Running on a healing stress fracture is all about risk | DOC

#149 Running on a healing stress fracture is all about risk management

Today, on the Doc On The Run podcast we’re talking about how running with a stress fracture is all about risk management. 

Running with a stress fracture is really just about risk management. 

I mean, it’s really risk versus reward. Think about this in terms of investments. I mean, there are  all different kinds of investments, right? Some people buy gold, some people put their money in startups, and those two things are totally different, right? You’re not going to lose all your money in gold. That’s unlikely, but it’s also not going to probably go up a thousand times in value, but a startup might, but then a startup might actually fail too, maybe the app won’t work. Maybe nobody would want to buy it. Who knows? Some people put their money in mutual funds where it’s just a collection of stocks. Some people put their money in a real estate investment trust, where it’s just a collection of properties. 

Those things are all different. And why do people invest in different risk levels of investments? I mean, why do you think about that? I’ve heard lots of different people talk about this and saying that, “If you’re older, you probably don’t want a lot of risk. If you’re younger, you can tolerate more risk because if you’re younger, you have more time to catch up, you have more time to repair the damage if something goes wrong.” Now, the same thing is really true for running with a stress fracture. It’s all about risk management. And the thing is that you have to think about your timeline and you have to think about your goals the same way that you would in any kind of other investment. You’re just investing in your health and your athletic activity and the risks that you tolerate really is related to your specific goal. 

So if it’s January or February and you get a stress fracture, but you’re running the Boston Marathon and you’ve been trying forever to qualify and you really want to run the Boston Marathon, you have to think very carefully about how much risk you’re willing to tolerate while you maintain your fitness and ramp up for the Boston Marathon in the middle of April. But if you get a stress fracture in January or February and you really don’t have another race on the calendar until the Houston Marathon another year later, well, you have a lot of time to mess around and to heal the thing and then rebuild your fitness before that next race. If you don’t really even have another race on the calendar at all, but your goal is just to continue running as long as possible to maintain your fitness, to stay active for a lifetime, then that’s also probably a different strategy you’re going to apply to healing your metatarsal stress fracture. 

And that’s really the bottom line. Medicine is all about risk versus benefit. Everything in medicine has risk. I tell the patients this all the time, I say, “There is no free treatment and medicine. There is nothing that comes without risk. You have to pay a price for everything. If you take Ibuprofen, it might hurt less, you could have kidney failure, you could get a stomach ulcer, you could get gastrointestinal bleeding, you can get those things from taking anti-inflammatories. There’s risk with everything. There is risk with using a fracture walking boot when you get a metatarsus stress fracture. You’re going to get weaker, you’re going to get stiff or you’re going to lose your neuromuscular connections. You’re going to lose your aerobic fitness and you’re actually going to be more at risk of other over-training injuries later. So there’s risk even with that. 

So some people say, “Oh, do the safe thing and wear a fracture walking boot or use crutches,” but there is risk with that too. It’s all about risk versus reward. The main thing that you have to do when you get a metatarsal stress fracture and you want to run is you have to figure out what your goal is, what’s really most important to you in terms of your timeline, and then you have to think about how bad do you really want it to heal faster than average? Do you really want to wait the standard amount of time to heal or is there something else you’re willing to do? What are you willing to do to heal your metatarsal stress fracture faster? What are you really willing to do? That’s the important thing. You’ve got to figure that out before you can get started. 

So when you get a metatarsal stress fracture, you have to realize that it’s not a specific thing that heals in a specific time that’s the same for everyone. It all depends on what you do. The more things that you do to make the metatarsal stress fracture heal faster, the faster it’s going to heal. The less stress you apply to the metatarsal stress fracture as your active, as your training, as you’re running, the faster it’s going to heal. The more you beat it up, the more you abuse it, the more you heard it, the more stress you apply to a stress fracture, the longer it’s going to take to heal. That’s it. 

You need to figure out what your timeline is. You have to figure out what’s important to you. You have to figure out what’s really important in terms of your timeline, what’s really most important to you. And then from there, you can actually figure out a strategy to heal it fast as you need in order to achieve your goals. But that’s really the key. You’ve got to figure out what you need, what you want, and what you’re willing to do to get your metatarsal stress fracture to heal so you can keep running.

Learn how you can heal a stress fracture and keep running.

If you have a question that you would like answered as a future edition 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. Thanks again for listening!