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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!


  1. I hate now long stress fracture take to heal. I got one shortly after I moved to Charlotte in 2012. It was so annoying. I think I was in a boot for 2+ months, maybe longer? I’m glad you are back to running without pain, though! I went from my stress fracture to my RA diagnosis so that was a horrible summer!!

  2. I'm so glad that you are recovered from this wicked injury. I totally agree that walk breaks are critical when coming back from a stress fracture in the foot. It doesn't matter how fast you are, those walk breaks are helpful in adjusting the bone to the weight. I admire your patience with this.