Olympic Sports Foot Injuries 2 – Basketball
Being a basketball player is very tough on your feet. Even with high performance shoes available today, hardwood has very little give to it. The combination of hardwood, the pounding and twisting motions basketball players make, and the individual athletes’ foot shape, contribute to a common basketball injury – the Jones’ Fracture.
A “Jones’ fracture” is a special type of stress fracture of the base of the 5th metatarsal (mid foot bone that is connected to the baby toe). The fracture itself often occurs acutely but the repetitive stress that leads up to the sudden fracture has often built up over time. Jones’ fractures occur in a manner that is similar to the way that you would break a paper clip (by wiggling it back and forth over and over again). Therefore, activities that repetitively load the foot (for example sports with running) may lead to a Jones’ fracture. These fractures tend to occur in people who have a high arched foot shape, or a leg shape that results in increased loading on the outside part of the foot. These fractures can be treated with a cast or a special boot. However they may break again because the reason why they occurred (loading pattern of the foot) has not changed. Therefore, surgical treatment of Jones’ fractures is common, and it sometimes involves re-aligning the foot to prevent the bone from breaking again in the future.
What is a Jones’ stress fracture?
Fracture is one of those words that people misunderstand. There are complete fractures, when the bone breaks all the way through. A stress fracture is the bone impending a break (as more of a crack). That’s why there is soreness rather than more severe pain.
It’s an overuse injury. So it starts with a little bit of soreness until it gets worse and finally the athlete will bring it to someone’s attention. They’re tough injuries to get better from. These athletes are used to playing with pain. A little ache in the foot won’t get their attention until it gets severe enough.
What differentiates the Jones’ fracture from other fractures? It’s really more toward the back of the foot, the back end of the long bone of the metatarsal, just forward from that. That has a very low blood supply and very low healing potential (without surgery) as a result.
Even in non-athletes, podiatrists tend to be more aggressive in treating this type of fracture. We’ve gotten more aggressive in treating this in the last 10 years. Some people still opt to treat conservatively, but a fair number of those will go on to not heal and need surgery. But with athletes and other people who spend a lot of time on their feet, we try to talk them into the surgery right away just because it’s a higher chance of getting them up quickly.
The big difference is that if it’s a stress fracture, they’re going to put a screw right into the bone, running a wire and then put a screw in to reinforce the foot. If somebody has a complete fracture, the second operation is typically a bone graft.
Orthopedic injuries tend to be very mechanical in nature. For the foot, what really makes a difference is the weight, how much weight and stress it sees, and also how much flexibility. Flat-footed people tend to be more flexible, while people with high arches tend to be more injury risks. That means more of an issue.
More on Jones
Who is this Jones and what does he have to do with this fracture?
The Jones in question is Sir Robert Jones. In 1902, he wrote a paper called “Fractures of the Base of the First Metatarsal Bone by Indirect Violence.” In the article, he describes six patients who had a fracture located in the outer midfoot area, despite not having had any direct trauma there. One of the patients was Sir Jones himself, who got his fracture from dancing.