Wednesday, August 10, 2011

Stress Fracture Breaking Point

For most of the summer I've been cognizant of a stress fracture in the early stages of the third metatarsal of my right foot. Each week I have been taking more rest days, a couple of easy jog days, and a longer mountain trail run in which I don't do any pounding. Tuesday evening I felt that I needed to get out for a real run and did exactly the kind of running I told myself to avoid. I ran 7.8 miles relatively hard on hilly trails and some pavement. I felt great; it's what I've been missing. It was clearly what I needed to avoid.

My stress fracture analogy is that you take a piece of copper wire and you bend it back and forth in the same place. It eventually becomes so weak that it severs. The same thing can happen to a bone under the right conditions; mine being that the bio-mechanics aren't quite right in my right foot. The difference between a bone a a piece of copper wire is that a bone can fix itself, but the repair happens slowly so if the "bending back and forth" outpaces the repair there will be an eventual complete failure like with the copper wire.

The foot probably needed total rest but I seemed to be getting away with the above-described running routine of 20 or so miles per week down from 40 something. If I stick with the wire bending analogy, on Tuesday, instead of long slow bends, I frantically did quick concentrated bends and took it right to the point of a complete break. I didn't even notice that evening, but when I got out of bed on Wednesday morning I couldn't put any weight down on the foot. I think if I had run to the mailbox I would have completed the break.

I tried wearing a shoe but found it didn't reduce the load on the foot enough. I still had a cam walker (boot) and a post-op shoe from last year's stress fracture. I wore the boot for six weeks; the post-op shoe was useless. I gave the shoe a try and it seems to offer enough protection so today is the third day wearing it.

I had been avoiding any NSAIDs over the past few weeks because they impede bone repair and I'm continuing with that. I had been taking 1000 mgs of calcium with magnesium and zinc and I have doubled that. Already, if I step down gently and evenly barefoot there isn't pain, but if I apply focused pressure up under the third metatarsal I feel pain so I plan to keep go with the post-op shoe for a week and then try some other presumably supportive shoe options.

With a complete break last year I was able to return to some easy jogging after 8 weeks. My hope is that I can rest this for about three weeks and return to the easy jogs and longer trail runs while favoring the foot the best I can. I'll see; if it needs more time, I'll take it. I want to do a 50K the last weekend of September.

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