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

The Midnight Run

After running my first marathon, and now that I am preparing for the second, people commonly ask me when I have time to run. My answer is always, "I don't have time!" I run now and have always because I want to, not because I have unlimited time to train for marathons. As the father of 9 and a fulltime podiatrist, I often need to modify my training for my schedule. Running may be early morning, or even late at night. Let me give an example...

Last week I was busy all day Saturday with soccer games and working in the yard. I didn't get out early to run, so I left home at about 9:00pm for the necessary 20 mile run. It was a special run, because I am training more aggressively this marathon to speed up my time and was to include lots of hills. Hill running is typically slower, and will lead to more running time. Needless to say, I was running well into the night.

Advantages: 1) Since the sun was down and the air was cooler, I required less fluids to run this distance. 2) Less cars were also encountered, allowing me to run more fully on the road and stay of the shoulders that are usally more canted. 3) No distractions or places I needed to be.

Disadvantages: 1) Time. Need I say more. I don't recommend running in the middle of the night unless no other options are available. 2) Less visibility. 3) Safety may also be an issue depending on where the run is done.

My biggest recommendation at this time is not to run late at night, but to make time to exercise. If you are training for a race or just running (or even exercising) for health reasons, it will never be convenient. Schedule time to exercise or run and make time to accomplish this task. It will definitely be worth it!

I loved my midnight run and ran because I love it. I have vowed to find the time to exercise so I can be ready for the marthon coming in 2 weeks.

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