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Wednesday, March 28, 2018


Ever since I hurt my foot in December, I've been wanting to use that blog post title. And it's not quite true. I actually went to see a doctor about my feet. I'm not in pain anymore, but having first one, and then a potential second fracture/reaction, made me think I needed to check in with an expert. And I changed doctors (again. I have already left doctor #1 before, for the exact same reason, misdiagnosing/blowing off a major injury. I think it's time to move on for real).
New doctor examined both feet, and said there was obvious evidence of a healed fracture on the left (still sporting a big old bone callous on that foot), but also some bone build up on the right. Without imaging, you can still see and feel it. He suggested I'd actually fractured both feet, but "came back too soon" on the right foot, since I never treated it in a boot. I had thought that foot was hurt, too, back in December when I hurt my left foot, just much more mildly. Either way, it's healing now, and he said running was fine, but I might want to change shoes. My arches are SO high and rigid that they don't provide much shock absorption; he recommended perhaps a higher arch support or even an insert. We'll see - I don't much like changing shoes, and it sometimes ends in disaster.

Meanwhile, I am still plugging along, slowly getting mileage and effort back up, feeling very much like a brand-new runner, especially as the humidity hits us as well. Next race is the Crescent City Classic 10k, which will be a cringe-worthy performance. Nothing like a hot, crowded 10k when you're not in shape!

Wednesday, March 21, 2018

Al Briede 5k, injury scare, and plugging along

With friends at the start (waiting and waiting because I didn't
realize that the 8 am start was for the kid's mile; the 5k wasn't
until 8:30!)
With the Crescent City Classic 10k fast approaching, I knew I had to get a 5k in to see where I was at speed-wise. I registered last minute for a 5k in the park, and it was as terrible as I thought it would be. I usually come back from a long break in the 20:30 - 21:00 range, and I ran 20:31. Almost exactly what I estimated I would run! But oof, it hurt: I am not ready to be racing yet. And worse, my RIGHT foot - not the one that fractured - started a familiar ache. I jogged home after the race (missing out on the generous age group awards of gift cards to A CHILDREN'S SHOE STORE, why would I want that, especially two years in a row!) and took off my shoe. To my dismay, my foot was bruised, just like the other side bruised when it was fractured!

I decided to take time off, and call a doctor (finally), but the earliest appointment I could make was the 27th. And oddly, my foot stopped hurting. I eased back into short, easy jogs, and the bruising vanished and pain went away, although I am constantly worrying about it returning. Now I'm considering canceling my doctor's appointment! That foot never swelled up, which is a telltale fracture sign and one that was very obvious in my other foot, so I don't know what happened, but I don't think it's fractured.

Now, here I am, heading into a 10k next week barely able to even run 6 miles straight, and feeling pretty out of shape. I had two workouts (ha!) for this race, and the 10k is a very hard distance for me anyway, so I expect it will be a really slow day. Anyone else raced out of shape? Or just coming back from injury? I dread it, but it has to be done!

Wednesday, March 7, 2018

Healing time: metatarsal stress fracture

I'm feeling 100% in my foot by now. I'm over 13 weeks out from injury at this point, but I didn't feel totally normal until almost 12 weeks.

Here's the breakdown of the healing process:

Week 1: Sudden onset of pain out of nowhere. Went to MD the next day. Was told it was not a fracture, but was metatarsalgia, so I did as I was told and loaded up on NSAIDs all week.
Week 2: Did test run as the doctor instructed me, but it was not good at all. I felt my foot pop, and limped home in incredible pain. Immediately, bruising spread across my arch. The top of my foot was quite swollen.When I reported this to my doctor, he said, "Hm, did you actually take the NSAIDs like I said?"
At this point I decided not to go back to my doctor. There were two reasons: one, I was certain it was a fracture and I was certain it would heal with rest; two, this is not the first time this doctor has insisted that I was not injured and should run on a serious injury. I just think we aren't a good doctor-patient fit.
Weeks 3 - 5: In the boot! I couldn't bear weight without pain, so I borrowed a friend's boot and stayed off my feet as much as possible. The swelling and discoloration remained. I could use the elliptical as long as I kept my feet completely flat, so I started light exercise again.
Weeks 6 - 8: I was able to transition to hard shoes (clogs) instead of the boot. Pain began improving daily; first, no pain at night in bed; then no pain at rest; finally, no pain with movement or palpation.
Week 9: Tentative, short run-walks. No bone pain, but the rest of my foot felt "off" - swollen, discolored, irritated. Ran four short days.
Week 10: Was able to start shortening and then eliminating walk breaks. Located source of irritation: my foot is simply a different shape now. Until the bone callous totally resorbs, it doesn't fit into shoes the same way. Re-tying a looser shoe helped a lot.
Week 11: Back to normal running. Inflammation decreased, then vanished.
Week 12: Able to add short, easy speed.

Some key points here:

  • This was a bad fracture. Extent of bruising at the site indicates depth of crack; if it bruises, you cracked all the way through the compact bone and into the marrow. No doubt the test run one week post-injury is what did it.
  • I wore a boot for about three weeks. I actually felt like a hard, wooden-soled shoe was more protective of my foot; the flat bottom of the boot had less arch support than my orthopedic swedish clogs. I found that when my foot muscles fatigued, the boot couldn't support them, and my muscles tugged on the bone.
  • I did not use a bone stimulator, which would have been great to reduce healing time. 
  • I did load up on calcium. I also ate normally (which includes indulging a lot!), so I gained some weight, but I never want to decrease calories while bone is healing!
  • I did not take any NSAIDS after the first week. NSAIDS are detrimental to bone growth, and taking them for a week probably significantly delayed my healing.
  • Left foot still swollen in January
  • I returned to activity before I was 100% healed. I am not recommending this: I would talk to your doctor, but I disagree with total rest of a fractured body part. Bone growth and calcium incorporation is stimulated by impact and loading, so once a callous starts to form, some level of weight bearing and muscle usage is a good idea. 
I wish I could offer some secret tips to reduce the healing time of a stress fracture, but in my case, it took the full amount of time the the literature suggests for a metatarsal fracture. And I don't have any amazing success stories about returning to run in prime fitness, thanks for my dedication to the pool or elliptical. I came back completely out of shape! But that's ok. I'm in comeback mode now, and I've done this before. Fitness comes back!