Is it a stress fracture, x-ray doesn't show anything?

10 messages
16/04/2014 at 13:29

Sorry for starting a new thread on an old theme but I'm at a bit of a low point's been 5 weeks since I hurt my foot on a run and it's been getting worse, not better.

My foot suddenly felt that it gave way and I couldn't run on it. There was sharp pain but nothing too bad. Very slight swelling, gave it about 10 days to rest then tried to run again. Within 10 minutes the pain was back and if anything worse. 

Saw a sports physio who said that he couldn't find anything wrong but the sharp pain might be an indicator of a stress fracture.Went for a x-ray but the results didn't show anything and the doctor was adamant it can't be a stress fracture because nothing came up on the x-ray. Waiting for an appointment to see a foot specialist, but who knows how long that will take.

Tried cross training in the first few weeks, that and life in general meant that I could hardly walk or put weight on the foot. Still got the sharp pain on the outside of the foot under the joint where the pain started, but now also pain running down from the big toe, a similar feeling to cramp.

Every time I overdo it, like walking around for too long, it hurts and I end up limping.

Just wondering what else it could be, is it a stress fracture, but it seems to be getting worse? I'm resting it and only doing a  tiny bit of cycling (carefully). Just reached rock bottom today, as there doesn't seem to be an answer to what I can do to get over it. I know when I do start running it's going to be like starting again, starting with 5 minutes. Just so frustrated with it all. Any ideas appreciated.

16/04/2014 at 13:48

I thought stress fractures in feet tended only to show up on x-rays once they had started the repair process, so I wouldn't expect one to show up within a couple of weeks - more like 6 weeks on. If I recall there's also a pre stress fracture condition (that won't show up at all) that will cause similar pain.

16/04/2014 at 17:39

Stress fracture or stress reaction often does NOT show up on x-ray, particularly initially. The very sharp pain would fit with a stress fracture. The good news is that if you REST it, really rest it, for about six weeks it should heal (I was advised to wear a shoe with a rigid sole). The bad thing is that if it's actually something else, it might not heal with rest (rest sorted my stress fracture back in 2011 but not the extensor tendonitis I'd developed at the same time - that needed physio).

As for re-starting, yes, you need to start with small distances/short times and work up again. But I worked up from restarting end of May to half-marathon by October and 50K by the following January. Good luck!

16/04/2014 at 18:00

Agree with others, stress fractures tend not to show on an x-ray.  Have you been back to the sports physio since your initial appointment?  You don't mention any follow up appointments.  I'd suggest you need to go back.  Also, if you keep doing little bits and it keeps hurting, then surely that is telling you something?  STOP!!!

Depending on where the fracture is, depends on whether you should even be cycling.  I've had friends with stress fractures, one was permitted to cycle, the other wasn't.  Can you swim?  That's not weight bearing.  If you're not a swimmer, then you're stuck with total rest.  Maybe do the jobs that you've been meaning to do for months?

Ultimately, few of us are qualified to know what it is.  Even those who are shouldn't diagnose without seeing you.  You need to go and see someone qualified to comment and in the meantime, stop flipping training on it if it's hurting you!!!  

Good luck.

16/04/2014 at 20:02

Thanks everyone. 

Yep, I've learnt the hard way to stop! I hate sitting around, that's why I'm in a foul mood. Realized couldn't do the cross training, swimming was making my foot cramp. Didn't occur to me that general activities would make the foot so bad like standing ironing for an hour, pushing a grocery trolley, stupid things like that. Really made a conscience effort the last few days and haven't had the pain or limping since Saturday. So, hopefully, it can start healing. But definitely tried too hard to keep some sort of fitness, think I need to let it go. Still try and do core strength activities and non weight bearing on my foot weights.

Frustrating not having a definite diagnosis, hoping the foot specialist when I get to see them can tell me. I know due to my stubborn nature, it's going to more like 12 weeks now....erghhhhh!

But feel better after reading Debra's reply, that maybe all is not lost for an autumn half marathon, and 50k is still right at the top of my bucket list. Need to look at my training and have just got a bike. Hoping this has a positive and can work on my cycling, swimming, this will push me to do new things. Cheers again.

16/04/2014 at 20:38

I found volunteering at my local parkrun to be a lot better than sitting around feeling frustrated because I couldn't run...

17/04/2014 at 08:35

I love parkrun, and did volunteer initially when it happened but for the last few weeks couldn't stand for that amount of time, need one of those shooting sticks to sit on! I'm usually standing on one foot now like some sort of flamingo. 

As soon as I can stand for any length of time, I'll be back. I miss seeing everyone. I think if I can be really strict with myself about rest, it will get back much quicker. Can't believe how much it has impeded on everything....


17/04/2014 at 13:00

Ask for a nuclear bone scan to prove or disprove the stress reaction....

16/05/2014 at 16:36

Thought I would give an update. The specialist thinks it's my peroneal tendon. Waiting for a MRI scan. Possible treatment being a cortisone injection and some physio.

Sorry, Six Physio wanted to say thank you for your post.

Does anyone know how long tendon take to sort themselves out? I'm bracing myself for a long time as so little blood circulating there to help with the healing.


16/05/2014 at 17:04

DDD: Hate to give you bad news but yes, tendons can take ages. It depends how badly you've injured it. I tore my posterior tibial tendon (cycling accident) and spent five months in an ankle brace, followed by some weeks of physio and exercises before starting running again - I'm now up to 4.5 miles per run and increasing gradually because I've been told there's tendon degeneration as well. Previous extensor tendonitis was six weeks rest (for the concurrent metatarsal stress fracture) then after the tendonitis was diagnosed (when my foot still hurt, in a different place, once I tried running again) about another six weeks or so physio and exercises then gradual return to running - with full recovery.

If it's tendonitis there's a good chance of full recovery. Degeneration is more of a problem. Good luck!

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