Which do you think is worse, a stress fracture or a stress reaction? Well, since a fracture is a crack and a reaction is just inflamed and irritating, you probably think stress reaction. However, it’s not true. Sometimes stress reactions take longer than stress fractures to heal in runners. Today, in this episode, I am going to talk about why.
Why can a stress reaction take longer than stress fractures to heal in a runner? Well, a couple of reasons for this and I heard an analogy recently, a completely unrelated to foot and ankle surgery or sports medicine, but it was an analogy that I thought was really appropriate for this particular episode.
The guy talking said it is really easy to retrain your brain not to do something because they asked him, how long does it take? And you hear all this stuff, 30 days, 45 days, 90 days of doing the same thing over and over and over before it comes in habit and he said, no, you can retrain your brain not to do something in one instant. You don’t believe me? Go right now, stick your finger in a light socket and you will train your brain not to do that in one single moment because you’ll remember how bad that is. Why does that have any relevance to this episode?
Well, it’s really simple. I was talking to a runner who had a calcaneal stress fracture, stress fracture in the heel bone. She was out on a run. She was on an eight-mile run, supposed to be an easy run and six miles in, she had this sudden pain in her heel that was so bad she couldn’t even walk. And had to call her husband to come pick her up.
When I talked to her 11 days later, she was still on crutches and not walking on it at all because it hurt really bad. Yet all the time I talked to runners who’ve been running on these things where they’re really not hurting that bad. There’s a guy I talked to recently who’s had pain for two years. He now has this huge bulge in his metatarsal because he was running on it and his body was trying to fix it and it’s formed so much extra bone around there that it’s bulging and taking up space in his foot. So that’s the is that this is a completely different set of circumstances where one of them hurts a whole lot and you stop immediately, and your body starts healing it.
The other one, it doesn’t really hurt that much. Maybe you run three miles instead of five. Maybe you run at an eight-minute pace instead of a seven-minute pace. Maybe you run every three or four days a week instead of six or seven days a week. But you basically dumb down your training. You slow down your runs. You shorten the distance. You do things to modify your training enough that it’s not killing you, but it’s still not getting better. And as a consequence, the stress reaction that didn’t really form a crack and completely break so much that it’s killing you can take a whole lot longer to get better. That’s really the big reason here.
So, you’ve got to really think about this discomfort that you have and there’s all these articles I’ve read where people say these, they try to come up with rules on when you should stop running. Well, if it, if it hurts for three days, then you should take some time off of running and go see a doctor or if it hurts so much, you can’t walk. You should go see a doctor. There’s a whole range of things from everywhere, like just complete and total nonsense to complete common sense that I don’t really understand how runners are supposed to make sense of these things and come up with an idea on their own.
But the way I think about it is really simple. You have to look at your goal, right? So, if you have a goal of running, let’s say a half marathon in on March 5th, just picking an arbitrary date, let’s say it’s March 5th and you only have a few months to train for that. If right now you have so much pain in your foot that, you know, you’re not training effectively, you’re not motivated and visualizing your finish at your finish goal time, but you’re running, basically trying to keep your foot from hurting more and more and more the whole time you’re running. Well, that’s a problem.
There’s no way that you should expect that if you continue to do that, it’s just going to magically go away. That it’s going to suddenly disappear that your dress fracture is just going to vanish while you’re still beating it up. So, if you’re running and it’s causing a disruption of the training that you have on your refrigerator, your actual training plan, you’re having to skip workouts that your coach is giving you, or when you do your runs, you’re worrying more about your foot than actually staying on pace or running with good running form. It’s not going to help. And that’s part of the reason that, I mean, that’s the biggest thing that I think runners have to look at when they’re trying make a decision about whether or not they really need help and whether or not they need to make some sudden change.
When you break it and it cracks and somebody has to pick you up and give you a ride home and you can’t even walk on it, we don’t have a choice. You can’t run on it and so in that reason that sometimes those stress fractures where there actually is a crack will get better faster than a stress reaction because the stress reaction allows you to misbehave and beat it up and neglect it and abuse it and continue just this maltreatment of the injury, but you think you’re still running and you’re just hoping it’s going to go away. That’s really the big problem.
If you want to understand more about the strategies that I use with runners who actually have metatarsal stress fractures, stress reactions, tibial stress reactions, all those kind of things, it’s all in the Stress Fracture Masterclass I put together. You can get it for free at www.docontherun.com/stressfracturemasterclass and it’s where I actually go into a deep dive on those exact strategies I use with every runner that calls me with one of those injuries. So, come check it out and I’ll see you in the training.
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