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How to Get Back to Running after Metatarsal Stress Fracture

There is no way of eliminating risk in sport or exercise. For runners, the possibility of injury is always just around the corner.  Running is not dangerous. But there’s always the chance that a misstep, loose rock or some other road debris can cause you to injure yourself. Your awareness of the environment will help you avoid these kinds of injuries.

What isn’t so easy to avoid, however, are the injuries you can’t see. Even if you’re doing everything right, you’re still not out of the woods when it comes to risk. Here’s the thing: the act of running itself can be damaging, especially for competitive runners and people that over-train. A common injury among high volume and non-competitive runners is the stress fracture. There are many types of stress fractures, but runners are prone to the most common (and most feared), the metatarsal stress fracture.

What is Metatarsal Stress Fracture?

The metatarsals are the long bones in your foot that connect the bones in your ankles with your toes. When you run, your entire foot feels the impact of every step. While the bones in your toes and ankles can bend to help absorb the impact, your metatarsals are more or less locked in place between those two points. This causes them to be more susceptible to the stress of impact. Over time, these stress on the bones causes them to break. This is a metatarsal stress fracture.


What Are the Symptoms of this Type of Fracture?

The most common and obvious stress fracture symptom will be the sensation of pain. Stress fractures develop over time so the pain often increases slowly. Sometimes the full force of pain happens the instant a bone finally gives. The pain might be localized to the break, or you might feel pain over the entire foot. 

Pain isn’t the only symptom, however. You might also notice swelling and redness in the area, which may get worse over time or after physical activity. 

X-Ray results will help your doctor diagnose the problem but if the fracture is tiny, it might be difficult to detect. Further testing will help your physician make a diagnosis.

Recovery Plan

A stress fracture isn’t the end of your running career. Most runners have come back from these injuries. The bad news, though, is that it will take time. How long does a stress fracture take to heal? This can vary from person to person, but the average recovery time is anywhere from six to eight weeks

Besides following your doctor’s medical advice, here are the basic steps you need to follow to get back running after your stress fracture.

1) Take a Break

Without a doubt, the most important thing you can do to recover from a stress fracture is to stay off of your feet. Healing takes time. Physical activity that puts pressure on your feet or impact the injury can increase the time to full recovery.  

But you’re a runner. And staying off your feet is hard to do. And what will happen to the progress you’ve made through your training? 

If it’s any consolation, think of this: whatever gains you lose in a few weeks of recovery pale in comparison to what you could lose if you ignore medical advice and return to running too soon

2)Wear Special Footwear if necessary

In some cases, your physician or physiotherapist might prescribe a stiff-soled walking or orthopaedic shoe.

This footwear might be uncomfortable at first, but it is designed to restrict movement and lessen the impact that walking has on the bones of your feet. Special shoes and orthotics are not always necessary, so leave this to your doctor’s discretion. You might have to wear this footwear for anywhere from four to eight weeks.

Orthotics can also prevent stress fractures (which account for around 15% of all running injuries). Custom orthotics, also called functional orthotics, work by helping to decrease the forces through vulnerable parts of the foot. Essentially, these simple devices help to distribute the weight evenly and reduce the chance of injury. Again, see a podiatrist or medical professional before using orthotics. Using them off-the-shelf will probably cause more problems in the long run.

3) Keep it Low Impact

Once you get the go-ahead to do your workouts again, keep it light. You’ll be instructed to perform only low-impact cross-training activities that keep the pressure off of your feet as much as possible. Activities like water jogging or swimming are non-load bearing exercises that help increase fitness levels. The important thing here is to remember that physical activity at this point should be viewed holistically. It’s for the benefit of your body and has little to do with improving your running. This is not the moment for getting back into running form. The minimal pressure on your foot through these activities and general daily movement will gradually increase as healing occurs.

4) Gradually Increase Your Running

Somewhere in the four to six-week timeframe, you’ll be cleared for light running. The key is to be aware of what your body can handle before pain begins. Listen to your body. It’s simple: If you feel pain, you are not ready for that level of activity. 

Finally, after weeks or months of recovery, your doctor will clear you to return to your previous running volume. Heed their advice! Returning to running too soon after a stress fracture will send you back to step #1 before you know it. And you might want to reevaluate your exercise schedule. Might it be the volume of training that gave you the injury in the first place? See a physiotherapist or exercise coach about planning a training schedule that meets your goals but keeps you out of the injury zone.

Your body loses strength and endurance during recovery periods so once you get the all clear, take it nice and slow.  

Physiotherapy for stress fractures

A fast-track to recovery is physiotherapy. Hastening the healing process with the guidance and services of a professional physiotherapist can be a great investment. Physiotherapy and soft tissue massage such as sports massage are ideal for the treatment and prevention of sports 

Your physio might also recommend foot taping strategies and offer footwear advice. They can also create a plan for running training and maintaining the health of your feet.

Metatarsal stress fracture rehabilitation exercises

Fists with your toes.

This is a great exercise for releasing tension and massaging your feet at any time. But it helps with the rehabilitation of an injured foot, especially for weaker feet recovering from stress fractures.

Wobble board balances

At the gym, you might have seen those strange-looking boards with a ball inserted into the centre. People use them for balance-related training (squats on the board, pushups with hands on the board) and you can use the wobble board to rehabilitate your feet. Keeping your balance on the board forces your body to recruit all the muscles of your feet and lower leg. The micro-adjustments required to maintain balance are great for gently strengthening the feet. 

wobble board exercises for recovery

It’s important to perform these exercises close to something you can grab onto or prevent a fall. Landing awkwardly on your foot will not move your recovery in the right direction.

Pencil pick up

This is simple. Put a pencil (or pen) on the floor in front of you. Using your toes, grab the pencil and lift it off the floor. Repeat ten times.

Foot stretches

There are a couple of ways to do this but here are two of the easiest and most effective methods:

1. Stand arm’s length from a wall. Place your hands on the wall around should height. Put leg closer (by a foot or two) to the wall. Gently lean forward without lifting your heels. Feel the stretch in your calves and feet.

2. Sitting on the floor with your feet out in front of you, grab one foot near the toes and pull the toes towards you. Maintain a straight leg (or as straight as possible). Feel the stretch along the base of the foot.

Hold both stretches for at least 30 seconds for maximum benefit. Repeat up to 10 times. You can increase the repetitions once you get used to it.

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