I have just received an unconfirmed (ie negative xray) diagnosis of a stress fracture on the base of the 4th metatarsal. Fit all the description of a stress fracture, and the first few days were very painful. However, a week later, I’m left with a hard lump that is painful to the touch, but otherwise walking or other things (biking/swimming) doesn’t bother it. I have a boot but I hate wearing it as it’s bothering my hip/back due to the hobbling around on uneven leg length.
I feel like in another week or two the pain may be completely gone. Does that sound like a stress fracture? Would you run on it if pain free or do you still have to give it 6-8 weeks?
Stress fracture pain can differ significantly depending on where the break is and how long you kept exercising on it after the injury occurred. There’s no rule of thumb for “it will hurt for x weeks.” Re getting back to running, I have learned the hard way that one must wait until ALL of the pain is gone, then wait an additional week, then do what you want to do. Do NOT fail to wait that additional week. Do not convince yourself that the pain is gone, so you’re good to go. All pain gone, then one additional week. Then you’re good to go. FWIW, I’ve never worn a boot. I’m not a doctor, and if a doc tells you it’s important to wear the boot, then wear the boot. But I’ve had a lot of stress fractures, and I’ve never been given a boot.
Never had one in my foot, but have had them in the legs a couple times. My experience is to put an X on the calendar and just accept the time off. To answer your question specifically, I’ve always done the jump test. If I can jump 30 plus times on the foot with no pain, then it’s time to address the issue, but for me thats always been over a month, then another week or two for safety.
I had a stress fracture in my fibula 3 years ago and I still get pain once in a while. Was told by the Dr. that I could expect occasional “nagging” for the up to 5 years. Yeah, it sucks…
I had a stress fracture in my foot in February. I went two weeks without a boot and it hurt pretty bad. Got a boot and wore it for 6 weeks. It only started feeling better after the fourth week. Then took it really easy for a couple weeks after I took the boot off. Started running a couple times a week after that and could feel it but it never hurt. Just felt weird. For the last few months I have ran 4-5 times a week and don’t feel a thing.
I guess I’m trying to say take the time off and let it heal. If you don’t it will continue nagging you.
I had a stress fracture in my foot also. As you describe, the pain went away after about 3 weeks, but my orthopedist was adamant that I spend the full 6 weeks in the walking boot and then ease back into running very slowly due to high rates of re-injury with stress fractures. I swam and biked a bunch during that time and I actually found it to be a blessing in disguise because my swim and bike improved quite a bit during that time and my running returned back to where it was in only 3 to four weeks. Be careful with stress fractures and do not rush back too early.
I have just received an unconfirmed (ie negative xray) diagnosis of a stress fracture on the base of the 4th metatarsal. Fit all the description of a stress fracture, and the first few days were very painful. However, a week later, I’m left with a hard lump that is painful to the touch, but otherwise walking or other things (biking/swimming) doesn’t bother it. I have a boot but I hate wearing it as it’s bothering my hip/back due to the hobbling around on uneven leg length.
I feel like in another week or two the pain may be completely gone. Does that sound like a stress fracture? Would you run on it if pain free or do you still have to give it 6-8 weeks?
Thanks
SS
Yes, you have to give it 6 to 8 weeks. This is not an injury you judge by how much it hurts today. You do what the doctor tells you, let it heal and be thankful that you have a professional to save you from yourself.
I’ve had a stress fracture in my pelvic bone since mid May. I am still not 100%. It’s difficult to heal when I’m on my feet all day. Doc says it could take up to 9 mo to heal. Couldn’t race all summer or fall. I have IMAZ on my calendar, but not racing.
Thanks all - very helpful. Re biking, I know there are mixed views out there – my dr said biking is fine but it does seem bizarre as of course there is pressure on the foot when biking (no pain though except from the top of the shoe pressure). Same for pushing off of the swimming wall.
Did most folks take a few weeks off ALL activity (which I haven’t done for 5 years) or keep biking, etc?
Big toe. I didn’t wear a boot, but I did avoid running for over 6 weeks – biking, swimming, pool jogging, yoga, but not land running.
I wouldn’t recommend running on it for the 6-8 weeks. That is asking for trouble.
3 years later I believe the stress fracture has turned into slight arthritis in that toe/foot. Annoying more than anything, but each twinge comes with the “oh no” and the fear I reinjured myself.
I had one on the lower third of my tibia the other year. I was able to ride and swim without issue, but running wasn’t possible. I took 8 weeks off just to be sure. Better then taking 5 weeks, re-injuring it by being too eager then having to take another 6 weeks off.
I did not take any time off. I just went straight into swimming and biking more because I did not want to lose my conditioning. I was able to return to running in January and in April set a new PR at 70.3 Galveston.
Biking was completely fine for my foot. There is not any where near the same amount of pressure on your foot when biking vs. running. My guess, is the stress fracture is much more because of the pounding force on your foot when running vs. just pressure. If it were a pressure issue, the walking boot would not be enough to heal the stress fracture.
Thanks all - very helpful. Re biking, I know there are mixed views out there – my dr said biking is fine but it does seem bizarre as of course there is pressure on the foot when biking (no pain though except from the top of the shoe pressure). Same for pushing off of the swimming wall.
Did most folks take a few weeks off ALL activity (which I haven’t done for 5 years) or keep biking, etc?
