How much should you move your ankle when you have a metatarsal stress fracture?
If you are recovering from a stress fracture and trying to stay fit while the bone heals, start with my stress fracture resources for runners:
Click here for the Doc On The Run stress fracture resources for runners.
I was on a call with an elite Masters track athlete who had a third metatarsal fracture. She noticed that her ankle was getting stiff from being in the fracture walking boot, and she was appropriately concerned that the stiffness could predispose her to other overtraining injuries once she returned to full running.
That was a very good question.
When your ankle becomes stiff after immobilization, it can take much more force to move the foot toward the end range of dorsiflexion. Since your foot acts like a lever on the end of your leg, increased ankle stiffness can change the forces going through the foot when you walk and run.
But there is an important problem: while you want to preserve ankle motion, you also have to protect the healing metatarsal.
The simplest way I explain this is that a little motion, a lot may be much better than a lot of motion, a little.
Trying to force the ankle through a large range of motion with a lot of pressure only a few times a day can apply substantial force through the foot and the healing metatarsal.
A different approach is frequent, gentle motion: something more like lightly pumping a gas pedal, doing gentle ankle movements, or moving the foot through a small comfortable range many times during the day.
The point is not to force the ankle to its end range. At the end ranges of motion, you can increase tension through structures attached around the foot and potentially increase stress around the healing metatarsal.
You do not want the metatarsal stress fracture to heal while you develop another problem that delays your return to running, such as excessive ankle stiffness, another stress injury, or Achilles tendon trouble.
At the same time, the metatarsal has to be stable enough for every new level of activity you add.
If you push too hard, create pain, or overload the healing bone, you can create a setback.
The most important practical point is to track your discomfort. If gentle range-of-motion activity causes discomfort, stop and follow the advice of the doctor treating your injury.
Without tracking your pain and discomfort, you have no objective way to know when it is appropriate to progress to the next level of activity or when you need to back down.
I created a free Stress Fracture Severity Worksheet to help runners systematically track symptoms and determine whether a stress fracture is improving or getting worse.
Click here to download the free Stress Fracture Severity Worksheet.
Use it so you can make better decisions as you increase activity and avoid the common mistakes runners make while recovering from a metatarsal stress fracture.
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