I seem to have stress fractured my metatarsal during my run today

You have to go through the regular routine. Go to the Dr. X-ray, then if needed MRI. If cleared, you might have a neuroma or something else.

Bottom line, see your Dr. Nobody here will be able to accurately diagnose you.

If it gradually appeared over time which seems to be the case, it's an overuse injury and that usually is a stress reaction not a stress fracture. A stress fracture might be the next stage if you dont take it easy. Usually stress fractures that just appear quite suddenly will be from some sort of blunt force trauma or stepping on something pointed like a sharp stone barefoot or kids' lego, not a repetitive motion on a flat surface like running on a treadmill (unless you carry on and push through obvious pain).

But as others have said it could be something else entirely.

Thanks for the responses. Got an X-ray today and it showed nothing, so doc recommended an MRI and asked me to see his sports doc colleague (that I’ve seen quite a while back) after the MRI. Doc seemed okay when I said I prefer to just walk slowly with a limp than use a brace or crutches.

Sounds exactly like my experience with metatarsal stress fracture. You absolutely need and MRI to diagnose it. Stress fractures only show up on an x ray sometimes, and only after they’ve been around a while and the bone has started to calcify around the injury. A radiologist will look for bone marrow edema on MRI for diagnosis. In the meantime, don’t run, get in a boot ASAP. 6 weeks in a boot followed by 6 weeks of a gradual return to training seems pretty standard from what I have heard.

Yep, at least get one of those hard-sole sandals instead of limping around. Otherwise you're delaying your recovery.

If the pain is on top of the foot and you can feel kind of a fleshy spot right above where the pain is, odds are 99.9% that it is a met stress fracture or stress reaction. Only difference between the two is that the stress reaction precedes a stress fracture. Both are bad and will require taking time off from running.

MRI or bone scan is the only way to know for sure. However, if your symptoms match the above and you have a high deductible, you probably can skip the imaging and just stay off it for 4-6 weeks.

The fun part about metatarsal stress fractures is that no one really knows what is the best treatment/recovery plan. Some say you have to be in a boot for 6-8 weeks. Others say you should never immobilize it and need to walk on it a little every day to encourage bone growth. Some say minimum 8-12 weeks of rest before returning to running. Others say stay off it until there is no more pain or sensitivity and then slowly start returning to running.

I had three different met stress fractures. One was a rebound next to another sfx. I did the boot for one and no boot for the other. Can't say whether I noticed any difference. The only big lesson I learned is to return to running with lower intensity workouts like tempos and long intervals. After a few months of that, you can start doing the faster track intervals, hill sprints, strides, etc.

Can you or anyone please clarify how exactly a boot helps recovery? I’m able walk slow and flat-footed using mostly the medial side of my forefoot and heel without pain. It hurts only if put weight on the lateral forefoot and flex and release the forefoot like in a normal walking motion (running being out of question). Walking is more comfortable with shoes, so I’ll just be shod in home shoes even indoors. Won’t a boot will still have me limping slowly like I anyway am?

I had a pain like that a few months ago, felt inside the shoe and felt a knot right where the pain was. I put a 2x2" piece of wood in the shoe and pounded the knot flat with a hammer. The pain was gone by the next day and I continued my usual training.

Your foot should heal quickly once the source of pain is eliminated. To speed along the healing put your foot in ice water a few times a day, to reduce inflammation and pain, and to drive the blood deep in the tissues for healing.

Here is a good resource summarizing the clinical evidence behind many stress fracture rehab protocols:

I’m not a physician nor any kind of legitimate expert but not using a boot seems unnecessarily risky. There’s plenty of evidence supporting the use of a boot and 6ish weeks off. I wouldn’t depart from that advice without the guidance of a clinician with expertise in running and knowledge of your particular scenario.

Thanks, having suffered a different (calcaneal) stress fracture a couple years back, I feel similarly about MRIs. Back then it took over two weeks to just get an MRI appointment, and I was already pain free and had resumed running by my MRI date, so the main benefit of the MRI was to see the “vertical linear hypointense signal” staring at me in my face and force a 6-week running break upon myself despite being able to run and then re-starting slowly.

This time around, if I get painfree before the MRI date, I plan to just cancel the MRI and follow a conservative recovery protocol assuming it’s a stress fracture because I honestly don’t see how knowing it’s a stress fracture helps at this point.

Here’s an article I found useful both on MRIs and boots as well as recovery protocols:

physioworkshsv.com

Do I need a boot for a stress fracture? What Exercises Help?

People are often put in boots for stress fractures - but are they always needed? Maybe not, and perhaps there are also better exercises! Read more at our blog!

Link:physioworkshsv.com/boots-for-stress-fr...

The boot is meant to completely fixate your foot and make you use it as little as possible. Idk if you need it or not, but my best tip is to take potential fractures VERY seriously. I've had a stress reaction and a fracture in the metatarsals and it took me 5-6 months to get back. I've also had a stress fracture in os naviculare and it's soon 2 years (including operation) and I'm not 100% pain free yet. MRI and as good of a doctor as you can possibly find is my best tip.

FWIW, the Walking Asymmetry metric on the iPhone Health app provides a quantitative measure of limp and how it’s improving by the day, which can be reassuring as it can be otherwise hard to sense day-to-day improvement.

People are so freaking stupid these days.

Running on a treadmill is not the same as running on other surfaces, and the stress on your feet is different too. Give it rest and ice for few days and see if it feels any different. You need imaging to confirm. My experience with shin stress fracture is it felt like knife stabbing in one spot and didn't go away. I wore an air cast for 6 weeks and did a lot of running in pool. It took awhile longer before I was able to run again and be pain free. There's still a bump on the spot decades later.

Metatarsaglia can be a lot of things besides a stress fracture

So one week out, my pain and limp have improved since the first couple days but still not gone, and I’m also beginning to think it might be a peroneal tendon issue, not a stress fracture, but I couldn’t find a good test to disambiguate between those two and whatever other possibilities there are. Pressing the foot doesn’t trigger much on the right compared to the left, nor does pretend-trying to break the fifth metatarsal with the thumb and fingers, but then again from what I recall about my calcaneal stress fracture a couple years back, these tests tend to be notoriously ambiguous. Are there good tests?

I scheduled my MRI for a couple of weeks out on the 23rd, but I’m hoping the pain would be gone by then so I can just cancel it, though I’m still curious what it is so I can try to be more careful about avoiding it in the future.