Help - stress fracture of 3rd metatarsal

filarl

Help - I recently got confirmation that I did in fact get a stress fracture - of the 3rd metatarsal on my left foot - 2 weeks ago on that Wednesday morning's VO2 trackworkout.

So would love some help if anyone has some experience in this space as I haven't had a stress fracture in nearly 30 years since i first started running!  Firstly - my dr put me in a boot and said no weight bearing for until 6 weeks, no outdoor riding for another 2 weeks, no running for 3 months. 

So - I did some research online and saw some slightly different guidance via Running Times that recommends starting back running very very gradually but more like at 6 -8 weeks out if it's healing well.  I also noticed a mention of an ultra sound treatment that claims to improve healing time by 38% - not sure if anyone has heard of this know if it's the real deal?  Training aside I have very active kids including a 3-year who will need to be tethered if I can't chase him down

I've been trying to get to the pool for deep water running when possible, deep end no impact at this point, but am thinking that at some point it'd be good to do some DWR in the 4-foot water wearing my aqua jogger shoes (from different past injury) as I also noticed that some of the advice was to provide some weight bearing when ready as a way to actually trigger stronger healing.  Not sure when would be the right time though. 

Also the dr started talking about kind of shoes that I run in and mentioned orthotics.  This is another area where I'm concerned.  As much as I want to avoid a repeat injury I think that this was a fluke (wearing old  pre-prego size track spikes that were a tad too small to avoid slipping on very wet track) and not due to nornal training shoe situation and clearly not a result of ramping up the miles.  While I admit that the VFF are a bit TOO minimalist for me, I'm strictly a SC-tri type, former mid-distance track runner and those clunky pronation shoes that the running store rep's always try to put me in HURT and won't let me run forefoot.  yes - already read through the minimalist shoe thread, but just curious about anyone aware of any studies out there one way or the other, or do I just get ortho's for my Nimbus's that I wear on longer and winter pavement running and nod my head that I'll be good and get those aweful control shoes and then stick with the more flexible ones anyways (I think I know the answer here but want to be sure that I'm not missing something.&#160

Anyways, any and all advice is welcome, including how not to get so depressed that I eat every bit of chocolate in sight and gain 400 lbs!

Thanks 

 

 

Carrie Chavez

Hi there, I can help for sure. Take a deep breath and don't panic. I had a stress fracture in my 4th metatarsal in 2006, 9 weeks before IMCDA and I was able to do the Ironman!!! YES! I was fully healed in time.

I got the boot and wore it when walking full weight bearing after week 2. The first 2 weeks it HURT so I used crutches to take the pressure off the foot. More by my choice because it hurt. Soon the pain was gone and I walked in the boot.

I did use a bone stimulator daily only because a friend of mine had one. I was so LUCKY to have it. My fracture was fully healed in 6 weeks a 2 days. The MD said I would know it was healed because I would be able to squeeze the bone and it would not hurt. She told me it would take 6 weeks. At 6 weeks it still hurt to squeeze it. At 6 weeks and 2 days, no pain and I went out and ran a mile. It felt great! I built up my runs over the next 2 1/2 weeks until the IM. My longest was 60 minutes the week before.

I pool ran 5-6 days a week in deep water. Did all my 2-2.5 hour runs in the pool.

I biked on the indoor trainer starting 2 weeks after the injury. I rode daily, fast spin, low resistance and no standing. Did all my long rides on there in prep for IM.

Got to IMCDA and had my fastest bike split ever. Ran the marathon only walking a little after mile 15. I still can't believe I did that IM.

I never gained weight. I ate clean. I felt super strong from pool running. Awesome core workout.

Run my training past your MD and see if you can try indoor biking with low resisitance.

Carrie

Carrie Chavez

One more thing. I went for the orthotics recomendations only to have wasted $400. They were horrible for me. My gut told me it was not a mecanical, anatomical issue but an overuse issue and I was right.

Hasanbaydoun

Linda, I'm gonna echo a lot what Carrie said

low resistance biking, and pool running.

U/S can lead to faster healing - no cponclusive studies on that. Does it harm? no. Will insurance cover it in your case? I doubt it. Does it harm no? NO. your best bet is to get it off eBay, or ask around in your local tri club, or even your doctor. He might ask his rep for a favor....

One piece of advice. AAVOID NSAIDs AT ALL COSTS. they delay bony healing. no advil. no alleve, no ibuprofen, no similar compounds. NO

As far as the orthotics, not sure what to say. can help, can not help; biut the bopttom line is if you've been doing it without them for a while, and you just had this injry - then I doubt that orthotics will help. Something really changed recently - you figured it out already

NO NSAIDs

Also, regarding the show type. if you run forefoot; not sure if the shoe type matters at all. go with what you feel comfortable in.

did I mention you need to stay away from NSAIDs ;-)

keep me posted

filarl

thank you! thank you! thank you! Thanks so much Carrie and Hasan! You've definitely given me some awesome advice not found elsewhere and helped reduce my panic. Will definitely up the DWR effort, spin with low resistance until I don't feel any pain with the higher resistance and yes will avoid NSAIDs. Hadn't actually heard that before but strangely had a feeling that it wasn't a good idea to use them after the initial few days of pain/super swelling but more that it masks pain that is telling me it's not ready yet to take more weight bearing. Will definitely be patient, but try the bone squeeze with no pain once I get to around 6 weeks as an indicator of healing - hadn't heard that anywhere else either THANKS!!
My first A Olympic race was meant to be June 26th so will either skip entirely or do as an unofficial aqua-bike if I can handle the hills (already paid) was planning on second A race as Sept 25th, but will now be the only A Olympic race. Given what you've said I should be able to run enough to manage. And am going to check e-bay for the ultra sound as well as local tri/running crowd. I just need to eat clean, will need to pull out the old food diary yet again.

THANKS!!!

Paul Hough

Linda - it's been 10 years, but in 1999 I fractured 2 metatarsals in my right foot. Then to complement that, I fractured one in my left foot in 2000. Maybe I wasn't drinking enough milk back then. Anyway, the medical advice I received was no running for 6 weeks. So I took 2 weeks completely off, then started a walking program for the next 4 weeks, then eased back into running. Basically, I followed the same test as Carrie...it didn't hurt to squeeze my foot from the sides. I haven't had any stress fractures since.

I've had a variety of foot problems over the years (actually decades) The prescription is always for a pair of orthotics which I'll use for a couple of months...then things get better and then I don't use the orthotics anymore.