So Why?

I’m no stranger to fractured bones, but that’s the problem.

In summary, last week my orthopedist sent for me to get an MRI.  For the last month, I’ve walked normally, and I’ve felt no pain.  I’ve felt a dull ache occasionally in my foot but not often.  Nothing that ever altered my stride or even anything that was enough to cause concern.

Never the less, after two weeks of rest I still felt my ankle, so I got an X-ray.  The X-Ray came out fine, and I felt dumb and like a worry wort.

My foot had been poked, prodded, tuning forked and grastoned with no major issue.

Was my bone broken here? Maybe.
Was my bone broken here? Maybe.

Finally, my newly found orthopedist ordered an MRI.  She was looking for inflamed muscles and tendons or possibly a sprained ankle.  Due to everything else appearing normal, it made sense to look for those sorts of issues.  Then the news of the dreaded news of a rebroken fifth metatarsal happened.

The injury doesn’t make any sense.

How was I able to walk, run and live a normal life with a fifth metatarsal fracture?

How was I able to PR at Broad Street or the Newport 10k? Or run a mile on the track?

All of those must have happened a fractured foot.  My injury hasn’t presented itself normally at all.  Often fifth metatarsal fractures are from blunt force or rolling your ankle. To be honest, I can’t remember doing either.  Maybe I did and didn’t realize it.  Could I have rolled my ankle but never felt it?

If the MRI hadn’t come back with a fracture, I would have probably gone for a short run last weekend.  I’m not limping and my foot feels the same.

However, I’m not running on a broken foot.  
A fracture is a break. 
My foot is broken.

Mentally, I’ve already come to terms with not running. I haven’t run in 3 weeks, what’s couple more?  I know I’ve lost running fitness, and that’s fine. If I heal well, the end of June will mark 6 weeks of not running. I could be running again by then. Since I’ve already taken 3 weeks of being lazy, I’ve had the urge to begin working out again.

Since I’ve already taken 3 weeks of being lazy, I’ve had the urge to begin working out again.  The motivation is the easier part.

I’m more worried about how the stress fracture appeared.

I’m no stranger to broken bones.

Broken bones with no cause are a huge red flag to bone density, eating enough for high mileage and overtraining. 

I’m 5’7 and 130 pounds.  I don’t track calories daily but when I’m running, I typically consume 3000+ calories.  Is it all healthy 3000 calories?  No, but I like diner cake and whipped cream.  It’s not all sugar calories either.  Do I think undereating or being underweight is the issue? No, but it’s something that should always be thought about when dealing with this issue.

With my last bone fracture, two years ago, I received a bone density test. While the results were surprising, I was in the healthy calcium and vitamin D range.  This year the test was the same, and I’m once again in the normal healthy range.  So low bone density is not the issue.

Another hard fact is the wear pattern and my running gait. I put a lot of pressure on my metatarsals.  As you can see from my training over the last few years, I don’t get a lot of muscle injuries.  For the most part, my injuries are foot and bone related.

Last year at the Runners World, Golden, the owner of Altra running was mentioning something about injury.  He said if you run on the forefront of your foot, then you are more susceptible to metatarsal fractures and injuries.  I strike at the very front of my foot so unless I change my stride this could be something I deal with every few years (which seems to be how it goes).

I’m open to having my gait looked at and I’ve already found a great physical therapist to go too.  Since you need to run to be able to have your gait looked at, I must wait.

Finally, the last and most common cause of my fracture could be I rolled or sprained my ankle. The problem with that idea is that I never felt an ankle roll.  There was not a point during any of my runs I felt myself “roll and crack.”  The only aspect of that diagnosis is that it wouldn’t hurt to be weight bearing, and I could run right through and not realize it.

So there begins the processing of thinking about everything I’ve done in the last month.  It reminds me of the TV Show “I didn’t know I was pregnant”, only “I didn’t know I had a fractured foot”.  As I said yesterday, I do have the best case scenario.  The summer was a down time of year for me with no major races on the radar.  Since I’ve already been resting, if all goes well I could run by the end of the month.

Questions for you:

Have you ever rolled your ankle?

What type of cross training should I do next? 



