Can I run with Jones Fracture?

Noooo! Or, I should say, you cannot run on a Jones fracture until it has healed enough to withstand the stress of running without re-injuring the fractured bone.

What is a Jones fracture?

A “Jones fracture” is a specific type of foot fracture in a specific location, in a very specific place in the fifth metatarsal bone. It is a common misconception that fractures of the base of the fifth metatarsal are all Jones fractures. That is not true. All fractures affecting the fifth metatarsal base are not Jone’s fractures.

Where is a Jones Fracture?

A Jones fracture is located in the area of the fifth metatarsal bone referred to by physicians as the “metaphyseal-diaphyseal junction.” What that means is that the long tubular shaft portion of the metatarsal bone starts to blend in with the lumpy portion of the bone at the base of the fifth metatarsal bone.

If you feel along the outside of your foot, about halfway between the heel bone and the pinky joint you will feel a lump of bone protruding under the skin. That lump of bone is the base of the fifth metatarsal bone. Doctors call that bump the “styloid process.” The styloid process is metaphyseal bone. It is not tubular like the skinny round shaft of the metatarsal bone. It is just a big lump.

The lumpy part of the bone at the base is metaphyseal bone.
The long skinny part is the diaphysial bone.
Where those two parts of the bone blend together is the “metaphyseal-diaphyseal junction.”

Even if you don’t understand all of the anatomy and the way bones develop, you can find this area very easily by looking at a foot x-ray. The fifth metatarsal bone is the one on the outside of the foot leading to the pinky toe. The fourth metatarsal bone is the next one over. If you look at the view of an x-ray taken from straight up to straight down toward the ground when you’re standing the point at which the fourth and fifth metatarsal bones begin to intersect is right where the metaphyseal-diaphyseal junction can be found.

So if you have a fracture that begins right at the intersection of those two bones and then see fracture lane that goes laterally, straight across the bone toward the outside of the foot, that is a Jones fracture.

Why is a Jones fracture so scary to runners?

The diaphyseal bone, making up the shaft of metatarsal, forms separately from the metaphyseal bone. Those different parts of the bone have separate blood supplies. Unfortunately, that leaves an area in between the two different parts of the bone that is known I have a poor blood supply and is difficult to heal, frequently requiring surgery to get it to heal.

If you got a Jones fracture which developed as a stress fracture, it will predictably get worse and fail to heal if you stress the 5th metatarsal bone in the same way that injured it. That of course means that if you run in the same way, with the same running biomechanics, the same type of workouts, in the same running shoes that stressed the bone enough to cause a stress fracture in the metatarsal bone, you will just make it worse if you continue that activity while the bone is trying to heal.

But that doesn’t mean you cannot keep working out.

The number one goal of every injured runner should be maintaining your running fitness while you heal the running injury. Unfortunately what we hear from doctors most of the time is that your goal is to rest. If you’re a sedentary individual, the goal of “just resting” is completely reasonable. Part of what the establishmed medical community preaches regarding “rest as the path to freedom” is a lie. If you’re an athlete, and you want to run later, you have to be aggressive in your approach to recovery. Rest is not enough.

If you have a Jones Fracture and you are stuck in a boot waiting and watching all of your hard-earning running fitness evaporate…you need to let it heal AND figure out what you can do to prevent all of the weakness, stiffness, loss of neuromuscular connections and dis-cooridination caused by the fracture boot and inactivity during the recovery process.