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Stress fracture - 2nd metatarsal
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My foot had been aching after runs for a day or two for the last 6? weeks but nothing too bad. I noticed it also hurt after doing maybe 2 miles of walking one day, so went to my PT and found out I have a stress fracture in my 2nd metatarsal. Been wearing a boot to immobilize it for the past week but was told it takes 4-6 weeks to heal.

Has anyone hear experienced a broken metatarsal before? How long did it take to heal? I am allowed to bike and have noticed that w/ stiff soled cycling shoes, I have NO pain at all walking. I was also wondering if I could swap wear some old cycling shoes (w/o cleats) instead of the boot.

Thanks in advance for sharing your experiences.
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Re: Stress fracture - 2nd metatarsal [nousername] [ In reply to ]
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I had a stress fracture in my second metatarsal head last spring. I had been having some pain but did the most damage during a half-marathon I wasn't prepared for at the end of April. My doctor (small town old dude at the time) did not suggest a boot, but I eventually bought one for myself after 2 months of not being able to run. I did a lot of cycling during that time, but I did not start running again till August 1st(injury occurred on April 26). I was very conservative and probably waited longer than I needed to, but I did not want to create a life-long problem by being impatient. I am doing an IM in 2 weeks and my running is coming along much better than I thought it would considering I started from scratch in August, so it's not the end of the world as long as you keep cycling and use this as an opportunity to focus on the bike.
As far as pain when walking is concerned...I always had a dull ache. It didn't matter what shoes I wore. The boot didn't help with pain at all, either, but I think it gave it some needed stability.
Good luck!
Jessica

Jessica
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Re: Stress fracture - 2nd metatarsal [nousername] [ In reply to ]
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How did your therapist diagnose your stress fx? I'd recommend seeing a podiatrist (as I am one and a little partial). Did they dx with an x-ray or possibly by using a vibrating mechanism. Sometimes an x-ray will not reveal a stress fracture for several weeks. If I am ruling out a stress fracture and it doesn't show up on x-ray, then I will usually rule it out with an MRI. Was there swelling over the top of your foot? If not, that is a little unusual but can happen. Also, sometimes a simple capsilits may be very painful just with simple range of motion the toe joint (MPJ) and may be confused. If an x-ray and MRI are both negative, and a joint capsilitis is diagnosed, it can be treated with a steroid injection or oral antiinflammatories and arch supports. However if it is a stress fracture, a steroid injection will be counterproductive in the long run to healing bone. So, back to your initial question...I usually keep my athletes from running/pounding exercises for upwards of 8-12 weeks. The downside of running to quickly on a stress fracture is that it could very easily refracture or create a delayed or nonhealing metatarsal fracture that would require surgery and further delaying your recovery. Obviously, I can't treat you so I would recommend visiting a podiatrist in your area. Hope this info is beneficial to you.
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Re: Stress fracture - 2nd metatarsal [nousername] [ In reply to ]
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People often use "wood shoes" instead of or while transitioning from the boot. "Post-op" or "stiff-sole" shoes are the same. Some stiff clogs work too -- as apparently do bike shoes. Basically, if the shoe doesn't flex between strides you'll probably be pretty comfortable. Treatment in a shoe also has the benefit of freeing your ankle so you don't get as stiff and weak. Ask your doctor if a stiff shoe would be appropriate for your injury, then go for it.
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Re: Stress fracture - 2nd metatarsal [nousername] [ In reply to ]
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How did a PT diagnose a stress fracture?
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Re: Stress fracture - 2nd metatarsal [nousername] [ In reply to ]
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I have fractured a fourth metatarsal - 6 weeks healing time.

Agree on the others, how was this diagnosed? Did you have x rays, bone scan... ? In this state at least PTs can't diagnose anything.

With any broken bone: 3 x 500mg of calcium a day, from food or supplements. Your body can't absorb more than that at one time.

Good luck with healing, but if you haven't seen a *doctor* to get this diagnosed you probably should. When did it happen - sometimes they take a couple weeks to show up on an xray (won't show there until it starts healing - bone scan will give you a faster diagnosis).

Am sorry to hear of the injury and sending (((((hugs)))))).
tc

disclaimer: PhD not MD
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Re: Stress fracture - 2nd metatarsal [nousername] [ In reply to ]
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I had a sfx of the thrid metatarsal this summer. I couldn't even walk w/out pain, so for the first couple weeks, I couldn't do anything. I eventually moved on to aquajogging, and then at about week 4, added ET (in the boot, still). At six weeks, I had no pain on walking, but any sort of resistance while cycling still hurt. By 8 weeks, I was able to ride normally, but still took it easy on hills and didn't race at the track.

