has a nasty habit of not joining up (if left to heal). The fifth metatarsal is the sticky-out bit on the outside of your foot, halfway between your ankle and your toes. These can be devastating injuries and often require surgery.īut the most common football injury I have seen over the years in terms of metatarsal fractures is a stress fracture of the fifth metatarsal – also known as a Jones fracture. A Lisfranc injury is usually a ligament injury in the mid-foot with small avulsion fractures, which are little bits of bone that pull off the metatarsals. The terms you’re likely to hear are avulsion fracture, which is when a little piece of bone pulls off a stress fracture or a Lisfranc injury to the foot. What terminology will I hear?Īside from a reference to David Beckham (who famously fractured his second metatarsal in the run up to the 2002 World Cup), you’re only really likely to hear ‘they’ve got a fractured metatarsal’, but that’s a bit like saying ‘there’s a flower growing in your garden’. So basically, a metatarsal fracture is any break of a metatarsal, and there’s lots of different types. If you’ve got a teacup that you’ve just driven over with a steamroller, you’ve still got a broken teacup, but you’ve got a completely different problem to deal with. The analogy I use is, if you’ve got a teacup and it’s got a crack in it, it’s technically a broken teacup.
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