Returning from Metatarsal Stress Reaction

[Lucas V]

Hi all,

I’ve been out from a metatarsal stress reaction (fracture? don’t know) for five weeks now, and I’m wondering when it it would be safe to initiate my return to running.

TLDR; What signs indicate readiness for a return to running barefoot?

Here’s what happened:

• had a great summer training before cross-country until it was cut off by patellofemoral pain and other knee issues
• started running again after having knee problems for 3 months
• I was desperate to get back into shape right before the season, so I pretty much went straight up to 30 mpw in the span of two weeks
• knees felt so good while barefoot, and I only ran about 70% of mileage barefoot while getting back into it (what my XC coach had me do)
  
• took 14 days of running with no rest days, something I had never done before and developed tenderness in the top of my foot over the second metatarsal
• I don’t remember when it started, and there was no distinct point where I felt it
• never felt pain or even uncomfortability while running or walking, just noticed that the spot was warm, swollen and painful to the touch

I stopped running and took 5 weeks off, and here I am: the swelling seems to be the same as it was as the first week off, but it hurts a lot less when I palpate the area. I don’t know if it was a stress fracture or reaction, but am just wondering when it would be appropriate to try to start running again.

I apologize for the long read, but thanks so much for your help!

 

[Barefoot TJ]

I take it you didn't see a doctor? I understand that stress fractures won't show up on an MRI until weeks after they've healed. Check on that. Maybe you could get one to see if it actually fractured. And if you didn't see a doctor, I would definitely go to one now.

I'm not a doctor (or your coach), but before running again, it would be a good idea to walk...a lot. Don't add extra stress to that area by pounding the pavement. And strengthen your feet, your arches, by exercising. There are no muscles that support the metatarsals (you do have fat pads below that provide a cushioning), but strengthening the arches, ankles, etc., should help provide support.

My biggest advice, and you're not going to want to hear this, is to be patient, really patient. I wouldn't run until I was fully healed.

Also, please copy your post to the Ask the Docs forum, and I will have Dr. Mark get back with his opinion.

Good luck to you.

 

[Lucas V]

Thank you for your help. Correct, I have not been to a doctor yet, but I have an appointment with a supposedly good podiatrist in about 2 weeks.