Heartbreak of a Bone Break

So it has been quite a while since I have posted anything, due in part to how busy I have been! I spent four weeks away at a summer intensive and had the most amazing experience. By the end, I felt like I had learned so much more and was really at the top of my game to go into this fall as a new dancer.

So it was kind of heartbreaking to break my foot the first day back at my home studio. It’s now been a week since I found out that I have a spiral fracture in my fifth metatarsal. I made it all through class feeling really great until grand allegro, when I landed on the outside part of my foot and heard a loud CRACK. I’m pretty sure that everyone else in the room heard it too.

Wisely, I stopped at MedExpress on the way home because I knew that this wasn’t just a sprain of some sort. They put me in a splint with crutches until I met with the orthopedist. The pain was pretty terrible the first day, but after taking many painkillers and icing and elevating my foot, I really didn’t feel anything. A week in, I am taking no painkillers and feeling almost no pain at all.

The orthopedist showed me my x-ray and told me that I have what is called a dancer’s fracture. When I googled common injuries for dancers, I found out it was the most common acute fracture for dancers, though I’d never heard of it before. A dancer’s fracture is when “a small fragment of bone at the base of the 5th metatarsal is pulled off by a strong ligament that is attached to this part of the bone. A Dancer’s fracture causes localized pain, swelling, and difficulty walking.” Also, don’t be surprised if when your splint comes off, you find a big nasty bruise across the top and bottom of your foot. Yuck!

My foot after four days in a splint, before I got my walking boot

My foot after four days in a splint, before I got my walking boot

The picture below is actually one I found on google images that looks very similar to mine, except that mine is the left foot.

Image

So of course the big question was “how long will I be out for?”. The hardest thing about this stage is that I really don’t know. At MedExpress, I was told 4-6 weeks, which I was already practically hyperventilating about. Then, I was given a sheet with recovery stats that said the average time to pain free WALKING was 6 weeks (range, 0 to 16); return to barre exercises was almost 12 weeks (range, 4 to 48); and return to performance was 19 weeks (range, 6 to 52)! It doesn’t sound too great, does it?

The doctor then told me that my fracture doesn’t look significantly hard to heal, since its elongated across the bone rather than a clean break. He also said I didn’t need surgery, which is really great news. They told me I could start walking in a medical boot right away, and as long as I had the boot on my bad foot when I had weight on it, I could start tendus right away. He also said that to keep the small muscles in my feet working, I could try to pick up socks with just my toes. And of course, as long as I was in the boot, I should stay in shape the very best I could. In four weeks, I will be x-rayed again, hopefully for them to tell me that through a miracle, I can start PT and get going again.

So I spent a couple days just feeling really bad for myself. I kinda felt like a raincloud around my bright sunshiney family. But I’ve decided that nothing about that attitude is going to help my foot heal faster or help me regain the progress I’ve made this summer. So I started researching about bones.

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First I learned about vitamins that the body needs to repair bones. By weight, bone is about 70% mineral content (calcium, phosphorus, magnesium, silicon, zinc, and others). The key vitamins I would have to keep in mind are Calcium, Vitamin D, and Vitamin K. Vitamins are essential because they catalyze processes involving the minerals. C, D, and K all lay down minerals in the new bone. One important thing to keep in mind is that taking extra calcium will NOT help you heal faster. You should really just focus on fulfilling the proper amount of calcium you need per day. My doctor gave me a Calcium and Vitamin D supplement from GNC, and I take one each morning with breakfast.

So another biggie with repairing bones is increasing your protein, since almost half of the bone IS protein. Some of the best protein you can get is from plants actually. Some really protein rich foods to add to your diet are soy, lentils, legumes, almonds, and quinoa. If you’ve taken biology, you know that proteins are made of amino acids. One of these amino acids is called lysine, which helps to increase calcium absorption, necessary for the regeneration of tissue.

On that note, now is not the time to limit your calorie intake. Fracture healing requires a TON of energy. Also, healing requires synthesis of new proteins, which is dependent upon plenty of amino acids from dietary protein, which comes from FOOD!

A third thing to focus on is increasing anti-inflammatory nutrients. When the break happens, the crazy rupturing of tissue inside lets off free radicals in your body, which overwhelm the body’s natural antioxidant defense mechanisms. Antioxidants are necessary because they suppress the inflammatory and destructive effects of free-radicals on the body. A way to get in your nutrients is to aim to eat a cup of berries a day, get a lot of leafy greens like kale and chard, or use an omega-3 supplement.

A final thing I didn’t know is to avoid aspirin and ibuprofen because these drugs interfere with your healing. I’m not getting too technical here. The big thing to know is that if your are feeling pain, go with acetaminophen (aka Tylenol).

