#851 Can I use a bone stimulator for a broken toe? - DOC

#851 Can I use a bone stimulator for a broken toe?

Can I use a bone stimulator for a broken toe? Well, that’s what we’re talking about today on the doc on the run podcast.



Yesterday, I was doing a consultation with an athlete who actually broke one of her toes and it’s pretty common, she actually kicked a piece of furniture and she fractured her little toe.

This is something that you have to understand, this is a minor injury, but it can really disrupt your activities. So, if you fracture your toe, and you just run and ignore it, well, it can turn into a painful nonunion.

What you have to do is you have to let it calm down, you have to let it solidify enough that you can actually return to activity without making it worse. So of course, as a runner, as an athlete, you want to speed that up as much as possible. And one of the ways to do that is a thing called a bone stimulator.

This particular athlete actually happened to already have a bone stimulator. She had had another fracture, she’d been using it for another injury previously and she still had it. So, her question was pretty obvious, you know, “Can I just use that bone stimulator for this broken toe? Since it’s a different kind of fracture?”

Well, the short answer is, yes, you can use a bone stimulator for other fractures but don’t ignore your doctor’s advice, I’m just telling you what to do with her and I said, “Yes, you can use a bone stimulator for your broken toe but there are a couple of problems with it.” And because of the type of fracture that she had, and the way that we needed to stabilize it, we had to tape the toe.

Keeping the fracture still in the initial phases of healing of a broken toe is really important and so since we use tape to stabilize the toe, that made using her bone stimulator problematic, because you have to remove the tape in order to actually get the bone stimulator to work because this particular type of bone stimulator uses ultrasound. And if you don’t have the electrode, and ultrasound gel, and then your skin, you don’t get conduction, and it won’t work, it won’t go through the tape.

You need to remove the tape, put the gel on the electrode and then put it on the toe and do it without the tape. So, in that sense, she has to make a decision, is it worth using the bone stimulator to speed up the healing and removing the tape but potentially moving the toe every time she removes the tape? Or is it better to just wait for a little while and then maybe use the bone stimulator later? Well, that’s a good question and the other thing is that with the toes, as opposed to like, let’s say, if you have a tibial stress fracture, your shin bone where your shins big, it’s really easy to wrap the retainer strap around your leg, put the gel in there, put the electrode on there and just leave it for the 20 minutes that the bone stimulator runs without causing any trouble and without any real difficulty.

That’s not going to work on a toe, the toe is tiny, and it will still work but you have to figure out a creative way to actually keep that in place. I have had athletes that actually put a little bit of excess gel on the toes and on the electrode, and then they cover it with a sock or something to actually hold it in place and that can work. But you’ve got to be creative if you’re going to do that.

But the real question here is, is it worth it or not? Is it worth the trouble of removing the tape? Is it worth the trouble of trying to hold it in place for that 20 minutes or not? And so in her case, I said “You might want to wait a little bit because right now, I think you have so much pain that you might want to just let it get a little more stable that you don’t really need the tape holding it still. You want to wait till some collagen actually forms between those two pieces of bone and then start using the bone stimulator.”

But did it speed it up? I don’t know, but I don’t know if it’s worth a gamble right now because she was having a lot of pain whenever she moved the toe or walked. So, that’s the way I think about it.

But if you want to learn some more about the way fracture healing works for us, particularly for athletes who are trying to maintain their activity and get back to running as quickly as possible, you might want to check out the stress fracture masterclass. This is where I go into a deep dive into the way that you have to think about fractures and returning to activity when you’re a runner, and you can get it for free at www.docontherun.com/stressfracturemasterclass. So, go check it out, and I’ll see you in the training.