#611 What if stress fracture still swells and hurts a lot? - DOC

#611 What if stress fracture still swells and hurts a lot?

 

Today’s episode from a question on the Doc On The Run YouTube channel.

Ivan has a great question. After watching the watching the video “Can I Run After Wearing a Fracture Boot?” he wanted to know: “It still swells and has a lot of pain what do I do?”

Anytime a runner gets a stress fracture, the main goal is to confirm the foot is healed enough to withstand the forces and stresses applied to the injured bone.

There are really 3 strategies:

  1. Wait long enough to guarantee the stress fracture is healed completely.
  2. Wait and get an imaging study that proves the stress fracture is healed completely.
  3. Figure out whether or not the stress fracture is healed enough to withstand stresses as you gradually increase forces applied to the bone in a graduated fashion when you begin running.

Although I cannot tell Ivan what to do, because I am not his doctor and I have not evaluated him personally, I can tell you how I would think about this situation.

There are 3 indicators of ongoing tissue damage when you have a stress fracture.

  1. Bruising
  2. Pain
  3. Swelling

If your foot swells and has a lot of pain you must have ongoing tissue damage. I have to presume that the forces being applied to the bone with the stress fracture are way too high. If the forces are too high you will get pain at the fracture site. If the bone is moving and potentially getting microfractures at the fracture site in an ongoing cycle of tissue repair and subsequent damage, that may show up as either bruising, swelling, or both.

If Ivan scheduled a consultation over WebCam with me the questions I would ask him are:

  • Did your doctor get an X-ray, CT scan or MRI or something confirmed the bone was healed?
  • Have you been tracking pain levels to judge whether or not the stress fracture is improving?
  • What are you doing to reduce stresses on the bone?
  • What have you been doing to gradually increase stresses while restoring your running specific fitness?

Remember, getting a stress fracture to heal and getting back to running is never about a timeline. It is all about how thoughtful you can be and how many different actions you take to encourage healing in the bone and maintain your running specific fitness to better support that injured bone when you actually return to running.

 

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