All told, I was in the boot full time for 6 weeks, then on and off for another two or so. I didn't resume land running for probably 10 weeks. I iced, babied it, and took calcium and it healed nicely. I figued it took out 99% of my season anyway, so no reason to push it getting back.


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Re: Stress fracture - 2nd metatarsal [nousername] [ In reply to ]
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Thanks for the advice everyone,
A lot of you asked how I was diagnosed. My PT is an ex-world champion runner turned PT who pretty much just works on athletes. He is kind of a legend in my area for diagnosing and curing running/cycling injuries. After looking at my foot, he was able to pinpoint an exact pt from which the pain was emanating and said something about "edema" and I believe that my foot was somewhat swollen based on my shoe on that foot feeling a bit tight. He then applied ultrasound, which caused pain after 10? seconds. He said it was 99% that it was a stress fracture but that only a bone scan 100% confirm it.

For those of you that cycled: Did you still climb or did you keep things to easy spinning? Did you stand up on the bike?

BTW - I have NO pain right now at all.
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Re: Stress fracture - 2nd metatarsal [nousername] [ In reply to ]
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Had suffered the same injury as you right around this time last year -- it took about 7 weeks to heal, and I managed to rein in my hypertrophied training drive for 2 weeks more before I started running again. (I suffered no significant loss of training fitness, by the way, and broke just about every one of my running PRs this summer. So don't stress and recovery properly.) As for biking: I had no pain or discomfort at all, and I continued as normal, including climbing etc.

Wishing you a swift recovery!
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Re: Stress fracture - 2nd metatarsal [nousername] [ In reply to ]
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In Reply To:
Thanks for the advice everyone,
A lot of you asked how I was diagnosed. My PT is an ex-world champion runner turned PT who pretty much just works on athletes. He is kind of a legend in my area for diagnosing and curing running/cycling injuries. After looking at my foot, he was able to pinpoint an exact pt from which the pain was emanating and said something about "edema" and I believe that my foot was somewhat swollen based on my shoe on that foot feeling a bit tight. He then applied ultrasound, which caused pain after 10? seconds. He said it was 99% that it was a stress fracture but that only a bone scan 100% confirm it.

For those of you that cycled: Did you still climb or did you keep things to easy spinning? Did you stand up on the bike?

BTW - I have NO pain right now at all.
I did not alter my cycling style at all. My foot would actually feel better the day after a long ride since that was time I wasn't spent walking around. ETA: I had my foot x-rayed twice with no sign of sfx (and it amazed me that none of the doctors I saw seemed to understand that a sfx will usually not show up on xray) and then finally got diagnosed after an MRI. WHen I went to a new doctor in July he was able to declare me "cured" after not being able to find any point on my toe that had pain when pressure was applied. IOW, if you have a distinct area of pain then your PT is probably correct in diagnosing sfx.
Jess

Jessica
Last edited by: Jessica: Nov 10, 08 9:34
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Re: Stress fracture - 2nd metatarsal [nousername] [ In reply to ]
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My ortho's advice was: if it doesn't hurt then you can do it. It took quite a while for me to get to that point--then I did easy spinning on the trainer only. Then added resistance. Then outside, but no hills. Then hills/standing in trainer. So it was a progression, and I didn't move to the next "level" until I was safely doing one for awhile with no ill-after effects.


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Re: Stress fracture - 2nd metatarsal [nousername] [ In reply to ]
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"Stress fracture of the 2nd metatarsal" may sound definitive, but it's not -- a lot depends on exactly where and how it's broken. The orthopods I work for will often bring me a patient and say "Try the shoe, if that bothers them give them a boot."

Bottom line -- as mentioned above -- is if it hurts don't do it. That doesn't mean go ahead if it doesn't hurt too much. If it hurts don't do it. If you're lucky, and the fracture doesn't hurt as long as you don't flex the foot, then cycling in a stiff soled shoe shouldn't be a problem at all.
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Re: Stress fracture - 2nd metatarsal [nousername] [ In reply to ]
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Similar to what other posters said s far as recovery goes. Seems to vary from 6-12 weeks. I had a stress fracture 3rd metatarsal during my build up to IM CDA '07 and was off running for 7 weeks. I substituted cycling and water jogging for most of the run days and when I was finally able to run I had lost very little endurance and a little bit of speed. Cycling was normal with plenty of climbing including the N. Ga Mountains and I also didn't have to wear a boot. My Podiatrist did build a hard foam insert into my running shoes to help alleviate the cause of the stress fracture. My wife is a PT and she told me it was a stress fracture using the ultra sound and a tuning fork. The vibration from the tuning fork made me want to jump off the table. She did tell me I needed to go see a Podiatrist and the x-ray confirmed the fracture. Good luck and quick recovery!
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