Stress fracture or not?

Confessions of a reckless runner! I have had 2 stress fractures in my running career. One many years ago when, after no training and a bottle of red and a dare I agreed to enter a long run the next morning and try and beat some older dudes. We did it but I got hurt!

Then three or four years ago I developed a 2nd metatarsal stress fracture after going out too far and too thin, too soon. Like any good runner at the first sign of a stress fracture I kept running until the metatarsal was completely ruptured (displaced fracture) and only then did I manage to give it the few weeks break that was needed for repair. Sometime thereafter I confessed to another runner that I had been a bit obsessive and he said: "but you're a runner, that's what runners do" and I felt a little better.

So when my foot got swollen and sore two weeks ago after a bit of intense running, I knew immediately that it looked and felt like a stress fracture. While I was quite sure that I had not upped my miles significantly my friend, Mr Fred Richardson said bluntly: " You've been hammering it". And so after a bottle of red and feeling a bit remorseful I posted the pic below and the blunt retort was "the left foot is swollen".

Being aware of the signals, including a stress reaction, I was pretty sure that this was a stress fracture. General pain across the top of the foot, pain when moving, and swelling were sure signs. After a few days I was sure that I would find the "hot" spot - the fracture. Notably, with maturity beyond even my advanced years I was wise enough to stop running but I didn't stop walking around barefoot, believing implicitly that some movement created faster and more robust heeling than immobility. The thought of going for scans and x-rays crossed my mind but previously when I had spent a fortune on these interventions I had still dismissed the expensive evidence and returned to running with careless abandon. Because of this I was not prepared to waste money on medical advice I knew I would ignore.

As predicted, after a few days my pain started to become localised. But it did so in strange places as marked below:

This was confusing! There were tender spots all over my foot and these were not indicative of a stress fracture - what was the culprit - I wondered morbidly if I had two or more stress fractures! Certainly the prospect of a 1st met stress fracture was very unusual as was a fracture of the navicular or cuneiform bones in the ankle. I was dismayed. I really couldn't work out what the issue was. I also had pain around the outer/lateral ankle bone (malleolus) at the point where a few tendons wrap around it (tibialis). I was stumped in more ways than one.

After a week of no running I started extending my walks and at this point I convinced myself that if I was suffering from a stress fracture it should prove itself and turn into a proper fracture. I'd get an-x-ray and would know the prognosis. And if it was not then I'd simply carry on with impunity. I constructed my own convoluted "win win" scenario ... or so I thought.

Simultaneously I started massaging my foot with anti inflammatories and I used my thumbs fairly aggressively to pummel the hot spots, leaving me purple and bruised. During this period of self abuse it suddenly occurred to me that many foot problems emanate from the calf muscles (too tight) especially the deeper calf muscle known as the soleus. And so I worked my thumbs into my lower leg until I found the KNOT!

At the same time I started doing some stretching of both the calf and the plantar. These were very tight and I knew I had to do some deeply invasive stretching. Simply place the foot against an upright surface, with toes extended upwards and manoeuvre the knee forwards, thus stretching everything from the calf to the toes (perhaps even the glutes).

Importantly this started to yield results and after 8 or nine days since the injury occurred I ventured forth on a gentle 3km run,  then two days later on a 5 km, and then more. Now two weeks later to the day and hour, I feel back to normal and am not suffering the indignation of another obsessive "too soon too much" outburst. It was simply a little soft tissue damage. Sorted!

Feet happy again in the old Pocket Rockets. But it does confirm that a little problem can refer to a far wider area and cause a disproportionate amount of distress.