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Question
Posted by: Mommy | 2012/03/05

foot fracture

Hi doc. I am a 40 year old female and have been running for quite a while, but last year I have improved my time over 10km''s a lot. I have started training with a personal trainer and I have been putting in more kms on the road. Unfortunately, I suffered a stress fracture in my forefoot (4th metatarsal) at the beginning of January and the bone also misplaced. I have been in a moonboot for the last 6 weeks which will come off at the end of this week. I have been doing weight training for the time being (mainly upper body and tummy exercises with my trainer), but am dying to take to the road again. The x-ray taken 2 weeks ago shows that the bone is healing fantastically and I have no pain in my foot anymore - I am allowed to walk barefoot at home only at this stage. What would be the best for me to be able to get back to running again? I am seeing the specialist on Monday and he said that he was going to also prescribe supporting soles for my running shoes after the boot comes off. Any advice would be appreciated.

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Our expert says:
Expert ImageFitnessDoc

Hi there

My condolences, that's a fairly common and stubborn injury to get, so I can appreciate your frustration. The key, and I know you won't want to hear this, is to take it very easy when you start again. The stress fracture was caused by excessive load for a long period, and if you go back in and don't take care, you'll just relapse, so you really need to keep the foot on the brake AND the handbrake up on this one!

I think barefoot walking is good, and I'd even suggest that you try to do some running barefoot. But here, we're talking VERY VERY SHORT durations. What I'd do is do a normal run session, and then take the shoes off for the last ONE minute and run home barefoot. One week later, up it to TWO minutes, then three minutes in week three, and so on. This will help to strengthen the foot. I'm not sure how I feel about supporting soles - I just think that the foot gets weak because we over-support it to begin with, and I would rather you spend some time getting stronger.

In terms of the running, it's really vital that you go right back to first principles. Don't go run 5km on day 1. Rather run 10 minutes. Or better yet, run 5 minutes, walk 2 minutes, run 5 minutes.. And do that for a week. It'll be very frustrating, but it's important. In week 2, increase by a small amount, and so forth. But you just have to hold yourself back the whole time, I think accept now that it's going to take you 2 to 3 months to work back to running say 45 minutes nonstop. Once there, then you should have overcome it, and can start ramping it up as you work on that time. But until then, slowly, slowly...

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Our users say:
Posted by: fitnessdoc | 2012/03/17

Hi there

My condolences, that's a fairly common and stubborn injury to get, so I can appreciate your frustration. The key, and I know you won't want to hear this, is to take it very easy when you start again. The stress fracture was caused by excessive load for a long period, and if you go back in and don't take care, you'll just relapse, so you really need to keep the foot on the brake AND the handbrake up on this one!

I think barefoot walking is good, and I'd even suggest that you try to do some running barefoot. But here, we're talking VERY VERY SHORT durations. What I'd do is do a normal run session, and then take the shoes off for the last ONE minute and run home barefoot. One week later, up it to TWO minutes, then three minutes in week three, and so on. This will help to strengthen the foot. I'm not sure how I feel about supporting soles - I just think that the foot gets weak because we over-support it to begin with, and I would rather you spend some time getting stronger.

In terms of the running, it's really vital that you go right back to first principles. Don't go run 5km on day 1. Rather run 10 minutes. Or better yet, run 5 minutes, walk 2 minutes, run 5 minutes.. And do that for a week. It'll be very frustrating, but it's important. In week 2, increase by a small amount, and so forth. But you just have to hold yourself back the whole time, I think accept now that it's going to take you 2 to 3 months to work back to running say 45 minutes nonstop. Once there, then you should have overcome it, and can start ramping it up as you work on that time. But until then, slowly, slowly...

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