This post is a response to an email I received this past week.
I found you on Facebook’s Barefoot Running group discussion about stress fractures and would like to seek your advice.
I am waiting for my appointment with a Sports Medical Doctor. In the mean time, my initial X-ray, taken 2 weeks ago, shows no signs of a stress fracture. The location is at the fourth metatarsal. I had been limping, unable to place my entire foot down to the ground without pain when walking. The pain is less now when I walk, but it is still not painless, and I can’t walk fast or for long without the pain coming back again.
I was running three times a week and swimming three times a week. I was alternating between Vibram Five Fingers and Newtons. I was increasing my mileage by 5 minutes each week and I was running at 45 minutes continuously before I felt pain in the metatarsal. I’ve never had any running injuries prior, nor any chronic pain problems. This is my first serious running injury and it took me by surprise. I am practicing Chi running and am always mindful about body alignment, mid foot strike, and light landing.
I have completely laid off running. Instead, I am swimming or using the elliptical machine. Currently, there is no pain post workout. There is a reddish spot and pain when pressed upon at the location of pain.
For now, I’m not sure if getting a roller will help me or should I use a golf/tennis ball instead? I’m also trying to walk as normally as possible so that I don’t turn limping into a habit – somehow, I have become fearful of stepping onto the outside part of the foot. I wonder if I will ever walk normally again, not to mention running.
Sorry to hear about your injury. It sounds like it has been a major challenge. Here are ten steps to help you recover from your running injury and become a better runner.
1. Get on crutches ASAP. You cannot mindfully control your posture or gait, especially if you are experiencing pain. If you have pain, you WILL limp. Walking around with a limp reinforces a limp behavior pattern into your gait. I consider this a permanent injury, because once a limp is established in your gait patter, you will never fully remove it, and it will leave you more prone to injuries down the road. Trust, me on this one, I’ve learned it the hard way. You need crutches until you are beyond the pain cycle.
2. Stop exercising. You really don’t know if this is solely a running injury or some combination of things. I suggest you take at least two weeks off. I know this is tough to hear. You will not lose your conditioning with a two week break. If anything, this injury is your body’s way of telling you it is time for a break. You WILL lose conditioning if this injury nags at you for six or twelve months. Any conditioning you lose with this important two week break you will get back in spades once you fully recover.
3. Injuries are a good thing. Yes, I just said that. Injuries are good. The degree to which you are injured suggests that you have some underlying problems that aren’t being adequately addressed, if at all. At one time, they may have been minor injuries, but they were ignored.
Pain is the device your body uses to communicate to you that what you are doing is not working, that something is wrong. Getting an injury is your body’s way of telling you that you are doing too much too fast, that you have been ignoring the subtle hints of minor aches and pains, and that it is time to reconnect and fully listen to what
your body needs. The longer you ignore pain, the louder your body will shout to get your attention, and the more severe the injury will become over time. Just like with your car, if you ignore the warning signals, you are heading for a breakdown. Taking the extra time to listen to your body now, and making the necessary adjustments in your life and training program will reduce the occurrence of pain and injury over the length of your entire life.
4. Get on the foam roller, soft ball, lacrosse ball, and golf ball and follow it up with flexibility and mobility exercises. Perform full body self-massage. Don’t focus on the injured side. Make sure to balance out the body. For now, don’t roll over the site of pain. It will be too painful, and you will probably inflame it more. Follow the examples in these two articles on foam roller therapy:
This is the foam roller I recommend: The Grid by Trigger Point Therapy
5. Find a highly qualified and experienced fascial therapist who specializes in injuries. Here is an article to help you find the best therapist in your area:
6. Rest and be patient. If you let your body rest adequately, it will heal. You will start to feel better. Before you know it you will be back to running. But for right now, you need pain free movement. It is time to rest your body and mind.
7. Once you are beyond the pain cycle, you can begin working on strengthening and stabilizing your posture with corrective exercises. Spend at least eight weeks on this phase. Postural instability is more than likely the primary contributing factor to your injury. Taking a few extra weeks working to improve core strength and postural stability will prevent injuries down the road. Here are a few articles with examples of corrective exercises for your feet, hips and shoulders.
8. Slowly integrate walking and running back into your program. You will need to start over – from the beginning, from scratch. Remember, injuries are your body telling you that you are doing something wrong. What it says is that there is a kink in your step. The only way to work out a kink is to start over from the beginning. I suggest starting with a Six Week Walking Program – Transition to Running and then transition to the Twelve Week Running Program For An Injury Free Barefoot/Minimalist Transition. Make sure you continue to use your self massage tools throughout this process. This may be a good time to find a highly qualified and experienced running coach.
9. Perform Functional Movement. Running is a great form of movement and exercise, but by itself it is not functional. The biggest reason runners get injured is that they RUN and nothing else. Running is purely a linear movement and it replicates another movement pattern that most of us do all day… Sitting. What your body needs is Functional Movement. You need to spend more time moving your body in all of the other ranges of motion it was designed for. Adding functional training into your program you will improve your running dramatically. You will run faster, farther, with less pain, and you will run well into old age.
10. Take your time. Don’t be in a hurry. Injuries are not the end of the world, even if they may feel that way right now. If you invest the nest few months on healing, listening, and strengthening your body from the inside out, you will look back on this injury as the best thing that could have happened to your running. Allow this time to be a teachable moment in your life. If you do, it will change your life for the better, forever.
Good luck and let me know if you have any more questions.
Jesse James Retherford
Licensed Massage Therapist
Jesse James Retherford teaches runners how to break the injury cycle, safely transition into a minimalist/barefoot lifestyle and raise their health and fitness level to new heights. His program incorporates deep tissue massage, which, in combination with self massage, will bring an end to the injury cycle. He instructs in corrective exercises to improve posture, gait mechanics, and running efficiency. He writes an individualized, fun, challenging functional training program to increase speed, agility, endurance, strength, balance, stability, power, and over-all body image. As a client, you will perform, play, and run faster and farther, with less pain and injury for the rest of your life.