Returning to Running After Metatarsal Stress Reaction

[Lucas V]

Hi all,

I’ve been out from a metatarsal stress reaction (fracture? don’t know) for six weeks now, and I’m wondering when it it would be safe to initiate my return to running.

TLDR; What signs indicate readiness for a return to running barefoot?

Here’s what happened:

• had a great summer training before cross-country until it was cut off by patellofemoral pain and other knee issues
• started running barefoot after having knee problems for 3 months of on and off pain
• I was desperate to get back into shape right before the season, so I pretty much went straight up to 30 mpw in the span of two weeks
• knees felt so good while barefoot, and I only ran about 70% of mileage barefoot on grass while getting back into it (what my XC coach had me do)
  
• took 14 days of running with no rest days because I was so enthusiastic, something I had never done before and developed tenderness in the top of my foot over the second metatarsal
• I don’t remember when it started, and there was no distinct point where I felt it
• never felt pain or even uncomfortability while running or walking, just noticed that the spot was warm, swollen and painful to the touch

I stopped running and took 6 weeks off, and here I am: the swelling seems to be the same as it was as the first week off, but it hurts a lot less when I palpate the area. I don’t know if it was a stress fracture or reaction, but am just wondering when it would be appropriate to try to start running again.

I apologize for the long read, but thanks so much for your help!

P.S. I have a podiatrist appointment for the 14th, but that’s still some time away, so would like to get some advice still.

 

[Dr. Mark]

Lucas a complicated question on email. answer "it depends". the bone needs to heal and then gradual loading to strengthen back to baseline. walking safest until absolutely no pain/swelling. issues w bone density and nutrition play in also. foot structure matters too . often if takes a few months and key is return slow and gradual.