How can your running shoe insert show you whether or not you’re at risk for a metatarsal stress fracture? Well, that’s what we’re talking about today on the Doc On The Run Podcast.
When you get a stress fracture, you have to remember that it is a stress related injury. That’s why it’s called a stress fracture. It’s not a run too much fracture, it’s not a ran too far fracture, it’s a too much stress fracture. So, if you want to know whether or not you’re at risk of getting one as you ramp up your training, one of the simplest things you can do is look at your running shoes. And what you’ll read a lot about when assessing your running shoes is things like assessing the wear pattern, the sole bottom of the foot, looking at where you’re landing, all that sort of stuff. But there’s another trick you can use, which I often use when I’m even doing webcam consultations with people. Or if somebody signs up for the metatarsal stress fracture course, I actually have them do this.
I’ll say, okay, here’s what you do. Take a running shoe. Any running shoe, preferably one you have run in a lot recently, what you do is you take the insert out of the shoe. And when you look at it, well first of all, a black shoe insert like this one, much more difficult to assess. But if you look at it from a number of angles in different light, you will start to see very clear where patterns, where your big toe is, where the second toe is, where the big toe joint is, where the fifth metatarsal actually lands, where the heel is, all of that. You’ll see that on the running shoe. If you have one that has a lighter colored insert like this one, that helps. So when you take this one out, it’s light. So, if you look at it on this one, it is much easier to see where the wear is under the big toe joint, where the wear is at the ball of the foot.
And if you look at this one in particular where the wear pattern is on the ball of the foot here, where the metatarsal heads 1, 2, 3, 4, and 5 all hit, well, it’s fairly uniform and even. But whenever I see runners who have had a metatarsal stress fracture, what happens is, I will take the insert out of the running shoes to look at them and modify them the same kind of way I show you to do in the metatarsal stress fracture course. And as soon as I pull the insert out and I look at it, there’s always significantly more wear right under the head of that metatarsal where the foot’s hitting the ground.
When you have too much pressure under that one metatarsal, that’s why it gets a stress fracture. So sometimes if you can modify the insert and you can reduce some pressure to that one metatarsal, it will really reduce your risk of getting a stress fracture. There’s some very, very simple ways to do that. But if you want to tell whether or not you’re at risk of that, pull out your running shoe. If you pull out your shoe insert, like the one I just showed you, it’s fairly even wear all the way across the ball of the foot where all five of the metatarsal bones are hitting the insert, very low risk of a stress fracture. If you have one area where you have lots of wear, lots of abrasion, lots of wearing away, or wearing a hole in the insert or something like that, in that one spot, that one structure in that spot is way more likely to get an injury, like a metatarsal stress fracture.
So, if you have an insert and you’re wondering about that, you can send them to me If you’re in the fast track challenge, for example, I use those as examples to show you like what to do to take pressure off of that, how to assess it as you’re going through and trying to figure out whether or not it’s safe for you to run as you have this aching pain in your foot. But you’ve got to look at your insert. So, if you want to send pictures of me, so I can use them as examples, I could, but very easy to do yourself. It’s not complicated.
You just have to remember where is the wear. What structure is taking the most stress based on that wear pattern? And when you look at your insert, particularly if you’ve been running the shoes for a while, they can give you a huge amount of help to making sure that you decrease the stress and strain to that one bone so that you don’t get a metatarsal stress fracture.
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