#160 Can I run my race with broken toes? | DOC

#160 Can I run my race with broken toes?

Today on the Doc On the Run Podcast, we’re talking about whether or not you can run your race with broken toes. 

Broken toes are common, but they can really hamper your training when you’re getting ready to run a race. If you break your toes a few weeks before a big race the question is always whether or not you will be able to run your race.

Today’s episode is based on the questions sent in for a runner who broke a couple of toes and wants to know whether or not she’s going to be able to run her race in a few weeks. This episode will help you understand the questions to ask if you break your toes and you still want to run. 

The listener wrote in and said, “This coming Wednesday will be six weeks since I’ve fractured/minimally displaced my fourth and fifth toes. I wore a boot for two weeks and now I’m in a stable ASICS running shoe. My follow up appointment was yesterday and by looking at the x-rays, the doctor said it looks good and is healing. My big concern is that I have a race coming up in about three weeks, Ragnar Relay” so for those of you that don’t know, Ragnar is a relay race where you race with a team. You do really long distances. You break it up into segments and you just keep running, taking turns after each other, and in this case, she is the team captain. 

She says, “Thankfully I took shorter legs this year, 3.4, 3.2, and 8.3 miles. This week, I plan on doing a long walk and seeing how my toes feel. Then I plan on running around a track. However, I am still curious if you think I should run this distances in four weeks even if I’m feeling decent. If not, I need to find a replacement and soon. Please help. Thank you.” 

Okay, this is a really great question and everybody wants a simple answer. They wanna know, “If I break my toes, can I run my race?” Well, that depends on lots of things. You have to remember there is so many factors that go into this. The first thing is if you think an analogy like a car accident. How long does it take to fix a car if you get into an accident? That depends. Did you sideswipe a shopping cart in a parking lot or did you drive it off a bridge? Who’s gonna be fixing it? Is it gonna be one guy or is gonna be a team of people? You have all these variables. 

The first thing I would say is if you’re really trying to figure it out, the first question is what did your doctor say to do? If your doctor said you can run, then you can probably run. If your doctor said you couldn’t, then maybe there are a couple other options. Maybe you could if you got some different information. Your doctor can help you decide. I can help you decide, or you can even decide yourself if you know the right questions to ask, and one of the courses I’ve put together is the stress fracture course that teaches all of the decisions you have to make when you have a fracture and you’re trying to figure out whether or not you can actually run. 

But here’s the gist of it. You gotta think about this. How does it actually feel now? It feels okay it sounds like, but what does it actually look like? Do you have any bruising now? Do you have any swelling now? How does it respond when you move it? When you touch it? When you squeeze it? When you walk on it? What is it exactly that the doctor saw on the x-rays? What is it that the doctor defined as “It looks great. It looks like it’s healing.” Is that trabeculation? Is it callus? What is it that the doctor actually saw?

The next thing is how healthy are you as a runner? How fast are you healing? What are you doing now to accelerate the healing process? What are you doing to protect the fracture while it’s healing right now? And what are you gonna do to protect the fracture when you’re actually running during the Ragnar Relay? As long as you know the answers to these kind of questions, and you really think about it, and you’re careful and you’re thoughtful, you usually can run with broken toes, but that depends on so many variables. You don’t really even need to call me to figure this out. You just have to think about it and think about what’s going on in your foot and the fracture specifically. The bottom line is when you have a fracture, whether it’s a metatarsal bone or broken toes, the thought process is actually pretty much the same. You have to think about several really important things.

Number one, what is your most important goal? If your most important goal this year is to run the relay race and to be team captain and participate in the way that you want to, it may be worth the risk of causing some disruption of the fracture healing. But then the second thing is you have to figure out how far along that healing process you actually have made it so far, and how much you can do to boost the healing and further stabilize it from now until the day you run.

You might wanna protect it more. You might wanna do some other stuff to stabilize it more. You might wanna do some stuff to speed up the actual healing process and make sure you’re really making that healing process over the next couple weeks really as fast as possible, so that it’s even stronger when you actually do run, and if you do that, of course, if it’s stronger on the day that you run when you participate in your event, then there’s a whole lot less chance that you’re gonna actually undo some of the healing that has taken place. 

