Zen and the Art of Triathlon

Has anybody in the forum experienced a stress fracture of the 2nd metatarsal or anywhere in the foot? I am experiencing pain on the head of my second metatarsal that hits me pretty hard when I toe off. I stopped running immediately but have continued doing other cardio and swimming, only pushing off of the wall on one foot because this too is painful. The pain feels like a pressure point being tweaked and is starting to send shooting pains up my second toe. I'm going to rest it really hard this weekend but if the pain has not subsided by midweek I plan on visiting my doctor for an X-Ray or MRI. I've seen a physical therapist at work and he says it also could be metatarsalgia.

I have to say that these symptoms have expressed themselves after about six weeks of building up my miles in Nike Frees and after about 10 days of owning a spanking new pair of Vibram Five Fingers. I was extremely conservative in my build-up and usage of both types of shoes so this set-back is rather frustrating. I'm just hoping it ends up being soft tissue damage so that I can continue building base in an attempt of hitting my BQ in October at the Portland Marathon. Any thoughts or advice would be much appreciated.

According to my runners bible "Lore of Running" by Tim Noakes, under Stress Fractures "The symptoms produced by a stress fracture are simple and unmistakeable - there is rapid onset of pain, well localised to any number of bones....In a Finish study of 142 stress fractures ...23% occured in the metatarsals (toe bones)". Also "The diagnosis of stress fracture is simple, First, the injury is usually of quite sudden onset, and there is no history of external trauma. Warning symptoms are usualy mild - the runner get little notice of the tragedy about to befall them. Then, they are suddenly no longer able to run." and "diagnosis may be confirmed if tenderness is felt, localised to the bone. Even gentle pressure on the injured bone will illicit exquisite, nauseating pain." The bad news is "Fractures of the the foot bones usually heal within six weeks..." And interestingly "Unfortunately few runners will accept a two-month rest period without some visible evidence that the diagnosis is correct." Later there is a discussion on the Causes, which includes a paragraph on them; 1. Femal Sex, 2. Menstral abnormalities or a low calcium diet, 3. Shoes, 4. Trainning Erors, 5. Genetic factors, 6. Low bone density, and 7. Race. Worth getting the book out of the library for a complete read. So some food for thought. Your idea of getting professional medical help seems warrented.
Cheers
Tom.

The onset sounds quite similar but the absence of exquisite, nauseating pain gives me hope. I'm hoping it's just a nasty bruise or some sort of soft tissue damage. I need to pick-up a copy of that book. Thanks, Tom!

Trevor,

Sorry to hear about your injury. That's a tough one, in many respects. First, I am a former Athletic Trainer (LSU -- Sorry Brett -- Geaux Tigers :) ).... I have a Master Degree in Sports Medicine, Kinesiology and Bio Behavioral Sciences and I have worked on a plethora of world class - professional and Olympic athletes --- so in other words, I sort of know what I am talking about. I apologize for speaking about myself.

Basically it boils down to this for you -- regardless if you have a stress fracture, a sprain or a tendinitis, any micro injury in that area is a severe pain in the ass, as I am sure you are finding out. At toe off, you are putting that area (mostly the 1st met (big toe) under enormous stress loads so healing of most injuries there takes a while and requires one essential thing COMPLETE REST. I know that sucks. But even if you swim, or cycle, each little mis-step can cause the 'micro injury" to open up again and you start from scratch in the healing process.

This is obviously an overuse injury (as opposed to acute), so you have to try to determine what caused it so it doesnt happen again ---! Great that you eased into barefoot running as you mentioned, but you might need to consider that either the FiveFingers or the Nike Free or both arent a match for you. And certainly, for the time being you need to stay away from them and try to wear runners at all times, (no sandals, vans, top siders, etc) .. you need support.

Icing is going to help. a 50/50 water and ice slush in a pot or bucket will do wonders. SUcks for the first three minutes.. then you'll go nice and numb. stay in for 15 minutes.

ICE AND REST, Bro..... the more of each of those you do, the quicker you will get better.

Just a note, be aware of any pain or tingling in that 2nd met. Not dangerous or serious, but indicative of what's called a Mortons Neuroma.

Also, you need to get this injury healed sufficiently because there is a likelihood of reoccurrence. Patience now will pay off nicely for the future.

Also, you may consider custom footbeds. They are a common helper of turf toe (very similiar beast to what you are suffering) and could help you get back to your proper form a little faster.

Hope all that helps a bit.

Good Luck.

BC