Stress reaction healing time?

ajb422

Barefooters
Sep 28, 2010
635
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I think my second metatarsal has a stress reaction as opposed to a stress fracture. All the descriptions of stress fractures seem to include alot worse pain than what I'm feeling. I'm having a really hard time finding a typical healing time for a stress reaction though. Have any of you had one of these and how long off running did it put you? Does it take longer to return to running barefoot since we probably put a bit more stress on our forefeet than shod runners?

Right now I'm thinking minimum week cross training and then reevaluate to probably include another week before adding in some light running?

Also will this require a total start over for mileage and buildup once its healed?
 
It has not been proven one

It has not been proven one way or the other, that I know of, that people who wear shoes have less stress on their forefeet. I have learned of many stories of people running in traditional running shoes receiving stress fractures to the forefeet. Now we are learning that more and more people running minimal (and some barefoot) are receiving them as well. I don't think stress fractures are inherent to barefoot runners, since they happen to shod runners all the time. I think there's more to the story here. Perhaps there could be a bone density issue, perhaps the runners runs too far up on their forefoot. The jury is still out. These kinds of questions were non-existent before barefoot and minimalist running was widely heard of, meaning the shod runners were the ones always asking about them. Visit the injury forums on any of the running sites out there, and you will see this is true.

I would think it would be the opposite, since we barefoot runners are lighter on our feet and not pounding on along. I know there have been studies that show there's more stress to a shod runner's heel strike due to the perceived protection of the padded heel combined with the landing forces though.

I don't know if two week's rest is enough. You should see a doctor to get a diagnosis. I understand that a stress reaction is what takes place just before a stress fracture. It's the pulling of tissue from the bone, and that pulling actually takes some of the bone with it. If that is what you have, then it will probably take more than two weeks to recover.

So sorry about this for you. Six weeks off for a stress fracture is typically what is recommended for a stress fracture, and that comes with a boot. Six weeks off for something you know you can heal from is not a bad experience. Six weeks off for something you are unsure about or know will be there at the end of six weeks (or in my case, much longer) is miserable. Sorry, I was just venting about my own problems.
 
I'm not blaming this on the

I'm not blaming this on the barefoot running at all. I think its the long distance running that is to blame. Overuse injuries being caused from overusing them and all :). I just assumed there is more force on the forefoot even if there is less force overall since when I ran shod I hit very hard with my heal and my forefoot didn't much come into play with how I ran at all. There's a ton of info out there about actual stress fractures so its obviously not a barefoot only thing. If anything I think being barefoot probably saved it from being a full blown stress fracture. If I was still in shoes I probably would of tried to run through the pain and actually fractured it.

The only real info I can find on this stress reaction thing is, cross train alot, don't run until it stops hurting but no one seems to give much of an idea of how long that takes. Just that a real fracture takes at least 6 weeks. If I thought the doctor would do anything I'd actually go but I know all they'll say is here's a boot you can wear if you want, take it easy on it don't run and you'll be fine so why bother. I don't want to have to explain I got this from running too much and get a lecture from him. Or worse have the possibility that he will use this an example of why not to run barefoot. In reality I'd probably not tell him I even ran barefoot to avoid that whole issue.

I don't think this is so much a muscle tearing issue though. From my reading it appears that stress reactions and fractures are more of an issue of balance between osteoblasts and osteoclasts and it makes the bone more susceptible to fractures. Basically if I'm reading correctly you are making regenerative tissue faster than you are making reabsoptive tissue and this obviously causes issues. If you start having the issue but you don't actually fracture it you get the sensitivity that is a stess reaction. When you actually get larger tears than just microfractures you now have a stress fracture. I've found some great articles. Its actually been pretty fascinating reading. I didn't realize how dynamic our bones really are. There's just no real timeline. I suppose thats probably my answer though. It varies so much there might not be an average.
 
Sorry if I sounded like I was

Sorry if I sounded like I was lecturing you. I actually thought your post was a good opportunity to keep the ideas flowing.

I happen to think, though, that the toes come into play on the roll off that takes place after the shod heel touches down. I think barefoot runners don't roll off "as much" as shod runners does, since that may require them to actually push off as well, but I do believe we roll, just not as much and with not as much weight, but that's another conversation.

