Stress Fracture - 2nd Metatarsal

[Elliot Fuller]

Ok, so another possible injury from me. I'll include some history just in case, so skip to the bottom if you already know what I've been up to.

I think I know the answer to this already, but as usual there are smarter people on here than I. Most of my searching leads me to believe this might be the beginnings of a stress fracture... looking back there are a number of things I've been doing wrong, including not following my own advice. Hopefully someone can clear things up or confirm my suspicions.

History:

Stopped my dedicated running training almost 2 months ago. Due to schedule have missed a good # of the more recent running WODs in the last couple months. Only this past week have I started to do them again: 3 rounds of 800m last Saturday, Murph, tonight's 1 mile, etc. Nothing major and nothing at truly uncomfortable speeds by my standards.

1.) I try to run POSE as best I can. At the very least I manage a BOF strike. It's likely not a perfect POSE stride, and likely not directly under my center of mass. In other words, I'm confident there is still some impact involved in my BOF strike.

2.) I run in my Vibram FiveFingers.

3.) There is a dirt path to run on near my house, but it is impossible to run on at night, given how uneven it can be at places, so I take the next best thing: asphalt and concrete. They are high impact, but they are at least flat and predictable in low-light.

4.) I do the "Foot Drills" that are oh so common around these parts.



Ok, so Saturday I was doing the 3 rounds of 800m/50 pull-ups. I finished it up with the typical soreness in my calves that I experience after a long enough time without BOF striking. The good kind of soreness. My feet felt a bit sore an hour or so later, and I promptly iced them (tops and bottoms), and rested until today (Tuesday). Feet felt better today although the calves were still sore.

Hit the WOD tonight on asphalt/concrete again, and did a 7:39 mile (fast by my standards). Feet felt a bit rough in the process, but not debilitating, and I managed the rest of the WOD without feeling like I was "working through the pain."

Now though, the pain is more pronounced. It's strictly in the tops of my feet on what feels to be the "inside" of the 2nd metatarsal. There is no visible bruising or swelling, and the pain is very "general" by itself -- in other words it's more of a light "throbbing" when I'm not actually touching it and just sitting still.

It is painful to the touch though; on a scale of 1-10 probably a 4 or 5 -- very bearable. When I finished the WOD I was perfectly mobile, but now it is a bit painful to walk, particularly in the "push-off" portion of my stride. The pain is in both feet.

Attached is a picture of where the pain is (dig my VFF tan line). It's not bad enough to force a limp; it feels more uncomfortable than anything; kind of like a joint that needs to be popped.

So I have a few questions, if you've made it this far:

1.) What are the odds that this is the beginning of a stress fracture rather than just typical soreness or bruising from getting back into POSE? Typically that kind of soreness is in my calves and Achilles rather than the tops of my feet.

2.) What corrective measures can I take, besides RICE, to get it healed quickly? Next week I have to start attending USMC pool functions, which will typically involve some running and I'd like to be able to participate if possible. I'd also like to avoid a doctor's visit at this point, unless it really seems necessary.

If I have to run (we're talking 1.5 miles tops here), should I just run in standard running shoes for the time being? I know it's a heel-strike, but it's over a fairly short distance. Will that adequately take the stress off of my BOF while still allowing me to run, or is this just a recipe for disaster? Probably a "durrrrr" question, but thought I'd ask anyways.

Should I continue to walk around barefoot in the hopes of strengthening up my feet still, or should I get as much support as I can and just rest them 100%? I spend most of my time at home barefoot, but work all day (desk job) in standard shoes.

In the future, if I'm going to run on asphalt on concrete, would it be better to just try and find some Nike Frees or something to that effect so as to at least offer a little cushioning, given my imperfect POSE stride?

Would appreciate it if someone could just confirm the obvious, or recommend anything else here. Obviously I don't want to aggravate it any more, but the bottom line is I'd like to participate in these pool functions if I can.

Much obliged, gents.

[Elliot Fuller]

I don't want to make a new thread, and I don't know what I was thinking writing a short story for such a simple question.

