It's open for comment. I've never had a lifter with this problem, but my sense is that doctors almost always fail to appreciate the contribution of stress to the healing process.
Member
Let's Talk About Broken Feet
I searched the forums, only to find anecdotal accounts of foot injuries. I'm surprised Ripp hasn't had any clients that have had one, at least, that I can find. I posted this in the Injuries section but got little feedback, so I wanted to open it up.
I broke almost all of my metatarsals and cuneiforms after an unfortunate accident. After viewing my CT scan the doctor decided to put me in a cast, to be re x-rayed again on the 14th. Since then I've been doing my research and hearing a lot of horror stories about the foot rebreaking easily and knowing the entire rehab philosophy over here, I gather that it is because we don't allow the foot to heal under normal circumstances.
But there's a fine line between reinjuring the foot during the recovery and letting it heal under normal use, and I'm having a hard time approaching it. I'm on crutches and he told me no weight bearing activity, but im slowly trying to put weight on it as I sit --- never standing. My arches are extremely sensitive right now since the breaks are all along the insertion point. Before I got casted it was difficult pointing my toes in the air and my arch was tight. I move my toes a little more each day but if I extend them too far I feel pinches in my arches.
If my X-ray goes good on the 14th, I think I'll move to a boot and I'm going to question my doctor about air squats -- either in or out of the boot. He estimated I'd be sidelined for 3 months, total.
I'm looking for personal stories and tips, but I'd like to talk about this rehab process in general.
For instance, I have good arches. But the cast is administered in a flat foot position, which doesn't make sense to me. Why would we want the foot to heal in an unfamiliar position?
Second, since my arch is so tight right now, restricting it's movement is going to heal it in an overly tight position, wouldn't it? I feel like I should be moving it, daily, over a good range of motion but the cast permits it.
Anyway, that's my rant.
TMPHBITEU
It's open for comment. I've never had a lifter with this problem, but my sense is that doctors almost always fail to appreciate the contribution of stress to the healing process.
Member
Having spent the past year getting metatarsal stress fractures healed, I can offer the following hints:
1) Make sure your Vitamin D status is good. There is a blood test for this, worth knowing your level. Consider supplementing Vitamin D, and take it with oil/fat for absorption, or get a sublingual version.
2) Generic calcium carbonate appeared not as helpful as calcium hydroxyapatite which is harvested from bone and has various other bone-components in there with it.
3) Supplemental micronutrients are also important in small amounts, apparently that includes Vitamin K and boron. There exist bone-health supplements combining a bunch of possibly useful things into one capsule for convenience. Check your health food store.
4) Take the calcium in divided doses. Apparently you can't absorb the full daily amount at once, so if you don't split up the doses, the unabsorbed amount is wasted.
No advice whatsoever here re squatting/deadlifting with the fractures since personally I've held off until now. The foot-stabilization for overhead press was enough to cause pain, so I didn't push my luck with even heavier loads.
My guess would be, if the bones hurt, back off: the pain feedback is telling you they're not structurally sound yet. You depend on adequate remineralization and crossbracing to support your loads. When they feel more solid (no pain), increase loading gradually. The usual advice for runners is 10% increase of distance per week to avoid producing stress fractures. If you get ahead of the teardown-rebuild process (wherein the osteoclasts break down the bone and osteoblasts build new bone) and the osteoblasts can't build new bone fast enough, fractures can recur. On the other hand, as Rip implies, stress is what guides remodeling and strengthening of healthy, connected bone.
Metatarsals are "cortical" bone (like a tube) with an overall turnover time (if I recall) of about 10-12 years, so the healing process may go on for some time after the initial break mends.
Good luck with this, hoping something here was helpful. Definitely look into bone-healing supplementation to be sure your body has what it needs to expedite the process. The body will try to work with whatever it's got, but with suboptimal nutrition you risk laying down brittle bone.
TMPHBITEU
Now, why in the hell would you you want to test for Vitamin D? Why wouldn't you just take some Vitamin D? Do you know lots of people that hypervitaminosis D has killed or maimed? This is medical-type advice -- never take anything that is essentially harmless anyway for which an expensive test can be first prescribed to prove the need for.Originally Posted by Titanium
Member
Unless you've got some granulomatous disease like tuberculosis or sarcoidosis, taking vitamin D3 supplements should be safe. 50,000 units daily for months will definitely cause toxicity; you should be safe taking 5000-10000 units daily. Safer yet would be just sunbathing for 30 minutes outdoors; your skin will synthesize up to 10,000 units with that amount of exposure. Of course, that would be impractical with cold or wet weather outside, so just take the supplements in that case.