If you go to the doctor, you can get a boot. I don't know if those things are prescribed or if you can actually just go to one of those medical supply companies and pick one up yourself. They have stuff like crutches, neck braces, leg braces, etc.

Would you like me to pose all of these concerns into an email to the Doc? He's free, and he understands the plight of the barefoot runner when it comes to seeking medical attention. Besides, others could benefit from the info, and it might make a good Ask the Doc, if he responds with enough info. ;-) It's completely your call though, and I don't want to make you feel uncomfortable. You can PM me about it either way.
 
6 weeks until you can get

6 weeks until you can get into some light exercise, I'd say more like 2mos before you're feeling pretty good out there on your foot. GL, lesson learned ;)

Rest easy, get your calcium and vit D
 
TJ- I knew your post was as

TJ- I knew your post was as much about explaining to others watching the forum and talking about it as answering me so I didn't take it as lecturing :).

If you think it would be helpful to other people feel free to email the Dr. on it. If not I'm not to worried. I was mostly wondering if anyone had had a similar situation with an idea on length. Every forum topic through my google searches were started pretty much like mine aka "I have a stress reaction...." and everyone who commented said well "for a stress fracture...." I even found a journal article that talked about four different stages of stress reaction and about training on them and it really gave no timelines. (in case anyone is interested http://www.agoodgroup.com/running/stress_fractures_return.pdf)

It's already not as tender as it was yesterday so I have hope that I won't be out the full six weeks.

Right now my shoes appear to be keeping it pretty stable for cross training purposes. I was able to row(frees) and bike (TRS) at full effort without the slightest pain. If I decide I need a boot I have some hookups in the medical community to get me one without bothering going to a Dr. even if I can't find them in a medical supply store. The lack of needing a boot currently is what has me pretty well convinced this isn't an actual stress fracture though. I've been walking around my house barefoot all day (socks all yesterday) without it being in much pain so long as I remember not to come up on my forefoot at all ever. And forgetting a few times is a pretty strong reminder not to do it again ouch.
 
Again, where is the pain at?

Again, where is the pain at?
 
 In the foot where the second

In the foot where the second toe meets up with the forefoot. From my googling/feeling around I think its in the second metatarsal. Its a fairly intermittent pain. In the mornings it hurts to walk even in shoes, by afternoon I can wander around barefoot so long as I don't put pressure on the forefoot its fine.
 
A couple weeks ago I had foot

A couple weeks ago I had foot soreness in the morning that would be gone by lunch, it cleared up in about a ten days. Hope it heals soon, good luck. :)
 
You were really smart to stop

You were really smart to stop running before it turned into an actual stress fracture. I was not so smart. I really don't think you will need a boot for this, since I didn't use a boot and I had an actual stress fracture (I wanted to avoid the muscle atrophy). I am not a dr. or an expert, but based on my own experiences and stuff I have read, I would just use pain as your guide, and when it feels better, I would recommend giving it a few more days of rest just to make sure its fully healed. If you don't let it fully heal, it could easily turn into a stress fracture.



The vitamin D suggestion is a good one, imho.

(http://onlinelibrary.wiley.com/doi/10.1359/jbmr.080102/full)



Out of curiosity, do you have morton's toe?
 
I just read through that

I just read through that paper you linked to, and it seems to recommend just adjusting your activity level based on your pain level. Also, it seems to say that it might take you about 3-5 weeks for a full recovery, provided you don't do anything to make it worse (see quote below).



Athletes diagnosed with a stress reaction or low-grade injury at a low-risk site
should follow treatment guidelines similar to those of a higher-grade injury. The
major difference is the expected time of treatment and the degree of relative rest
required. It has been shown that grade 1 and 2 stress reactions can heal with no
changes in activity level [29]. In Arendt and Griffith’s [21] study, return to full
activity for early stress injuries (grade 1, 3.3 weeks; grade 2, 5.5 weeks) was
significantly faster than for more severe injuries (grade 3, 11.4 weeks; grade 4,
14.3 weeks). This finding stresses the importance of temporarily modifying
activity to the level at which symptoms and injuries do not progress.
 
I don't have Mortan's toe.

I don't have Mortan's toe. And I don't know how in the world I missed those week statements. I even remember reading that paragraph and thinking I needed to read the cited papers to get a better idea of what grade level this was. I was actually fully amazed by the statement that you could heal from 1 and 2 without any change in activity level. I couldn't really imagine running on this but I've never much seen the point of doing something if it hurts at all. That ruins the fun.

