How likely is a setback if I run while my stress fracture heals? Well, that’s a great question and that’s what we’re talking about today on the Doc On The Run Podcast.
This is a great question that I got from a runner who had a 4th metatarsal stress fracture while training for a marathon, and he wanted to know how likely is a setback if he’s actually running while the stress fracture heals. That depends really on three things.
The first thing is, how strong is the bone right now? So if you say, “I had a 4th metatarsal stress fracture and I have to do a marathon, how likely is it I’m going to get re-injured?” It depends. How strong is the bone now? How much has it healed already? How much more does it have to heal before it’s really anywhere close to full strength? And what have you done to ensure that you’re reducing the stress on it while it’s healing? Because it’s not based on time, it’s based on a physiologic process that has to happen.
Everybody gets confused about this. Doctors at conferences will tell me, “How long does it take for this?” That depends. Is the patient really healthy? Does the patient eat really well? Does the patient sleep really well? Is the patient totally stressed out, or are they actually relaxed? Those things all matter.
The strength of the bone right now depends on what you’ve been doing to fuel the actual healing process of it in terms of your nutrition, your sleep, all those things. Have you been using a bone stimulator or not? That could also change things. Have you been unnecessarily stressing the bone like you’re supposed to be wearing a fracture walking boot? And you did, but you didn’t sleep with it, and then when you’d get up in the middle of the night to use the bathroom, you didn’t wear the boot that slows it down. All of those things factor into the timeline.
That’s why, if you actually look up the largest meta-analysis ever published about running injuries and stress fractures, the average, or the meantime, ranged in all of these different studies from 4 to 52 weeks. That’s anywhere from a month to a year. Why do you think there could be a month or a year? It could be a month or a year, depending upon what you’re doing.
So, if you get a fracture and you just go run outside and you keep doing your same training, it’s probably going to take forever to heal. Maybe never heal. But if you’re really treating it and respecting it, it’ll get stronger and stronger and stronger. Part of that also means, if you’re going to run with the stress fracture and you want to know if it’s going to heal while you run, it depends on how much you reduce the stress applied to the bone.
There are lots of different strategies to put the stress somewhere else. You can run in special treadmills that actually reduce the force of gravity when you run. You can modify your shoes to reduce the force of gravity, and the forces applied to the specific bone that’s injured. All of that matters.
The third thing that also matters is, how strong are you? Not how strong is the bone, but how strong are you as an athlete? Because the weaker you get, the longer you’re in a boot, the longer you’re on crutches, the longer you’re off of running, the weaker you get, the more unstable you become, and the more you wobble when you run. That will also increase your chances of getting another injury to that specific bone when you actually return to full training.
But all three of those things matter, and you have to think about those things more than you think about a specific number on a wild guess of your timeline.
If you liked this episode, please like it, please subscribe. If you want to check out more about stress fractures, you can check out the Stress Fracture Masterclass, and you can get it for free at docontherun.com/stressfracturemasterclass. So go check it out, and I’ll see you in the training.