Sidelined - Injury Report

There is nothing to fear, but fear itself. Unless of course, you are training for a marathon and you think you might have a broken foot. I actually don’t think I have a broken foot, but something is not right.

I first noticed the injury soon after I was through patting myself on the back for the 20 miler on Saturday. The day after the run, my legs felt generally sore, but on Monday, I felt a noticeable pain on the top of my left foot. If felt like I had been hit with a baseball. The pain wasn’t great, but it was constant.

It didn’t take long to Google my symptoms and come up with a preliminary diagnosis: Metatarsal Stress Fracture. I became quickly educated on metatarsals and stress fractures. I can even go as far as to say, my problem is with the second metatarsal. I took each toe in my hand and gave them a tug and a wiggle. I felt nothing, except on metatarsal number 2. It’s the toe next to the big one. When I probed my foot to find the tender spot, it was at an area that lines up with that bone.

On Tuesday, I took Danny to a college music audition. I was home in the early afternoon and the went to Y for a run. There was no pain as I walked around on Tuesday and it seemed safe to test the foot. I ran six miles on the treadmill and I could feel it, but still the pain was not enough for me to stop. I rested on Wednesday and did some more research and ran again on Thursday with similar results. Although I did notice a momentary sharper pain on Thursday’s run.

So I’m spending all my time walking around trying to gauge how the foot feels. It has become an obsession as I foolishly search the Internet for a Costana-esqe ‘Stress Fracture,, Get out of here!’

Upon sifting through hundreds of web pages on the topic, I can find some common ground that probably qualifies as fact.

Of all metatarsal stress fractures, a fracture of the second is most common for runners – That’s Me
The cause is an increase in duration or intensity of activity – Me Again
The pain is localized to a specific spot on the top of your foot – Guilty

On the other hand, there is other information that causes me to be optimistic.

I have no swelling or redness
I can do the hop test (hop up and down on the bad foot) and the tippy toe test without any pain
While I can find the spot with my finger, I can not cause a sharp pain.
I do not have an irregular menstrual cycle

The good news is that this type of injury virtually always heals without complication. The bad news is that 4-6 weeks of no activity is the prescribed cure. Furthermore, this injury will not show up on an X-Ray until scar tissue from the healing process is present. It is often diagnosed from the symptoms alone. This leads me to the really far fetched idea of seeing a doctor.

I took Madeline to a sports podiatrist during last years track season. This guy has impeccable qualifications and I will go to him if the time is right. But I’m not there yet. If I were to visit him now, I think I know how it would go. He would likely interview me for my symptoms, tug on my toes, prod my foot and come to the same conclusion: it might be a stress fracture. He would order some combination of X-Ray, MRI and Bone Scan. And for the four weeks it would take, while I get a initial appointment, and then get the tests and the results processed and see him again for follow up, he would tell me to stop running. When he got around to letting me run again, I would be back at Week Two mileage. In other words, the 2008 Ocean Drive Marathon would be off.

I’m going with a more moderate approach:

* I have pain on the top of my foot
* I’m going to take a week off from running and concentrate on cross training
* I will ice the foot twice a day, every day
* I’ll see how it feels when I start running again in a week

A one week break is really more like two weeks, because you can’t just pick up where you left off. But I think I can afford it. I will rest and cross train during Week 13. I will then have six weeks of training before I start my taper (which I must now reduce from 3 weeks to 2 weeks). It is still to be determined how I train during the six weeks. I need to plan this with the assumption that my google-based medical research was an idiotic waste of time, and I am really OK, just a little banged up.

I have no intention of running through a serious condition. I have no intention of ignoring significant pain. But I do intend to the take the course of action that maximizes my chances for getting back on track for the race in March.