Today on The Doc On The Run Podcast we’re talking about whether or not it’s dangerous to run on a stress fracture.
Is it dangerous to run on a stress fracture? Well that’s a great question. You know stress fractures are one of the most common problems runners get when they’re over training or when they just do too much. And when you get injured, stress fractures can keep you off of running for a really long time.
Somebody on Twitter recently kind of went off when I was giving a webinar about how to run with a metatarsal stress fracture. He kind of exploded and said, “you shouldn’t do it, it’s horribly irresponsible.” He had seven calcaneal stress fractures which is a stress fracture in the heel bone. Now calcaneal stress fractures are a different thing than metatarsal stress fractures.
Lots of runners who ask me whether or not it’s dangerous to run on a stress fracture. First of all the truth is, runners are often running on stress fractures. Sometimes knowingly, sometimes unknowingly. Sometimes they just think they have this vague ache or foot pain. They think they sprained their foot. But it’s actually a stress fracture that’s starting to get worse. You have to figure out whether or not you’re gonna really cause any permanent damage to decide whether or not it’s dangerous to run on a stress fracture.
First of all, anybody who gets seven stress fractures in the heel bone is doing something wrong. Either you have a metabolic disorder or you really need to really rethink the way that you’re training if you’re getting that many stress fractures in one particular bone. Something is definitely wrong, so you have got to figure out what’s going on there. But obviously calcaneal stress fractures are a completely different injury than metatarsal stress fractures. So if you have a calcaneal stress fracture, that’s an entirely different type of bone.
A metatarsal bone is tubular. Its round, it’s a cylinder, so it’s pretty strong. It can withstand a lot of beating. But the calcaneus or the heel bone is a trabecular bone, it’s different, it’s a very thin shell on the outside and is very soft on the inside. And when you get a crack in it, it’s already a thin, weak shell so now you have a crack in a thin, weak shell kind of like a hard-boiled egg. If you have a crack in a hard-boiled egg it’s not very strong. So you have got to let that bone heal. You can’t ignore it. But again, that injury is different than a metatarsal stress fracture.
The other important point with a metatarsal stress fracture is you have five metatarsal bones. You only have one heel bone, so if you have let’s say a fourth metatarsal stress fracture, in theory you could actually do some things like padding your shoe, change your inserts, modifying the ground underneath you, in a sense, by modifying the inserts in your shoe to take stress off of that one injured metatarsal and move the force of running to the another bone.
So if you apply more stress to the first, second, third and fifth metatarsal bones you theoretically reduce stress to the fourth metatarsal bone. So if you’re doing that, that’s not as dangerous.
So if you take pressure and stress off the injured bone and you don’t have any pain, if you do that and you walk around you don’t feel any discomfort, then it may be safe for you to walk around with that modified insert.
As it heals, as it strengthens, as it gets a little bit more stability then you might be able to use a modified insert like that and start running without it being dangerous. But with the heel bone it’s very difficult to take pressure away from the heel bone and put it somewhere else because all the forces are going through the heel bone when you run. You only have one heel bone in your foot. So that’s different.
So you have to remember it is dangerous to run on a stress fracture if you don’t do anything to reduce the stress applied to that bone when you run.
It’s not really complicated, if you keep doing the same thing, you should keep expecting the same result. So if you continue to beat up that bone in the same way by running in the same shoes, with the same inserts, on the same course, at the same pace, at the same stride and length, if you don’t modify anything…why would it get better? That would not be dangerous, that would be stupid. You’re doing the same thing that caused the stress injury.
You know you’re going to make it worse because that’s what caused the injury in the first place. But if you modify some things, if you change some things in what you do, you change some things in the routine to change the stress on the bone, then in theory it may not be dangerous.
You just have to figure out what you can do to reduce the stress to that one particular structure to allow it to heal while you keep running. Now if you do that, it’s not necessarily dangerous. So it doesn’t always have to be risky for you to run on a stress fracture.
But you have to talk to your doctor specifically about that with your circumstances, with your particular injury. What is the unique plan that you guys can come up with together? What is the plan that you can talk to your coach about and put together so that you have a set of workouts that will strengthen and fortify everything else in the system while that one injured structure is healing.
If you do that, even if you have a stress fracture you can maintain your running fitness and you can get back to running sooner.
If you have a question that you would like answered as a future edition of the Doc On The Run Podcast, send it to me. And then make sure you join me in the next edition of the Doc On The Run Podcast.