#511 Can a stress fracture spread from one metatarsal to the bone next to it? - DOC

#511 Can a stress fracture spread from one metatarsal to the bone next to it?

Can a stress fractures spread from one bone to another? That’s a great question and that’s what we’re talking about today on the Doc On The Run Podcast.


Before we get started in this episode I just want to let you know I created something for you that I think you might find really useful. It’s a presentation sharing the three main secrets I have discovered that are used by injured runners so they can maintain their running fitness and still recover from any over-training injury. Even if it’s a stress fracture, a plantar plate tear, a partial rupture of the plantar facia or Achilles Tendinitis.. this will help you get up and get moving!

So if you’ve been told you have to sit on the couch and wait for an x-ray or for something to change, you need to check this out.

I’ll explain more at the end of the episode. And let’s queue up the theme song and get started with today’s show.

All right now one thing that’s really demoralizing if you get a stress fracture is to spend a bunch of time in a fracture walking boot to spend several weeks not running, not training, not doing anything and then go get something like an MRI and be shocked and horrified when the doctor says, “Well, not only do you have a stress fracture in that bone, it looks like you’ve got a stress fracture in another bone as well.”

If you think this stress fracture might have spread well, it could, but not the way an infection would. This is not a contagious thing, but there is a way that you can actually get inflammation in a neighboring bone that happens as a result of getting an original stress fracture.

For example, let’s say that you have a third metatarsal stress fracture. So if you have a third metatarsal stress fracture and it hurts when you walk and it hurts when you train, it hurts when you ride a bike, it hurts when you’re doing any kind of workout, but because you’re an athlete, you don’t really notice it so much. Well, what you’re going to do normally is you’re going to limp. You’re going to compensate. You’re going to walk in ways that actually put that pressure someplace else. And the first three metatarsals, the one that goes to the big toe, the second toe and the middle toe. Well, they all line up with the navicular that lines up with the talus bone.

Why is that important? Well, that basically acts as independent suspension from the other two that go to the pinky toe and the fourth metatarsal. So the fourth and fifth are like your lateral suspension and the other three of your medial suspension. So if you get a stress fracture on the third, and then you tilt your foot to take stress off of the first, second, and third, all that pressure shoots over to the fourth. You might get an MRI that has a real stress fracture on the third metatarsal, and then shows some inflammation in the bone that’s really a stress reaction that’s kind of heading toward a stress fracture, just because you’ve been compensating so much.

The other way is that it spreads from the metatarsal out into the toe. The way that can happen is that if you have, let’s say a stress fracture at the neck of the metatarsal, right near the knuckle, right near the head of the metatarsal, it can get so inflamed that you actually get something we call, reactive edema, where the first bone in the toe, the first of those three, the one called the proximal phalanx bone, well it actually starts to become inflamed just because it’s in the neighborhood of all that noise.

That’s not really a concern because stress fractures in the toes don’t really turn into a problematic thing very much at all. So it’s more concerning that if you’re getting multiple metatarsals that are joining in the party and they’re getting stress reactions or stress fractures as well, that’s a totally different story, but it can spread.

It’s not that the infectious process or the inflammatory process is damaging those bones. It’s usually because it’s either reactive inflammation, just because it’s in the same area or you’re compensating and you’re shifting the forces away from that primary injury. And now you’re starting to get a secondary injury because you’re putting too much stress on another injury, but that’s a great question.

So that’s the way that the stress can move from one bone to a neighboring bone and look like your stress fracture is kind of spreading from one bone to another. So make sure you remove the stress if you want to continue training, but the name of the game is make sure that you actually keep your fitness as you heal that stress fracture.

That’s the most important thing if you’re a runner who wants to get back to running as quickly as possible.

At the beginning this episode I told you that I have created a presentation that you really need to see if you are injured and are trying to figure out what to do next. You’re going to find really useful if you have an overtraining injury and you are told that the key is to sit still, rest, recover and, in short…do nothing other than watch your fitness evaporate.

It doesn’t have to be that way. I will show you 3 Secrets to Overtraining Recovery that injured runners use to maintain their running fitness and still recover from any overtraining injury. You can use the presentation get moving, maintain your hard-earned running fitness and get past any overtraining injury.

Registration is free just go to docontherun.com/overtrainingsecrets and sign up there.