With all of these kind of injuries whether it’s a fracture of the toes, a fracture of the metatarsal bone or whatever, you have to decide what your timeline is. You have to realize that if you have a finite period of time before your race, which of course, almost every runner has a very well-defined timeline because you’ve signed up for a race and then you got injured, you have to figure out how you can speed up the healing and whether or not it’s a risk … worth the risk of disrupting that healing when you actually do the race. So many variables go into that. It’s all of the stuff you do. Truthfully, how much you sleep, how much you eat, what you’re doing to prevent any recurring inflammation, what you’re doing to prevent any ongoing damage to the healing process right now. What you’re doing to really protect it and speed up that healing. Those things really make a huge difference. 

But it’s really also just math. If you think about it, let’s say you have up to a 100 points of stress. Let’s say we could call stress units. Stress applied to the healing fracture and you have basically a 100 points of stress before it becomes disrupted, and let’s just call it, to make it simpler for this explanation, a 100 is the breaking point where you disrupt the healing and you have to start healing all over. Okay. If you’re walking around barefoot, we know that’s more stressful than wearing the protective ASICS shoes, whichever kind of shoe that is, and there might be other shoes though, you could choose that would stabilize you better, protect the toes better, and decrease some of the force through the toes when you’re walking, and if you wore those shoes, you’d decrease that number even more. 

The way I always think about this with runners is you have to figure out how can you reduce the stress as much as possible during your other daily activities and then use up those points of stress while you’re running? Now if you do that, then you basically get free extra distance while you’re running before you cause any particular problem with the healing process in the fractured area where it’s trying to heal. It’s just math. You have to think about all the stuff that you’re doing right now that’s applying force to the toes that could disrupt the healing and not do that. You have to figure out what you could do to speed up the healing process, fuel the healing process, protect the healing process so you don’t unnecessarily burn any of those points, and maybe frankly, even add some more potential stress to it. 

Remember the healing process is a continuum. You break the bone and it’s broken. Somewhere down the road, many weeks later, it’s basically healed but you don’t have to wait until that happens for you to run because … and you don’t have to wait to that to happen before you start doing some stuff to maintain your running fitness either. Every single day that the healing process proceeds uninterrupted, uninhibited, and undamaged, the bone is getting stronger. It’s getting stronger all the way from day one to the day it’s completely healed. But the deal with that is that you have to realize that most doctors are trying to tell you that you have to wait until it’s healed before you start doing activity because otherwise you could screw it up. 

That’s true, but you know that basically halfway through, it’s halfway healed and it’s halfway strong. Well, does that mean that you could run on it that day? Maybe not, but you could probably do a lot of other stuff. You could probably do some stuff that’s gonna maintain your fitness and not disrupt the healing, so you’ve gotta think about these questions and then figure out how it applies to you, your state of healing, your particular health, and all the things that you’re doing to basically accelerate the healing process to decide whether or not you’re gonna be ready on race day. 

Then you have to know how to evaluate it, how to look at it, how to decide whether or not you’re actually on track, or if you’re losing ground to see whether you’re gonna be ready on race day. But that’s the kind of stuff we put on the metatarsal stress fracture course and teach you all those things because that is the process that I use with runners, so when somebody calls me, I basically go through and ask them all those questions, on a consultation call, on a webcam visit, whatever, and I basically get them to answer those questions so that we can figure out together exactly where you are, where you need to be, and how you’re gonna be ready on race day and how you’re gonna know that you’re ready on race day. But you have to figure that out. 

You don’t necessarily need me to do it, but you can do it if you really think about it and you really think about all the stuff you’ve been given so far to help the healing process and if you can make an assessment about where you are now, then you can do that, or of course, you can just ask your doctor and try to pin your doctor down. A lot of doctors don’t wanna do that. They don’t wanna take the risk of telling you it’s okay to run on it. They wanna tell you, “Just wait and see. If it feels okay, then it’s okay.” These very vague descriptions that aren’t really that helpful, but if you’re really direct with them and you pin them down, sometimes you can get them to give you a straight answer on whether or not you’re gonna be ready to run that day. 

But it is possible to figure it out on your own. You just have to know what questions to ask, and then what you can do in response to the answers to those questions so that you can decide are you really on track or not? Is it getting better or not? Are you disrupting the healing or not? And is there anything you can do different right now to speed up the healing process so that you know you are ready on race day. 

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!

 

If you have  fracture and want to run…you need this course!  It will help understand the exact process I use with injured runners when the get a fracture and want to keep running…