New question:

My supposed "stress fracture" is improving, but still giving me some pains. I've been icing it morning and night and I've noticed some improvement. It's still a little tender to the touch, but there is no visible bruising, swelling or inflammation.

Flexibility and ROM is not affected, although it's uncomfortable to put much pressure on it when barefoot. Wearing thick running shoes helps with the discomfort.

I've read that sometimes stress fractures hurt less during physical activity, despite still being present. Tomorrow's WOD is double-unders. Common sense tells me that whether it hurts or not while doing them, that jumping rope is not a wise choice when trying to nurse a potential stress fracture.

So... does this fall under the rule:
"If it doesn't hurt, it's probably ok."

Or should I be a bit more cautious with it and really give it time to recover, whether it hurts doing double-unders or not?

Side question: What are the odds that this actually is a stress fracture, if there's no visible bruising, swelling, or limited ROM? How likely is it that it's just muscle soreness on the tops of my feet? It's a very localized pain, so it doesn't feel like just a sore muscle.

Second side question: I know tuck jumps can be used to sub for double-unders, but they would be just as high impact. Can anyone think of another sub that might have the same benefits? I was thinking of subbing some rows or just doing a different WOD.

[Elliot Fuller]

I know no one responded, but I went to the podiatrist to get this checked out and x-rayed. Turns out nothing's broken as far as the x-rays go (might need a bone scan if it doesn't get better soon).

When I went in though, they asked what I may have done lately to aggravate it. I said "Well I've been running 6-7 months barefoot --" and before I could finish my sentence he said "Well there's your problem."

Lesson learned on things not to say at the podiatrist. It sucks trying to explain to someone part of their own profession

I also think I once had psoriasis on my feet, and had to disclose that to them. The assistant kinda bobbed his said, jotted it down on his chart, then stepped out of the office and said the doctor would be in soon. Outside I heard them talking:

"He said he had psoriasis on his feet?"
- "What's psoriasis?"
"It's a liver disease."
- "Oh ok.............."
"But he had it on his feet."

Then I swear to god I think I heard them Googling it because I heard keys typing on a keyboard, and then one of the doctors said:

"No I think it's p-s-o-r-i-a-s-i-s"

Couple minutes later the assistant comes back in:

"Hey...... what's psoriasis?"



Finally an actual doctor came in and knew what the deal was, but it was pretty damn funny. Feet are still sore, hoping they'll be better in another week.

[Steven Low]

That's hilarious.

Sorry, I would have responded but I don't really know too much about feet at the moment so I'm pretty useless here... other than the massage, ice and rest recommedation. -_-

It does sound like some sort of shin splints except in your feet. I'd try to get a video of your running and see if it's any good.

[Rayna McGinnis]

Last all I developed a stress fracture on the inside of my foot from hiking and alot of box jumps. Now- as a female- i'm much more susceptible to these.

I ignored it for about a week and continued working out and it just because more and more painful. My doctor eventually said, take two weeks off and then if it hurts, stop.

Ofcourse, i still worked out, just went easy on the foot. She explained to me something interesting though. Stress fractures don't heal unless you let them and eventually if you keep using it before it does, your bone can actually break. I found alot of very helpful information via my own research online.

It took my foot about 3-4 months to completely heal- I'm sure this is because I was adamant about working out and never let my foot heal.

odd note- mine never showed up in an x-ray anyways but my doctor was positive that's what it was, so said the bone scan wasn't necessary. Seems to be doing okay now that I had to take 6 weeks off due to Rhabdo :-)

- hope this helps.

[Elliot Fuller]

Originally Posted by Rayna McGinnis

Seems to be doing okay now that I had to take 6 weeks off due to Rhabdo :-)

You're one tough cookie if that's something for you to smile about

x-rays showed nothing for me as well, and as there's no swelling and only mild tenderness, the podiatrist said he didn't think it was a stress fracture. In another week or two if it's the same I'll just go back in and get the bone scan.

I'm not doing any forefoot activities outside of walking around the house/work, so it should be getting plenty of rest. Thanks for the advice