Yes, biking is fine. I had several stress fractures in my foot about 15-16 years ago when I was a single sport runner. Each time I had to take 6 weeks off per the advice below. Now I’m 57, and I did Powerman Zofingen in Sep where the downhills beat me to a pulp. I only took a few days off and struggled to return to running. A few weeks later I collapsed in the street when my left knee gave out just 1.5 miles into a run. Saw the doctor and was diagnosed with a stress fracture in my left foot, a stress fracture in my left tibia, and a torn popliteus muscle behind the left knee which is what sent me down. Never heard of that muscle, but I looked it up on the internet and saw that excessive downhill running can injure it. Anyway, I have IMFL this week with a giant hole in my run training. I spent 4 weeks off the leg but doing lots of water running, elliptical and ARC trainer. Biking was not an issue, I put in between 210-265 miles a week for 5 straight weeks. Yes, there is pressure on the foot when you bike, but it is not the same as a foot strike with the sudden loading of several times your body weight.
I started back running one week ago and did 22 miles in 4 runs last week, each faster than the last but all slow. My limiter is the lower hamstring around the left knee. The sports doc knows I will be doing IMFL but will be using HOKA’s instead of my typical racing flats. The run will be an unknown. I will go easy until/unless I feel I am going to hurt myself, then I am prepared to walk/shuffle. Then back to the sports doc to re-evaluate.
Good stuff- that’s some serious volume. just curious, though it’s probably too early for me to think about a come back plan, did your doc say it was ok to jump from 6 weeks off to 22 miles of running in a week? sounds good to me, though i suspect a more conservative approach would be to start at 20-30 min per run and go up by 10% from there, though that will take a very long time to get to 40 mpw…
Foot = First two weeks unbearable pain, slightest movement was excruciating and even sitting still with it elevated hurt. Got a boot and that started to help I guess. Week 3 got a little better but still couldnt sleep. Week 4 finally got dx with stress fracture and it took probably two more weeks to be pain free. Nothing helped first 2-3 weeks, Advil - oxycodine - perks and something else. I usually don’t take pain killers so when I do I feel like they generally work great. With this, nothing seemed to work.
Good stuff- that’s some serious volume. just curious, though it’s probably too early for me to think about a come back plan, did your doc say it was ok to jump from 6 weeks off to 22 miles of running in a week? sounds good to me, though i suspect a more conservative approach would be to start at 20-30 min per run and go up by 10% from there, though that will take a very long time to get to 40 mpw…
SS
He’s a sports doc, not a GP, and a believer in aggressive treatments. Two years ago I ruptured the plantar fascia in my left foot and I was running again within 6 weeks. A podiatrist would have put me in a boot leading to permanent scar tissue. Nonetheless, I am obviously not following conservative protocol. The 22 miles was embarrassingly slow, but what are you going to do when you have an IM the next week…go in with zero? My long “run” for IMFL was the week before I started running again and consisted of 3 hrs machines as 60 mins elliptical - 60 mins ARC - 30 mins elliptical and 30 mins ARC. No pounding. So here’s last week’s return to JOGGING:
Mon - 3 miles @ 11:12 pace
Wed - 5 miles @ 10:44
Fri - 7 miles @ 10:11
Sun - 7 miles @ 9:39
No one is going to fear my marathon run at IMFL! My left leg is the limiter, but not because of the stress fractures. My lower left leg was swollen and puffy for over a month and that finally went away. I had bruising and swelling in my left foot too. Doesn’t hurt to run, but strangely I feel it when I walk on occasion. The real problem is the residual left knee weakness due to that dinky little muscle behind the knee, and the resulting overload work on my lower hamstring. I’m getting PT and it’s all about the knee and lower hamstring.
I plan to take 10 days no running after IMFL, then start back on a more realistic schedule that won’t get me to 40mpw for about 2 months.
I think if you’re pain free, you can ease back into it gradually.
I wasn’t so lucky - I didn’t even have a ‘break’ on my MRI, (looked normal on xray) but mine hurt like heck, and even after 9 weeks off, still hurt like 7/10 every single time I started running on it (was 2/10 at rest.) Rather than just totally wimp out, I started self-rehabbing my running by doing 0.25-1.0mile easy runs and monitoring the pain to see if it worsened or improved. Sure enough, it improved, but it really took mine awhile to get better - i think it was nearly 4 months total before I could run even 3 miles without feeling at least 5/10 pain in the same spot, and I was running really wimpy slow low-mileage stuff compared to my ex-marathon self.
Jan 26 at mile 20 I felt the sharp pain, and was diagnosed with a stress fracture. Put a boot on for 4 weeks, and the pain went away after 2 weeks.
Jogged a half marathon with my wife on March 2nd (5 weeks after injury) and it felt fine. Other than the half, I didn’t run from Jan 28 until April 5th in a sprint tri (13.1 miles over 10 weeks). After the sprint and 2 more runs, I went back to the doctor, and he told me to take another 8 weeks off. So 19 weeks after the day it got too painful to run, I was totally ready to run.
Lesson learned - don’t run just because it feels better. Water run or total rest for 8-10 weeks.
Broke my 3rd metatarsal about a year ago. Took me a while to get back to running. I believe it was almost 2 months where I could jog again. Camille Herron’s blog helped me learn a lot about stress fractures, such as what to expect, and how to possibly prevent it in the future. In my case it was doing too much, too soon. Maybe it can help you as well. Good luck, and speedy recovery!