Today on the Doc On The Run Podcast, we’re talking about the top three questions to ask your doctor when she tells you, you have to stop running because you have a metatarsal stress fracture.
There is nothing worse than being told to stop running except when you have no idea how long you’re not going to run. So, if you go to the doctor and you like your doctor, she is nice, she is smart, she is helpful, she seems to really care about your running, she even listens to you about your last run and stuff, but then she tells you, you have a stress fracture and you cannot run. Well, there are three questions that you need to ask, and you should write these down.
The very first one is, how bad is ii and when she says, oh it’s a Kaeding-Miller grade three stress fracture, you want clarification. Say, okay well I don’t understand all this medical mumbo jumbo, maybe you can break it down for me. Is it a stress response? That’s a normal physiologic thing. Is it a stress reaction where the bone is inflamed and irritated but not cracked? Or is it an actual stress fracture where there is a crack that you can see, you have confirmed, you’ve seen it on an MRI, a CT, an ultrasound, an x-ray, something where you can tell it’s broken.
Is it displaced? Is it moved out of position? Does it need surgery to put it back together? How bad is it? And it’s going to seem confrontational if you ask that question because if you say how bad is it and they say not that bad, that’s not good enough. You need to be able to quantify things because you need to be able to see it improving before you can start running.
I very carefully track people’s pain, improvement, everything when I’m working with them to get them back to running way ahead of schedule. And by ahead of schedule, I mean ahead of the usual schedule, which is almost always arbitrary. It’s not tailored for you. So, the first thing is ask them and pin them down on how bad is it exactly and what does that mean in terms of when I’m supposed to be able to run. As soon as you have that, let’s say two weeks, doctor says you can run in two weeks, or they say you can run in six weeks, or they say you can run in three months. Whatever the answer is, no matter what that is, say, okay, since you said it’s going to be six weeks before I can run, what can I do to make it heal faster so that I might be able to run in four weeks or five weeks. That’s the next question.
You’re not trying to get into a fight with the doctor or an argument, but what you’re trying to do is get them to stop and think for a second. Is there anything else I could do that will potentially make this thing heal faster. If we confirmed it’s a stress fracture and we confirmed how bad it is, and we have some way to quantify that, is there a way to speed up the process of it recovering so that we can see that it’s improving based on what we just decided in question number one, and actually then have a chance of getting back to running sooner.
Then what you want to do is what else can I do to make sure I can run sooner. What that does is it shifts the doctor’s thinking from the actual physiology of bone healing to something different, because healing the bone is one part of the equation. Most of the time when you get a stress fracture, go to the doctor, and the doctor takes an x-ray and sees your foot and tells you, you have a stress fracture, they immediately start thinking we have to get the bone to heal. It takes this long for bone to heal. That’s how long it’s going to take. Then sometime after that, you’re going to start to run.
No, the bone takes as long as it needs to heal, and if you do other things, it will heal faster for sure. You also know some things will make it heal slower. We know for a fact if you smoke, it will take longer to heal. If you eat a poor diet, it will take longer to heal. The exact same thing is true in reverse. If you don’t smoke, if you sleep well, if you meditate, if you eat a healthy diet, if you do certain things, the bone will heal faster. So, if you do things that you know are making the bone heal faster, great.
But while you’re waiting for that to happen, bad things are happening to your running body. You’re losing your neuromuscular connections. You’re getting weaker. Your ankle is getting stiffer. It’s increasing the amount of force that it takes to push your foot upward. That increases stress on the metatarsals and puts you at higher risk of getting another stress fracture when you start running.
You have to strengthen. You have to stretch. You have to do all of these things that support your running body to support and strengthen everything that is not injured, so that when you return to running again, you will be stronger.
Just today, I was on a call with a cross-country runner who is very dedicated, very disciplined. He got a really bad stress fracture. It’s one of the really scary ones, and he was told he wasn’t going to be able to run for a long period of time. He had this sort of vague timeline in the distant future. We started working together, did the exact same things I’m talking about here, and figured out everything that he could do to strengthen himself, everything he could do to speed up the healing and he not only was already running before the spring season started, he finished his season running with his team, and he was elated.
Now he’s running in the spring season. I just talked to him today, and he said, after our break, and now that we just started running, I feel like I am stronger than a bunch of my other teammates because of this stuff that I was doing that made me stronger while I was waiting for the stress fracture to heal.
The third question you ask the doctor about what can I do to make sure I can run sooner will shift their thinking to that particular part of the overall healing equation so that you really can get back to running a lot faster even when you have a stress fracture.
If you want some ways to facilitate this conversation with your doctor, and you want to actually try to make some assessments yourself on how bad it might actually be, well, you can get this for free. It’s a two-page worksheet. It’s the same thing that I ask runners who’ve been calling me for consultation, second opinions, and so on. You can get that for free. It’s a two-page worksheet. It’s PDF you can download. It’s at www.stressfracturesecrets.com. So go get it, and then when you go back to the doctor, make sure you ask them those three questions. Thanks for watching, and I’ll see you in the next training.
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