Today on the Doc On The Run podcast we’re talking about the five most important things you can do for first aid for a metatarsal stress fracture if you’re a runner.
Let’s say you’re out on a run and you start noticing this weird aching pain in your foot and so you suspect you have a metatarsal stress fracture. I often get consultation calls and webcam visits, and I even do house calls for athletes who have metatarsal stress fractures.
Now, the good news is that a lot of the times, if you actually do something, when you first notice that aching pain in your foot, when you’re running, it may not actually be a true stress fracture. It’s more likely that it will actually be something called a stress reaction. Now, a stress reaction is really the precursor to a true stress fracture, where you have an actual crack in the bone.
Many times you will notice that you’ll feel this aching pain, and you’ll feel some aching at the end of the day. You’ll feel this very slight weird sensation, not really pain, but just discomfort every time your foot lands when you’re running. And that is indicative of something, that’s becoming a metatarsal stress fracture.
The issue here is that if you keep running on it and you keep pounding on it, it is going to get worse, plain and simple. But if you’re in that phase where it’s just a stress reaction and you do the appropriate first aid right away, you can prevent it from becoming a stress fracture that takes a lot longer to heal.
I was just doing a consultation call with a runner over webcam and I talked about the things that you should do right away to make sure that doesn’t happen. The first thing that you need to do is pretty simple. You need to stop doing anything that hurts that metatarsal bone. So, if you’re running and it hurts, then you’re loading the bone in the same way that applied the stresses that led to the stress reaction or the stress fracture and you need to stop doing that plain and simple.
If it hurts when you’re walking around your house barefoot, but it doesn’t hurt when you’re walking around wearing running shoes, well obviously you should do that. But you really need to pay close attention and you need to make sure that whatever you’re doing activity wise is not causing pain in that bone, or you know that you’re stressing the bone in a way that’s going to make the injury worse.
Now, the second thing you need to do, is you need to document your pain level. This is crucial. The most useful thing I can get from runners who are injured, who call me for a second opinion or a consultation over webcam, is to understand how bad the injury is and that is based on your pain level, more than anything else. So, if you go to the website and you print out the pain journal, or you create your own, you’re just trying to document how much pain you have in your foot. When you’re sitting still, how much you have when you’re walking barefoot, how much you have when you’re walking in running shoes, how much you have walking up the stairs in terms of discomfort, all of those things.
You really need to document them in a way that you can analyze them, say on a scale of one to 10, so that we can make sure that you’re getting better and you’re not going to do any damage as you return to activity and continue training.
The third thing you need to do is decrease the inflammation. When you have a stress reaction, you actually have increased inflammation within the bone. You have inflammation within the soft tissues and that inflammation, that swelling within the bone, within the tissues is what’s actually causing the pain. So, you’ve got to do something to decrease the inflammation right away.
The fourth thing is that you should really rest the foot completely for three days to let it settle down and calm down before you start testing it out and trying to increase your activity again. Three days is not going to mess up your running fitness, but three days can actually really jumpstart the recovery process and save you tons of time later.
The fifth step is to really work hard to stay fit by doing anything in terms of exercises that does not cause any pain or discomfort when you’re exercising later that evening after you exercise or the next morning after you exercise, but it has to be all three. Just because it doesn’t hurt when you’re doing the exercise, is not really a clear indication that it’s safe for you.
So, make sure that you analyze these things very closely so that you can figure out how to get back to running as quickly as possible. But those are really the most important five steps you can take as first aid for a metatarsal stress fracture if you’re a runner.