Tuesday, July 20, 2010



It's been a week since the onset of Sudden Sedentary Summer Syndrome. I had assumed, given the symptoms and an Xray that didn't reveal a fracture, that I had a stress fracture in the second metatarsal. I wanted to make sure I was not doing it any harm and that I was optimizing the prospects for a speedy recovery so I made an appointment to have it checked out again.

My regular doctor apparently is on vacation but I felt confident when the alternative said she thought I looked familiar, that maybe she had seen me "on the trails". I doubt it, but at least she let me know she was a runner.

She must have asked sixty times or so whether this or that hurt when she did this or that as she felt around my foot. She clearly knew where it was going to be excruciating and she saved applying pressure there for last. Interestingly, she felt that it wasn't a stress fracture as I had assumed. Even before I started barefoot running I had a relatively thick callous in the center of the ball of my right foot. Since I've been running barefoot or minimalistically that callous and the callous in general on the foot has developed more than that of the left foot. Evidently, this center callous is related to the metatarsal directly above it. I think that mostly because of this detail and the fact that the pain is relatively localized and came on rather suddenly she diagnosed it as metatarsalgia. From what I have now read regarding metatarsalgia, it could basically be called a nasty bone bruise at the joint end of the bone.

She tried to fit me with a post-op shoe but we couldn't get it to allow me to walk without significant pain so she tried one of those big post-op boots and that allowed me to walk without any pain, although it does seem to torque the knee somewhat.

The questions now are: Is this better than a stress fracture in that the recovery time is faster? (I saw references to recovery times of 2 to 4 weeks to 5 to 6 months)Will I be prone to recurrences? Did the barefoot running alone cause this or would it have happened anyway with higher mileage? Will I be able to continue running minimalistically?

Oh, and NSAIDS are now thought to impede bone healing.


  1. Can the callous be shaved? I regularly trim the ends of my toes (not toe nails). You could soften if up and try a grater.

    Rick had a bone bruise and it seemed to take forever, but, he also thought he was aggravating all the soft tissue around it cause of the way he was using the leg due to the bruise.

    I'm going running this am. Try to call afternoon.

  2. I bought an "exfoliating stone file" yesterday and took it down quite a bit. Evidently the bone could be unusually low there because of a tight calf (a culprit in so many foot issues).

    I was walking on the edge of my foot to avoid putting weight on it, which of course would cause stress elsewhere. Having it immobilized with the boot seems to be helping a lot.

  3. hmmmm...tight calves. Sounds like you should go even slower with the barefoot start-up. It seems like I remember it affecting your calves a lot.

  4. I've done a little more research and found these words at www.mortonsfoot.com/metatarsalgia

    "Metatarsalgia pain comes from excessive pressure and friction. A callus often forms in that region right behind the second toe. The cause is hyperpronation. When you hyperpronate, the first metatarsal and big toe are not carrying their load, so most of your body weight at push-off is carried by the second metatarsal. To make matters worse, the hyperpronating foot also twists inside the shoe aggravating the pain by adding friction."

    This sounds like me. Interestingly, the entire area of the right foot that has contact with the ground is significantly thicker than the left, not just from callous but the internal flesh as well. I can't remember if long ago the chiropractor said that I tilted to the right at the hips or that the right leg was a bit shorter, or both but the problem could certainly begin higher up.

    So aside from some possible chiropractic maintnenance I wonder if a little orthotic pad under the ball of the foot at the big toe inside the FiveFingers and running shoes would do the trick.

    Sunshine (our late canine family member) was missing most of the small pads of one rear paw and the main pad compensated by growing to almost twice the size as the one on the other foot. Maybe I should let the pad thicken instead of rasping it away! The doctor said that bones can even change their shapes to accommodate load and stress demands on them but get stress fractures when the demand is greater than what the breaking down and building up processes.

  5. For those who continue to read this particular post, possible because of the metatarsalgia title, the eventual diagnosis was a STRESS FRACTURE of the second metatarsal.

  6. it is likely to crack. This normally occurs in healthy and fit individuals who subject their body to excess physical activities. This kind of fracture is normally experienced by sportspersons and military recruits who engage in physical activities for long periods of time. They develop a stress fracture that leads to foot pain. The second situation is where people have extremely weak bones. This commonly affects women with osteoporosis.