jeetle the impossible
how to tell the difference between a stress fracture and other kinds of foot pain... 1/18/2008 4:03PM Reply | Return to Index | Report Post
After a long uptempo run in racing flats that show forced me to do mostly on pavement, the ball of one of my feet started to hurt. The pain is located on the metatarsal bones on the other side of my big toe and second toe. It is mostly a dull ache like the area has been bruised, and it hurts only when I run. I can run through the pain, but I don't know if I should. I'd say it ranges between a 3-6 on a 1-10 pain scale when I am running, and it doesn't hurt at all when I am not. I have never had a stress fracture, so I don't know what one feels like. Can anyone help me to diagnose this?
jeetle the impossible
RE: how to tell the difference between a stress fracture and other kinds of foot pain... 1/18/2008 4:05PM - in reply to jeetle the impossible Reply | Return to Index | Report Post
oh yes and the area is painful when I press on it with my fingers.
sgh
RE: how to tell the difference between a stress fracture and other kinds of foot pain... 1/18/2008 5:06PM - in reply to jeetle the impossible Reply | Return to Index | Report Post
two things to try...

1st-look for point tenderness (hurts only in a very tiny area, push a fraction over and there is no pain, nut on the spot pain is about an 8 or higher.

2nd- If there is point tenderness, try a tunning fork. Bang it on a table, then put the handle on the area that hurts. Pain factor 9++ if there is a fratcure, basically 0 if not.

If you do have a fratcure DO NOT RUN. I did and it is now permanent. It still hurts 10 years later.
jeetle the impossible
RE: how to tell the difference between a stress fracture and other kinds of foot pain... 1/18/2008 6:12PM - in reply to sgh Reply | Return to Index | Report Post
The pain is actually pretty diffuse even when I prod on it. I'll try to get my hands on a tuning fork.

Thanks
Got it 2
RE: how to tell the difference between a stress fracture and other kinds of foot pain... 1/18/2008 7:15PM - in reply to jeetle the impossible Reply | Return to Index | Report Post
Man, I was going to post the same thing. Mine may have happened on a tempo run or possibly while stretching. Mine is also on the ball of my foot (or joint) below the 2nd toe.

Here’s what I read. Maybe someone can confirm this. The metatarsal stress fracture seems to be lower down. Not on the joint but about an inch or so closer to the ankle. Also, I read that the pain is mostly on the top of your foot, not underneath. This isn’t to say that you could get a stress fracture on the joint? Can anyone confirm this??

Mine MAY have been caused while stretching my toes/arch against a door stop. My toes get in a 90 degree angle pointing straight up while the foot is flat. This is a great PF stretch but can put some torque on the ball of the foot. OP, do you do this stretch as well ??

Anyway, I took one day off but have run on it the past 3 days. I am also icing it over a frozen bottle and taking advil. Still sore but will “train through it” with hopes of it going away. Seems to have gotten more sore after I did some half mile surges during my run.

Keep me informed on how yours is doing and I will do the same.

Good luck
listen
RE: how to tell the difference between a stress fracture and other kinds of foot pain... 1/18/2008 8:37PM - in reply to jeetle the impossible Reply | Return to Index | Report Post
jeetle,
i broke my 2nd metatarsal, left foot, about 4 years ago. What I remember most is that the pain was not really around the toe, but on the TOP of the foot itself. It was a bad pain that wouldn't go away, like muscle injuries sometimes do when you go out for a run. I remember coming back from runs, really really wincing at the pain.

from what you describe, I think this might be some bruising, rather than a fracture... try some gel inserts or something to give it a little cushioning. ice seemed to help too, if you can stand it.

good luck bro. stick to the soft stuff if you can.
Bagger
RE: how to tell the difference between a stress fracture and other kinds of foot pain... 1/18/2008 8:43PM - in reply to jeetle the impossible Reply | Return to Index | Report Post

jeetle the impossible wrote:
Can anyone help me to diagnose this?

If you don't have access to a trainer, see a doc. Not worth monkeying around with a possible SF. You certainly won't get the diagnosis on here.
jeetle the impossible
RE: how to tell the difference between a stress fracture and other kinds of foot pain... 1/18/2008 8:48PM - in reply to listen Reply | Return to Index | Report Post
Thanks for what sounds like decent news everyone. I swapped spinning--I can't understand how anyone can do this for any extended length of time--for my second run today, and I will do the same for the next couple of days to be cautious. However, as I walk around I really don't feel any pain at all, and the pain that prodding it produces is a dull ache around the joint. From everyone's descriptions it sounds like stress fractures hurt like hell and I hope I never get one.
dd
RE: how to tell the difference between a stress fracture and other kinds of foot pain... 1/18/2008 8:55PM - in reply to Bagger Reply | Return to Index | Report Post
I thought the same thing about the tuning fork bit- turns out there is absolutely no reliable evidence that this works. Back when I had a stress fracture later supported by a positive bone scan, the tuning fork was uncomfortable, but it was uncomfortable on my other shin as well.

Bone scans measure uptake of divalent cations to the area, so intense uptake supports a fracture, also supports a deep bruise, infection (usually why we get them in the hospital), tumor, basically any bone more active than the surrounding bone.

MRI can detect inflammation, tissue swelling in the bone, and various other more technical things that radiologists can use to help support a stress fracture.

Ditto with CT scans

Plain x-rays are useless early, may show a LARGE stress fracture, or healing bone later.

Basically, there is no way to tell with any certainty by examining the foot/leg, imaging modalities can make it a more cetain diagnosis, but the end result is the same as for a deep bone bruise: rest, eat well, and build up slowly when you return. Take the downtime to strengthen the muscles/tendons around the area.

-MN MD