Ankle avulsion fracture

Your ankle avulsion fracture or 5th metatarsal fracture may be referred to as a fracture, break or crack. These terms all mean the same thing.

When you have a fracture, it's not just the bone that's affected. You'll also have injured some of the soft tissues around it. Soft tissues include the:

  • muscles
  • ligaments
  • tendons
  • nerves

Recovery times

Most of the healing happens between 4 to 6 weeks after the fracture. It's normal to have aches and discomfort beyond this. This often happens when you try activities you haven’t done for a while.

It's also normal for the area to be more sensitive for several months after the injury.

What can affect your recovery?

There are some things that may affect your recovery.

Smoking

Smoking affects all of your tissues and slows facture healing times. In some people, it can stop healing altogether.

Stopping smoking as your fracture heals will help to ensure the best recovery.

Get help to stop smoking.

General Health

Some medical conditions, like diabetes, may slow down the healing process.

Eating a healthy diet and keeping yourself active will help your recovery.

Medication

Some medications can slow down fracture healing. If you have concerns about your medication talk to a healthcare professional.

Anti-inflammatory medication, like Ibuprofen or Naproxen, has been shown to delay healing.

What to expect after an ankle avulsion or 5th Metatarsal Fracture

This type of fracture is a minor fracture. It's often treated in the same way as a strain or sprain. Some people may be fitted with a boot or plaster. Some might be given crutches.

Walking on your foot can help your recovery but may be uncomfortable at first.

Help and instructions for using crutches.

Pain after a fracture

It's normal to have some discomfort in the areas around your fracture, including:

  • other soft tissues
  • nearby joints
  • areas that have been immobilised

Pain can change from day to day and it doesn’t always depend on what you're doing. It's common to have pain at rest.

It's normal to have some pain even when your fracture has healed. Some people also experience discomfort in the fracture site during colder weather.

Your local pharmacy can give you advice on managing pain after a fracture.

Find your local pharmacy

Use Scotland's Service Directory to find your local pharmacy.

Pharmacies

Swelling

Swelling is the start of healing. It's normal to have it near the fracture first. It often spreads down your leg.

The amount of swelling changes with:

  • your position
  • your activity
  • the time of day

Even when your fracture has healed, it's normal to have some swelling. This can last for several months.

How can I help swelling?

Having a lot of swelling can become uncomfortable or limit your movement. However, there are some things you can do to help the swelling. You can:

  • raise your foot above your heart when you're resting - you can do this by supporting it with pillows
  • keep the other joints in your leg moving normally
  • avoid too much rest and too much activity
  • massage the swelling from your foot towards your groin

Bruising

It's normal to have bruising after a fracture.

Bruising can be widespread and may appear a long way from your fracture. It can be very purple to start with and may change colour as you recover.

Getting back to normal activities

In general, you should gradually pace yourself back to your activities as you feel able.

Driving

You should contact your insurance provider before driving as your injury may affect your insurance.

Once you're out of your moonboot or cast the general advice is you must be able to safely perform an emergency stop or manoeuvre.

You should always be in full control of your vehicle.

Work

Your return to work will depend on the type of work you do and your employer. You might be able to discuss a phased return to work or changed duties.

You don’t need to see a healthcare professional to return to work.

Daily activities

Keep doing any activities you're able to, as your pain allows. Over time, gradually increase what you do.

Reduced flexibility and strength might make things more difficult to start with. This will get better as you slowly build up to all your usual activities.

Mood

Frustration or low mood after an injury is normal. As you get back to normal life this should get better.

Falls

Loss of confidence is common after a fracture.

Advice about preventing falls.

Bone scanning

You may be sent a letter inviting you for a scan of your bone density after a fracture.

It's routine to be assessed for any further risk of fracture, especially if you:

  • are over the age of 50
  • have increased risk factors for fracture

Rehabilitation plan

There are things you can do to help your recovery after an ankle fracture.

0 to 2 weeks after your injury

In the weeks just after your injury, you should:

2 to 6 weeks after your injury

Between 2 to 6 weeks after your injury, you should:

6 to 12 weeks after your injury

Between 6 to 12 weeks, you can:

  • return to full function
  • resume normal day to day activity
  • return to higher impact activity

Help and support

If your ankle function hasn’t improved within 6 weeks of following this advice, it’s a good idea to talk to a healthcare professional about your symptoms.

Gentle exercises

Practise gentle foot and ankle exercises to build up strength and movement.

Stop these exercises if they make your symptoms worse, or they cause new pain.

Ankle bend

  1. Begin in a comfortable seated position.
  2. Place the heel of one foot on the ground with your toes pointing towards the sky. The other foot should be firmly planted on the ground.
  3. Slowly begin to point the toes forwards.
  4. Hold for a few seconds and then return to the starting position.
Woman sitting on a chair. She points the toes of her right foot out in front.
Slowly point your toes forwards.

Ankle tilt

  1. Begin in a comfortable seated position.
  2. Place the heel of one foot on the ground with your toes pointing towards the sky. The other foot should be firmly planted on the ground.
  3. Tilt your ankle so that your toes point towards the left.
  4. Hold for a few seconds and then tilt your ankle to the right.
Woman sitting on a chair. She points the toes of her right foot up and to the left, keeping her heel on the ground.
Tilt your ankle to the left and then the right.

Seated heel raise

  1. Begin in a comfortable seated position.
  2. Place your feet flat on the ground.
  3. Gradually lift up your heel as far as is comfortable.
  4. Slowly lower your heels back to the ground.
Woman sitting on a chair. The toes of both feet touch the ground and she has lifted her heels upwards.
A seated heel raise.

Standing calf stretch

  1. Place a chair in front of your body and use this to lean on.
  2. Bring one leg out behind you until you feel a stretch. The other leg should be slightly bent out in front.
  3. Hold for a few seconds.
  4. Return to the starting position.
Woman standing with her right leg bent in front and her left leg stretched out to the back of her body. She leans on a chair in front for support.
Make sure you have plenty of space around you to do a standing calf stretch.

Big toe lift and hold

  1. Sit down with your feet flat on the ground.
  2. Slowly begin to point the toes towards the sky.
  3. Hold for a few seconds and then slowly lower the toes to the ground again.
Foot placed on the ground. The toes are lifted off the ground to point upwards.
Practise exercises like the big toe hold and lift.

Toe curl

  1. You should do this exercise whilst sitting down or lying down.
  2. Place your heel on the ground with your toes pointing towards the sky.
  3. Curl your toes in tightly.
  4. Release your toes once again.
Foot with heel on the ground and toes curled up.
A toe curl exercise.

Last updated:
01 August 2022