Does a stress response equal rest in peace to my VO2 max? Well, that is a good question and that is what we’re talking about today on the Doc On The Run Podcast.
Today’s episode comes from a question and not really a comment on the Doc On The Run YouTube channel and this was a comment that Brian posted on a video entitled “Proof you do not have to stop running with a metatarsal stress response.”
Brian was clearly frustrated. He commented, “I wish… I have a big swollen reason under the second metatarsal. It tingles a bit while running. Slight burning. I have to alter my landing to not irritate it. I’m finished. Rest in peace to my running VO2 max. I got to focus on cycling.”
Okay, well, I feel your pain, Brian. I actually had a stress fracture one time, and I was told that I had to stop doing everything and wear a fracture walking boot for six weeks and canceled an event that my buddy and I were doing together, and I am still upset about it.
But number one, a couple of things I think are really important in Brian’s comment here is number one, you have to know the difference between a stress response, stress reaction and stress fracture. They are very, very different. A stress response, number one, is not pathologic. It is not wrong. It is not a bad thing. If you get an MRI of your foot because you think you have plantar fasciitis and you’ve just done a 50-mile trail race and the radiologist says you have a stress fracture in your third metatarsal, but you don’t have any pain there, it’s probably not a stress reaction at all. It’s probably a stress response which is not pathologic and by definition it means you have no pain.
Also, two different studies show that with ultra marathoners who do stage races and professional marathoners, if you have a stress response, you do not need to mitigate your training plan at all. You don’t have to change the training plan. You don’t have to decrease it. You don’t have to stop running.
If you alter your running form to avoid irritating it, then you do not have a stress response and that is what Brian says that he has to change his gait in order to make it not hurt. That means it’s at least a stress reaction and maybe even a stress fracture and that is a key difference. So, there’s a big difference in the severity of what’s going on with the pain when you have a stress response, stress reaction and stress fracture and the number one mistake I see runners make with metatarsal stress injuries of all varieties is failing to figure out the actual severity of the injury when the problem begins. All of your effort has to maintain your running fitness and all of those efforts have to be based on the injury severity.
The stress fracture masterclass is a thing that I put together that shows you the differences between a stress response like Brian thinks that he has and a stress reaction which seems more probable to me based on his description that he might actually have, but I don’t know because it sounds like a doctor diagnosed him, but the stress fracture masterclass that I put together would help Brian understand the exact differences between a stress response, a stress reaction and a stress fracture in the metatarsal bones in the foot and you’ve been told you can’t run.
It also really walks you through the strategy I would use with somebody like Brian to figure out how to reduce the stress and strain enough that you could actually maintain your running fitness and not lose all that hard-earned VO2 max. So yes, you might be able to cycle, but sometimes when you cycle it applies so much stress to the metatarsal that it slows down the healing anyway.
It’s real important to understand the strategies that will help you avoid that problem so that your VO2 max does not have to just rest in peace. It doesn’t have to be that way. So come to www.docontherun.com/stressfracturemasterclass, it’s completely free. You can sign up and I’ll see you in the training.
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