Here’s a question I get pretty often: why feet? And I answer, because I love feet. And usually I’ll add a comment about how it’s a good thing I’m not a gastroenterologist or a urologist or something along those lines.
The Sochi Olympics are in full swing. And it sure is thrilling. Skiing, figure skating, bob sledding, and that great Olympic tradition - curling. Ok so what exactly is that sport? Because I’ve swept a few floors in my day, I might just be qualified. But I digress. The news was filled last week with the thrill of victory and the agony of de-feet (couldn’t resist). And one particular injury is especially intriguing to my NYC podiatry patients - the fractured metatarsal sustained by Poland’s Justyna Kowalczyk, followed by an amazing gold medal win only two weeks later. So what kind of injury is this and is a similar recovery possible for us mere mortals?
As we have previously discussed other fascinating and thought provoking blogs, the metatarsals are the long bones of the foot. The fifth metatarsal sits on the outside of the foot, and because of its position it is subject to unique stress in twisting injuries of the foot. A sudden snap of the foot, such as when stepping off a curb or coming down from a layup can pull the tendon that inserts onto the base of the metatarsal, which is the part of the bone that sticks out of the middle of the outside of the foot. With enough force, the tendon can pull a piece of the bone, which is known as an avulsion fracture. A less sudden, more gradual twist, such as a sports injury, may result in a torqueing injury of the shaft of the metatarsal, producing a fracture pattern that looks like Justyna’s X-ray.
Now despite the multiple fracture fragments, Justyna’s fracture should heal remarkably well. In fact, a recent study confirmed that even fifth metatarsal shaft fractures with some displacement of the fragments, meaning the bones are not quite lined up, almost always heal very well with conservative treatment. In my NYC podiatry practice this means partial weight bearing in a CAM walker type of fracture boot for 3-6 weeks, depending on the severity of fracture and age, activity level, and bone quality of the patient, and then back into a comfortable shoe. And although most of my NYC podiatry patients are not former or current Olympic athletes, they will almost invariably resume full activity, somewhere between 2-3 months after the injury, with low impact exercise commencing within 2-6 weeks after injury.
So, to answer the question, could someone recover so quickly and go on to win gold? Well, I think we have seen the answer is a resounding yes. And I think that with the right motivation, and perhaps a strategically placed and timed injection, any of my NYC podiatry patients could achieve a similar feat with their feet. I can’t guarantee a gold, but skiing in a closed boot, which essentially mimics a fracture boot, two weeks after a fracture is definitely feasible. But don’t necessarily take my word for it, I’m the idiot who skied half a day on a torn ACL (and yes, I’m still running).
See you in the office.
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