Member
Not sure about the US, but It's actually free in Australia. I get blood tested regularly and not a single dollar comes out of my pocket
TMPHBITEU
Safety is very important, yessir, especially when a volitile compound like Vitamin D is concerned.
Nothing is FREE, you moron. It's just that YOU don't pay for it. This is the thinking of the masses, and it is why we're soon fucked.
✓ Member
About 4 years ago I broke my fifth metatarsal, the outermost one walking off the mat after a jujitsu session. My ankle rolled and it busted, no idea how or why, but there it was. Had nothing to do with the jujitsu as far as I or the orthopedist could tell. He told me that the bones of the feet in general and this particular one especially, are not abundantly supplied with blood that aids the healing and knitting process. He put me in a fiberglass walking cast with velcro straps for 12 weeks and said to stay away from long periods of standing, forget a lot of walking, and running? Ha!
I carefully interrogated and negotiated with him for what was safe and OK to do because he said if this didn't heal in a timely manner which was entirely likely at my age (I was in my mid 50's then) the next step would be a stainless steel screw. Didn't want that for damn sure. Lifting was OK he said, but added I should lay off the jujitsu because of the uncontrolled and unpredictablity of the falls along with the tendency to use the feet for sweeps and kicks. His reasoning was relatively slow and controlled movements with weights might stress the foot, but that was far less problematic than the short, sharp, shocks of walking and running, let alone the other foot techniques I already mentioned.
I was out of the dojo for 12 weeks, which set back my learning and progress 6 months, and my foot ached on and off for about 18 months. Now, at 60, I have no ill effects at all. But that's just me. Your injuries sound way more extensive than mine were.
Member
OP said "I've been doing my research and hearing a lot of horror stories about the foot rebreaking easily" -- he is concerned about refracture after a fairly substantial set of fractures.
The only time to capture the 'initial state of the system' with respect to Vitamin D -- IF you find that useful -- is before supplementing more D. If it shows initial deficiency (which is reportedly common), that helps explain the fractures, gives added confidence that in time the bones will become stronger, and makes it imperative that the OP will have to stay on D supplementation when not getting enough D from sunlight or food.
It's systems-engineering and failure-analysis advice to understand the system, not medical apprehension. I'm a big fan of Vitamin D.
You 'can' just add reasonable D supplementation but you lose the possibility of pinpointing why the original failure happened. Doing the test doesn't guarantee you'll find deficiency, all may be fine. But if you DO find initial deficiency, you can have more confidence that with supplementation over time, the bones can become stronger than before with less chance for the fractures to recur, and as mentioned above, the OP would need to remain on supplementation.
Furthermore it IS possible to become D deficient even when taking a multivitamin "containing D" -- malabsorption of D at the villus level, or not taking it with adequate oil/fat for absorption, absolutely CAN result in deficiency. Even if you "think" you're getting supplemental Vitamin D, you may not be.
So I will push my luck here and state that if it were my situation, not only would I do the pretest for D as a failure diagnostic and baseline value, but if it's deficient, then after several months of supplementation, I'd retest and make damn sure the ingested D is showing up in the bloodstream.
Incidentally I pay $100+ out-of-pocket per Vitamin D test (no coverage for those), am painfully aware they're not cheap, and I do not expect others to pay this for me.
Member
"..and stay off my damn lawn, ya whipper-snapper!"
Seriously, things like pandemics (against which public health policies and, yes, even "giving away" "free" tests are often our best defense) are far more likely to wipe us out than the fact that we are not all strong, intensely independent curmudgeons with a well-stocked fall-out shelter.
Then again, the more insidious danger involved in our all being couch-surfing bags of goo definitely competes with the one-off horror scenarios - so more power to the curmudgeons promoting some dietary restraint and genuine physical culture.
Just realize that if we were "soon fucked" because we're a bit lazy and can't ever quite give up on the idea of a free lunch, our species would have probably never come into being.
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