David Beckham has done it, so has Michael Owen and now Wayne Rooney has fallen foul of what has been the curse of many a footballer, a broken metatarsal bone, for the second time. SCP podiatrist Nicola Blower assesses his chances of playing in the World Cup this summer.
Society podiatrist Nicola Blower, who works at Preston’s Physiotherapy and Health Clinic, and is co-head of Hospital Podiatry at Queen Elizabeth Hospital in King’s Lynn, treats clients who are experiencing pain in their lower limbs.
Here she answers the questions that have been perplexing England fans.
What and where is a metatarsal bone?
There are five metatarsals in each foot. They move and act differently depending on whether the foot is in a flat (shock-absorbing) position or high-arched (pushing) position.
When the foot is flat, they spread and move around more freely and when the foot is in a high-arched position, they are more rigid and less likely to move.
They attach in joints with the toes towards the end of the foot, allowing your toes to bend and make-up part of the “arch”, towards the middle of the foot.
Various tendons and muscles attach to the metatarsals, and where the metatarsals form part of a joint they are covered with ligaments and joint capsule.
What causes a metatarsal fracture?
Technically, any of the five metatarsals can “break”, but the second, fourth and fifth metatarsals are more common sites. The commonest type of fracture is a stress fracture, which is an overuse injury. It occurs when muscles become fatigued and are unable to absorb shock and repeated impacts, or when there is increasing pressure to the bone.
Over time this stress/pressure to the bone results in a small crack (a stress fracture)/ However, full-thickness bone fractures can also occur in the metatarsals.
What’s the treatment?
The bone needs to heal, so it needs to have pressure taken off it in order for this to happen, otherwise, the continued pressure will cause the fracture to worsen and may lead to long-term problems.
In stress fractures, no surgery is necessary, but in full fractures, part of the bone may have moved and this may need fixing surgically with a pin or a screw if good alignment of the bone cannot be achieved without this.
However, in most cases, the foot is put into a fibre glass cast or an Aircast Walker (Beckham Boot). Until x-rays show that the fracture has healed.
An Aircast boot, which Wayne Rooney is pictured wearing far left, allows the patient to weight-bear on the foot, without putting excessive pressure through the site of fracture, thanks to inflatable aircells at the front, back and sides, which hold the leg and foot in place and due to a curved sole, which allows the foot to rock forwards, rather than bend at the ankle.
How long does it take to heal?
At least six weeks, but this depends on the patient’s fitness and ability to heal. In the case of Wayne Rooney, his body should be able to heal the fracture well, so long as he does not put too much pressure on it too soon. He will also have access to state of the art technology such as Oxygen tents and nutritional support, which will enable the bone to heal more quickly.
Soc Chiropodists & Podiatrists 30-May-2006
Categories: Sports, Footnote
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