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  1. Like I said yesterday, I’m super happy that you’re into having a plan for this, and I love that you’re analyzing where the injury may have come from and working on prevention. When *some* or *most* (I can’t decide which just yet) people get injured, they’re usually like “Oh, PF — guess I’ll stop running for a week”, without discovering what may have caused it to begin with. Newsflash: It’ll come back if you do the same thing over and over again.

    Swimming! Correct me if I’m wrong — you were/are a swimmer, as well?

  2. I’m glad you got your foot x rayed and carefully looked at.running on fracture foot is not the best idea for anyone,
    I’m not sure what cross training is good to do that intrest you. I see you were a swimmer,how bout something new like bike ridding, or yoga.just some ideas.
    Get well my friend.

  3. That sounds so frustrating.. not knowing when or why something happened, especially when you can walk around and do “normal” things. That’s nuts. I’m glad you got checked out though and are being safe. I always recommend strength training to endurance athletes. It’s the only way to improve bone strength and density (other than high impact sports). Plus strength training provides power to so you can run with less effort, especially up hills.

  4. I’m glad you are taking the time to find the cause of your fracture. Its important not to just hurry up and heal and do it all over again. I agree with the recommendation to do some strength training. I’ve always really enjoyed it. Of course if you wanted to get back in the pool again…you know that’s wonderful exercise 🙂

  5. I’m so glad you went ahead and got the MRI. Sometimes these things are so baffling but at the very least, you are now headed in the right direction. Wish I had some experience in that area to offer you but all my injuries seem to be calf area and above.

  6. Hollie argh frustrating I’m so sorry! I have been through the same and honestly the only solution I found was to switch mileage for cross training. I run at a similar level to you and doing 50-60mpw left me with stress fractures on a couple of occasions. If your problem
    Is related to foot strike could you reduce the miles and replace with elliptical or swimming? I
    Now only do
    30-35mpw and still run at the same

    1. I could definitely replace mileage with cross training and that’s definitely something to look into when I begin running again! Thanks!

  7. I know what you mean about worrying once you start getting a bunch of fractures. I think the general rule of thumb is that the closer the break is to your toes, the more likely mechanics are to blame, but the closer it is to your hip, the more likely bone density is to blame. Like you, I don’t have bone density problems, but have had two stress fractures in less than two years. Both of them were within 3 inches of my right ankle, which sounded off alarm bells for me. I went to a PT for an ankle evaluation and he found a lot of very bad instability, so now I have preventative exercises to do. Hopefully you can get to the bottom of it, because not running is not fun.

  8. Sorry to hear about your injury, Hollie, but I think it’s great that you’re taking a proactive approach to recovery and not letting yourself wallow. Have you though about doing more strength training? It’s a great way to strengthen the muscles that support our bones and also to prevent bone density loss, which is something us ladies need to think about as we get older.

  9. I’m so sorry you’re dealing with this – especially since there are so many more questions that go along with it! But at least you found the cause and now your other questions can (hopefully!) be answered and solved so you don’t have to continue dealing with this every few years! I know some people have mentioned strength training already, but I’m going to second that suggestion too! Good luck!!

  10. Being injured sucks, especially when you don’t know why. It sounds like you are handling it the best way possible though! I’m curious about your gait analysis, I run on the forefront of my foot as well and have had a stress fracture in a metatarsal too. Good luck with the rest and x-training, and here’s hoping you have a speedy recovery!!

  11. I’m sure that it is frustrating to be dealing with a somewhat repeat injury when it appears that you should otherwise not be susceptible to it. I had a questionable spot on one of my metatarsals recently as well. I iced the heck out of it and saw my sports chiro once a week and thankfully it is feeling better. I know you have a good shoe rotation, but are there possibly some shoes that would help your foot strike not put as much pressure on the metatarsals?

  12. That’s really tough. I think sometimes these things just happen with no good explanation. I think taking Calcium + Vitamin D would be good. I’ve read that Vitamin D is great for athletes, but we hardly get any of it in the foods we eat. Pool running worked like a charm for me– in deep water with a belt.

