Should I stop using the metatarsal offloading pads after I start running again and my stress fracture is healing? Well, that is a great question and that is what we’re talking about today on the Doc On The Run Podcast.
Let us say you get a metatarsal stress fracture like the second metatarsal. Well, one of the best ways to reduce stress and strain to that structure so that it can heal faster because it has got less stress on the stress fracture is to put the pressure somewhere else. So, if you apply more pressure to the first metatarsal and the other metatarsals, it leaves this one alone and so you are reducing the stress on that bone, and it will heal faster.
That is one of the things I show you how to do in the stress fracture course. And so, one of the runners who signed up for the metatarsal stress fracture course for runners was doing way better and he was starting to run. He asked me a question I had just not thought of before. He said, “Okay, I’m doing better, I’m starting to run. Should I stop using the pad?” Well, yes and no and I’m going to explain what the yes is and what the no is.
Yes, you should remove the metatarsal pad, and you should stop using it if you think that you’re putting so much stress on one of these other structures that those other structures could break or get a metatarsal stress fracture. So that depends on which form of offloading you’re using, which form of padding you’re using, how thick it is, how firm it is, and how much you have moved the force to individual structures.
So, that is a little more complicated than we can explain in one podcast. But the short answer is yes, you should not use the pad if you think that pad is going to apply so much stress to something else that you’re going to get a different stress fracture or different injury on those other things that are trying to support that one recovering metatarsal stress fracture.
No, you should not remove the metatarsal pad if you want to add distance while keeping the stress low on the recovering stress fracture. Again, the way I always think about this is your goal as a runner is to run as far as possible, as much as possible without increasing the stress and strain to that metatarsal enough to slow down the healing or crack it again.
One of the best ways to do that is put the stress someplace else. So, if you’re ramping up and you’re running and you’re sure that you’ve done it correctly, then you should not stop using the pad. I got an injury one time was using a form of offloading in one of my running shoes to reduce the stress and strain. I used it when I was walking around. I used it when I ran on flat ground. I even was using it when I started running on trails again and then one day a runner asked me how to apply padding to reduce stress to one particular injury.
I grabbed an old pair of running shoes, pulled it out and to my surprise, that pad was still there and sometimes those pads, depending upon which ones they use, they’ll sort of compress and deteriorate over time. And then you don’t even realize they’re there. So, they’re almost like self-imploding and so as you run on it more and more, it changes the offloading and decreases the offloading a little bit over time as that pad compresses down and gets thinner.
You don’t really have to remove it. But it is really important to think about how much offloading you actually need, how much you need to reduce the stress and strain on that metatarsal to match the strength in that metatarsal as you’re running and getting back to training.
If you want to learn more about the strategies I use with runners who have stress fractures, use the exact step-by-step strategies I use and the same ones I teach to physicians at medical conferences, when I lecture on stress fractures in runners, you can get that for free at www.docontherun.com/stressfracturemasterclass. So, come sign up and I’ll see you in the training.
