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The Stress Fracture Sidestep: A Runner’s Dance

Close Call.

A few weeks ago, I noticed that my right ankle was purple and swollen. It didn’t hurt, but swelling is never a good sign, right? And purple foods may be fun, but purple feet are another story entirely.

“Please go away,” I silently begged the violet puffiness. Oddly enough, it didn’t listen. (Shocking, I know.) Since there was no pain accompanying the swelling, I decided to continue running like normal. But as the days passed and the swelling remained, I booked a trip to the doctor, just to be sure. Once there, I heard the words that every runner dreads: “You may have a stress fracture. I think you should see an Orthopedist.”

Stress fracture? No no no, please. Something else: a sprain, a strain, something where I can just take a magic pill and make it go away! I was aghast when I googled the recovery period for stress fractures: at least 4-6 weeks. Rationally, I should’ve been thankful that it wasn’t something worse (a broken leg! surgery!). But I wasn’t thinking rationally. The morning of my Orthopedist appointment, I glumly set off for what I figured would be a “goodbye” run.

Lesson #1: Don’t assume things.

After looking at the X-rays, the Orthopedist told me that I didn’t have a stress fracture after all. I wanted to hug him!

Lesson #2: Don’t get upset over something that you don’t know is true.

He examined my feet (Lesson #3: Get a pedicure before going to see a cute foot doctor!) and told me I was a supronator, or underpronator, meaning that my feet don’t roll inward enough, which can cause injuries if the wrong shoes are worn. Runners’ feet are classified in one of three categories: Overpronation, Neutral, and Underpronation or Supronation. I’d previously been told—by running store employees—that my feet were neutral.

Turns out that the swelling in my foot was due to Achilles Tendonitis. The doctor gave me some stretches to do and made me an appointment to get orthotics. He also said I can continue to run. Feeling as if I’d been given a second chance, I walked out of the office with a new appreciation for my health—and a new appreciation for my feet!

Lesson #5: Do NOT take your feet for granted!

Right away, I bought a new pair of shoes, because I’d never had any injury problems until I switched away from them.

Published on October 15, 2009

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  1. jcd says

    I’m an underpronator too! The folks at the running shop told me they don’t see to many of our type and said neutral shoes would be my best bet to start out with. I have only started running though, so I don’t have any advice. (I’ll be lurking to see what others say.)

    I wish you well and get better soon!!

  2. fitforfree says

    Phew for no stress fracture!!
    I have the same problem as you, and got orthotics six months ago and they have done wonders (I have so much less leg soreness when I run now, and increased my mileage without discomfort!!).
    The biggest piece of advice I can give you is MAKE SURE the podiatrist measures your feet properly and checks to see if one foot is larger/one leg is longer. Also, ease into running slowly after you get the orthotics, since everything will be aligned slightly differently, and you don’t want to injure yourself until you’re used to the orthotics. I started wearing them all day (in my casual shoes/boots as well as my running shoes) and that sped up the process!
    Good luck!!

  3. Jenn says

    Hey Katie, sorry about your Achilles Tendonitis, but I do find it cool that I’m in med school and just learned about that a little while ago. You’re lucky it didn’t cause you any pain, most people experience a lot of pay in the morning when it hasn’t been stretched out yet. And I’m a pronator so I don’t have any tips for ya but hope you get better soon!

  4. Jessica says

    I am also an underpronator! We have a great running store near us and they are sooo thorough when you want to buy new shoes. Glad it’s not a stree frac!

  5. Kristen @ Simply Savor says

    Go glad you don’t have a stress fracture!! I’m glad you brought this up because I never think about the shoes I’m buying to workout in and have just started paying attention to how important it is. I’m looking forward to reading the comments from everyone to learn more!

    Have a great run today girl!

    …and I hope you got that cute doctors phone number before you left! 😉

  6. Abby says

    BLAH.. sounds crappy, at least its not a stress fracture. Im sure some of those fudge babies will make ya feel better!! 🙂
    It usually takes something crappy happening for us to realize how lucky we are.

    Rest up 🙂

  7. The voracious Vegan says

    SO glad to hear it is not a fracture! Whew! I know how miserable it is to think you might have to miss a workout, glad you don’t have to!