    1. I’ve lapped swam a couple of times with no issue. Personally I think after swimming for so long I do better with that. I appreciate all of your help and advice Elizabeth!

  13. I really feel for you. This has got be so challenging to deal with. I am with everyone else on the strength training! I will be thinking about you. Not running is hard!

  14. This is VERY strange. What is even stranger is that a good friend of mine also has a fractured foot right now and has no clue how she did it either! What’s worse is that she is NOT a runner.
    I just hope you are able to figure this all out and that you heal up and can run again. I think you’re onto something with the foot strike though so maybe you can work on changing your gait – which I realize is not small task but…
    Good luck!!

  15. I know a few people who have fractured the 5th metatarsal, but they did it on impact and immediately felt the break. Sometimes I wonder if runners actually do sustain a lot more stress fractures than they realize and just run through them. I do think these things just sometimes happen, but they’re extremely frustrating when they do.

  16. Very frustrating for you hey? I’ve never had a fracture before and I’ve done 75 marathons and ultra’s. My problems are more to do with my right knee and left hip when I am running very high mileage. Interesting that yours are contained in your foot as photo’s of you running looks like you are floating effortlessly! I wish you all the best in your healing. I don’t know if you’ve ever tried a rowing machine, but I really enjoy it when I can’t run. 🙂

  17. I actually rolled my ankle during my last race. For better or worse, I’m used to it from my basketball days, but it was still swollen for a few days. When I first started working at my old running store, one of the first concepts they instilled in us was a runner’s footstrike is essentially a “pick your poison” decision. When you run, you are going to feel the impact somewhere, and how you land determines where. Since I’m midfoot, I’ve become used to having tight calves–and my calves are always the first area to flare up when I run off the bike. 🙂

  18. Most of my issues have been calf, plantar, and one time hip related so can’t offer much advice in terms of a fractured foot but it sounds like you are on the right track…just fortunate that you did find it in time so you can heal. Cross-training for me has typically been swimming (though i’m awful at it) and cycling…best of luck with recovery and getting back out there.

  19. Sorry you’re injured again. You mentioned getting tested for your calcium and vitamin D levels, but did you get a DEXA scan as well? I had both tests done last fall. Even if your calcium and vitamin D are ok, it’s still possible your bones have issues, so a DEXA scan would help figure that out. Get well soon!!!

  20. I’m glad to hear your bone density is looking good!! That’s probably a big relief! I’m still sorry about the injury, though. It’s never fun to be hurt and out of doing what you love. You always have a good attitude about injury, though! I’m sure you’ll be back to running in no time 🙂

  21. I’m very sorry to hear about you injury… I injured my third metatarsal last summer and had to take 8 weeks off… It was NOT fun. That was my second stress fracture (first was in my tibia) and, just like you, it does not depend on bone density and such: my bones are strong and my calcium and vitamin D levels are optimal. I’m a overpronator though and, just to be safe, I finally had my gait checked by a podiatrist. I was told that I put way too much pressure on my metatarsals and heel when I run and none on the middle part of my foot. I was consequaently prescribed orthotics. Do you wear orthotics/did you ever check if you might need them? I think you are right re: what caused the injury (gait issues vs bones issues). Re: cross-training – the only thing I was allowed to do was swimming. I used to go to the pool 4 times per week for 90 min or so. Pool running is supposed to be good, but I cannot stand it. Thank goodness I grew up as a swimmer and had zero problems coming up with different workouts. I also worked more on core strength+upper body strength. Re: ankle – I roll my ankle more often than not and it usually feels better after 3/4 days completely off+ice/compression/elevation. It can however take months until it heals 100%. Hugs to you!

    1. Thank you for your insight Martina! I don’t wear Orthotics but I did add Superfeet into my shoes and I’ve found they take a lot of the pressure away from my “problem areas” so I might even continue to run in them when I start that.

  22. It is interesting to hear you’re a forefoot striker. I also strike with my forefoot; my running shoes show considerably less wear in the heel. Over the years I have suffered from a number of stress fractures in my feet and tibia, which have largely been chalked up to my running form. I’d be interested to hear any advice you receive or things you learn along the way because I have yet to run into someone experiencing this issue.

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