When Should I Run Again After A Fracture?

As a runner with a 5th metatarsal fracture, I understand the desire to return to running.  This type of fracture doesn't just hurt physically, but interferes mentally because you may need to cancel your race and can't get the runner's "high" that comes with a nice run.  In fact, runners often get in a hurry to get back and can cause additional injury from not waiting until the appropriate time to return to running. 

With this thought in mind, and while currently only 2 weeks into the healing process, I thought it would be useful to discuss how I will be transitioning back to running.

- Pain is improved can I run?  Depending on the extent of the fracture, pain can significantly improve and sometimes resolve at 2-3 weeks, with most fractures being painfree at 4 week.  Although painfree is a good sign it is not a guarantee that healing is complete and running can be initiated.  I am 2 weeks into a fracture and have a painfree foot (finally).  My x-rays, however, show a fracture that is still healing.  If I were to run too quickly, I could create a situation requiring a return to cast or boot and possibly even surgery.

- What is the most accurate indication of healing?  Bone healing, as with fractures, is usually confirmed on x-ray.  If the x-ray shows sufficient callus formation across a fracture, the area is healed.  This means the bone is stable and reinjury risks are decreased.  I wll therefore be confirming healing on x-ray and only start running after the bone is visibly healed on x-ray.  I want to get back to running painfree, and will not rush it for that reason.  I plan for years of running, not just one more race, etc.

- How do I get back to running?  The best way to get back to running is to do it slowly.  You have been limited activity for 6-8 weeks and should take twice to 3 times that (at least) to get back to where you were.  Start slow, preferrably on a surface that will protect you from reinjury.  As I transition back (hopefully in 4 weeks), I will be running upto 1 mile only for the first 3-5 days, and then start progressing slowly back to my normal running routine.  Again, I will take close to 12 weeks to get back to the point where I am ready to train for a marathon.  This will preclude me from running my marathons this year, but will allow me to run many marathons to come.

Just like you use care in training to not under or over train for any particular event or race, you should use care to not progress to soon or too quickly back to running after a fracture.  Your body will thank you!

Dr Brandt R Gibson
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
801-756-0765
www.UtahFootDoc.com

When Life Interferes With Running

We love to run.  In fact, I run to relax and enjoy every run I am able to participate in.  But what do you do when running is not possible because of interferences of life?  I am currently facing this issue with a fractured foot that will not heal with continued running.  Here is what I am doing to "survive" while not able to run.

- Focus On Health:  This includes taking in sufficient fluids (at least 6-8 cups a day of water), eating healthy foods and avoiding unnecessary interferences in my health.  This will allow me to feel better even without the runners high and allow me to heal more easily.

- Focus On Healing:  I can truthfully say that my fracture makes me angry, but I have stopped focussing on that.  I now think about what I need to do to heal.  This includes wearing my cast boot like a cast (24 hours a day, except for showering).  As I focus on these aspects, it is easier to follow the doctor's instructions (even if they came from me for me).

- Be Prepared To Start Back Slowly:  After my injury, I will need to start back running more slowly than usual.  This is important so that I don't get irritated as I start back.

Healing correctly is imperative to returning to running without limitations.  For this reason I need to stay focused and not allow it to interfere with my regular activities or get me down.  Although this fracture is inconvenient, it will not have any longterm effect on me.

Dr Brandt R Gibson
Mountain West Foot & Ankle Institute
36 North 1100 East, Suite B
American Fork, UT 84003
801-756-0765
www.UtahFootDoc.com