I have been taking lots and lots of calcium and vitamin D since this happened, based of Zumba's suggestion in the thread on actual stress fractures and this one and will probably continue to take it a few times a week once its totally healed. I used to take it regularly when I lived up north and didn't get enough sunshine but I've been pretty lax about it since moving here.
 
The good news is that once my

The good news is that once my stress fracture healed up, I have not had any more problems with it. In general, I believe bone tends to heal stronger than it was pre-injury. Just make sure you let it heal. I couldn't imagine running with this either, but I guess some activity (other than running) is ok as long as it's not painful.
 
I was hunting for solutions

I was hunting for solutions to my own current foot problem, and I happened to come accross this thread which seems to confirm a 3 week recovery period for a stress reaction injury. I am starting to think I may have one of these myself.

http://www.runnersworld.com/community/forums/runner-communities/barefoot-running/another-update-could-worsevisited-podiatrist-today/.0
 
 Yeah I'm nearly convinced at

Yeah I'm nearly convinced at this point that its what I have. Everything is getting better each day but I'm certainly going to need another 3 days minimum of crosstraining before even attempting to run. And I'm guessing it'll be more like a full second week before I can do shorter distances again. I suppose even at a full three weeks I'm guessing there isn't much skin or muscle conditioning lost. I'm glad you are thinking this is whats going on with you too, much better than a real fracture and the full six weeks :-(
 
Wishing you guys speedy

Wishing you guys speedy recoveries.
 
ajb422 wrote:I have been

ajb422 said:
I have been taking lots and lots of calcium and vitamin D since this happened, based of Zumba's suggestion in the thread on actual stress fractures and this one and will probably continue to take it a few times a week once its totally healed. I used to take it regularly when I lived up north and didn't get enough sunshine but I've been pretty lax about it since moving here.



I am a little concern about you taking "lot and lots of calcium".

How much are you taking? Your body can only absorb 500 mg at the time..just my $.02 cents.

Wishing you a quick recovery..
 
 Sorry I shouldn't have said

Sorry I shouldn't have said "lots". Lots of a vitamin for me is one a day. Most the time when I take vitamins I only take one every other day or even less because there is so much debate about whether they are actually good for you. The calcium I've been switching off between once a day and then the next day twice a day. But now that its mostly healed I'm just doing once a day again. Once its all the way healed it'll go back to being just every other day or less.
 
ajb422, relax. slow down.

ajb422,



relax. slow down. your body is yelling at you. little pain and discomfort is it talking, yours is yelling. lucky it didn't make you stop completely. no one can give you a time line. you have to just learn to listen to your body.



on my second bf run it felt so incredible i started sprinting. i ran close to 4 miles on the trails. it was great. that is until i went to work that night. my right foot hurt so bad i had a hard time walking. it felt like my tendons were pulling away from the bones on my right metetarsals. it lasted a good two to three weeks. funny things is it felt fine that i could go on easy runs but walking was painful.



any new activity is going to to build bone first where it is stressed, then muscle. i would have to look at my anatomy and physiology book to give a timeline but can remember it takes a few weeks. bone is dynamic living tissue. if you don't stress it, it weakens. likely a big reason we see so much osteoporisis in this country. we don't have to work hard anymore.



mike
 
Hello ,Same thing happened

Hello ,

Same thing happened to me on November 1st (at least makes it easier for me to count the days..).

Now, after 2 months I finally began to run again. I did it twice in running shoes, perhaps next week I'll switch to Vibram and ASAP barefoot again.

I couldn't just rest. Not clever, but you all know how it is...

I did some workouts on the elliptical machine.
I also walk to my office everyday (cca 3km) and do some mountainbiking during weekends. Just to say that I try to move, whenever I can. Well, except for the first 3-4 weeks after the injury. Too much pain.

So, after 2 months I don't feel the pain anymore, altough I can still feel some 'discomfort'. Perhaps it's normal, I don't know.

Regarding the diet; I've been taking cca 1000mg of Calcium (per day) for the past 2 months, mixed with Vitamin D. Reading things about the popular 'Paleo Diet' i found out that SALT apparently drains the Calcium out of your bones, so I'm avoiding it as much as I can.


Regards from Slovenia.