The good news is that I am young, as my doctor said, and my bones are going to heal a lot faster than a 60 year old’s bones are. This is because with bones, there are two competing cycles: breakdown and regeneration. Osteoclast cells absorb worn-out bone, removing them, while osteoblast cells take calcium from the blood and redistribute it to the bone. Until about age 20, your bones are focused on getting bigger, building bone faster than it can be replaced, making your bones thicker and denser using calcium. When you get older though, the bone-builders cant keep up with the bone-removers. So luckily, as a young dancer, my body is diverting extra repair cells to my fifth metatarsal while my bone is working at a super growth rate.

So how does this whole bone repair thing work? Well, when I first broke my foot, the break also severed blood vessels near the bone causing a clot called a fracture hematoma to form. This helped to stabilize the bone for mending and cut off the flow of blood to jagged bone edges. This way, without fresh blood, the bone cells could die quickly. As a result of removing dead and damaged tissue, swelling and inflammation occurred (and this is when you ice and elevate!). Days later, the fracture developed tougher tissue, making it a soft callus. Fibroblast cells started to make collagen fibers (major protein in the bone and connective tissue). Fibrocartilage then started to form to transform the callus into a tougher fibrocartilaginous callus, bridging the gap between two pieces of bone. This callus apparently lasts for about 3 weeks. Then, osteoblasts will produce bone cells, changing the callus into a bone callus, providing necessary protection and stability for the bone to enter the final stage of healing. Hopefully this is where I am by week four.

*Thank you to all the google sites I found so I was able to learn and paraphrase this information for you!

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It’s a lot of bother, but it makes me feel a little better that I know what is going on with my foot. While I can’t dance, I’m going to take advantage of the free time I have. I’m going to look into swimming, pilates, and exercises I can do from home. It feels like a setback from the peak I was at this summer, but I think that this is an experience that will teach me to take care of – and especially appreciate – my body.

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7 thoughts on “Heartbreak of a Bone Break

  1. Hello!

    I’m so sorry to hear that your foot is broken!! My name is Jillian, and I found your site because I am also a high school girl with a spiral fracture in her fifth metatarsal. I broke it three weeks ago – the first day after I returned from a camp, like you! Although, mine is in the left foot rather than the right, and I broke it three weeks ago on the stairs instead of in dance class. But I digress….

    What I wanted to say is that your post was really helpful, and you made me feel less alone in the woes of ugly medical boots and ridiculous recovery times. I hope that your metatarsal makes a speedy recovery and that you are back on pointe again soon! 😀

    Get well!
    ~Jillian

    Oh – also – if you are interested, I posted about my broken foot on my blog a few weeks ago. So, if you wanted to see the x-rays, they are pictured at jadoredessiner.wordpress.com 😀

    • Hi Jillian!

      I actually just used that x-ray photo to show the break because it is similar to mine. My break is actually in the left foot also! I am so glad that my post was helpful to you! My doctor actually told me that this fracture is so common that people even break their fifth metatarsal by dropping those really heavy shampoo bottles on their feet in the shower!! It’s been just over two weeks, and I am currently pain free in the walking boot. I hope you heal quickly too!

      Molly

  2. Both of your blogs are really comforting to my daughter, who is a competitive Irish Dancer. She is 1 week in the boot (but still on crutches) and her swelling is nominal and her foot is no longer black and blue. She has an appointment with a certified Pilates instructor next weekend (after she is sanctioned to be off the crutches) to start exercises to keep her core strong and hopefully improve her hip strength too. You both are such an inspiration to Katie. It is helping to make this time away from dance a little easier.

  3. Hi-
    This has proved really useful as I am on week 8 of my fifth metatarsal break (photos are on my blog)… I have been hitting the vitamins D and K as well as the Calcium pretty hard… and will now get on the protein after reading this! I am 37 and starting yoga teacher training in two months… this bone really cannot heal fast enough and is really taking its time. I believe, once healed, it will be stronger than ever, so fingers crossed.

    Thank you again,
    Rachel

  4. Reblogged this on padyoga and commented:
    Just thought I’d share this inspiring article by a young woman suffering a similar break to mine who is now working en pointe in ballet. It has loads of sound advice on healing. A great blog, really inspiring.

  5. wow, I usually don’t post on things like this, but Thank You so much for posting this. It’s is going to help me in the long run, i know it. Unfortunately, i have been taking extra calcium pills, hoping to get better faster. I have been in this boot for about 3 months now. I was at track practice, and stumbled over a hurdle, yes i am a hurdler haha! i would have been a 3-time regional qualifier, but due to my left-foot 5th metatarsal injury, it definitely feels like a major sit-back. But anyways, Thanks Again for the information! 🙂

  6. Hi, I just wanted to say, how much reading your website means to me. I actually used to live in Morristown, New Jersey, and am still playing the catch up game in ballet. So immediately i felt a connection. However, when I read what you felt and delt with during your injury really touched me. Two weeks ago I landed a grande jete wrong and ended up with a dancers fracture in my left foot. Right now I am feeling so lost and alone in what I am going through, reading this has changed my whole outlook on my injury, and how I can not only recover, but improve as a dancer. Thank you for writing this, you have helped me so much. 😊

    – Camilla

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