    I’m not a runner, I do all my cardio on the summit climber, bicycle, elliptical and my horse, of course! But I will hop on the treadmill for a jog occasionally and I can see how consistent running can take a toll on the body!

    I have the Nike Pegasus too! I love them. EXCEPT I bought them maybe 2 months ago and back then they fit perfectly and now they are slightly too small! Isn’t that so weird? I have no idea how my feet just grew half a size at the age of 27 but seriously, my toes are all cramped and I need to buy a bigger size. Oh well…

    This was a great post with good news, I’m glad you are okay, Katie!

  8. Jessica says

    Yay for good news! I’m really glad you don’t have a fracture. About two and a half years ago, I tore my achilles tendon when I was running. It took me almost a year to get back on track — eek!! I believe my feet are “neutral” but maybe I should go to the doctor just to be sure! I was miserable having to sit on the sidelines for so long…

  9. JoLynn says

    So glad to hear it wasn’t a fracture! I’m not much of a runner but I bike, hike, pilates, etc. I might try those Nike Pegasus, I have narrow feet and Nike’s fit so nicely.

    One more thing do you really have to keep showing those yummy raw fudge thingys, I mean I drool all over my key board every time I see them.

  10. tabitha says

    yay katie!
    glad you can run.
    i was a walker while my husband was working out of town (home with 3 little children alone didn’t allow for run time)
    when he lost his job i started running as a stress reliever
    i LOVED it!!
    such a beautiful time of year too
    i was so upset when i injured my achilles-i’ve never done that. i hobbled for 2 weeks barely walking til my co-workers had me go to the dr
    podiatrist said an insertional achilles tendon tear (where the tendon attaches to the heel)
    i wore a boot for a bit and it did wonders!!
    i’m bootless now and feel good, but i hear it takes months to be able to run again..i go back in a couple weeks
    fortunately it’s been crazy cold and rainy recently so i’m not so miserable on the sidelines

    so…i guess i just stole your space to tell my story…cause my only advice is to take it easy…you don’t want to tear the darned thing!

  11. *Andrea* says

    haha my foot dr. is a hottie too 😉 i am an over-pronator?? my feet roll inward.. i use orthodics to keep an arch and try and stretch the balls of my feet. other than that i don’t do much… but i only run about 3-6 miles 5-6 days a week.

  12. Caroline says

    Hi Katie,

    I had a fibular stress fracture last year! Basically, it felt like shin splints that just kept getting worse and worse and worse. You can get them if you increase your mileage suddenly, don’t get enough carbs or calories, are amenorrehic, or don’t get enough calcium. However, it seems like you don’t have any of these problems so I would not put you in that risk category.

    I use orthotics now but I don’t really know much about them. My orthopedist just told me to get a certain kind…

    Achilles tendonitis…you can do many stretches found online, try to avoid running on hills for a little while because they are harder on the achilles, do calf raises for strength, and ICE, ICE, baby!!

    And, I know it’s expensive, but change your shoes after 300 miles! I know it seems wasteful to change every six weeks, but it’s a good idea. Seriously, I start to get some niggles after six weeks, but then when I change my shoes, they all go away.

    If you’re really concerned about preventing injuries, you can cross train on the elliptical, in the pool, or doing stationary bike intervals (these are actually a great change of pace and can be even more intense than running if you do them correctly).

    Good luck!

    Your Fellow Runner

  13. Andrea says

    I’m an overpronator… so the exact opposite. Unfortunately I am also prone to stress fractures, and I can tell you they are no fun! Overtraining is definitely a big culprit here – not just long distances, but speed work too. I hope that your Achilles heals quickly and that you are back to full speed in no time!

  14. The Foodie Diaries says

    My ortho is so cute, too! I definitely create imaginary sexual tension in my head haha.

    So, I’ve had THREE stress fractures. I don’t know why… prettty sure my body just hates me haha. But some things I’ve learned– stretch, stretch, stretch! Do not skimp on stretching. Every time I’ve gotten a stress fracture, it’s stemmed from the areas being too tight. Also I’ve read that strength training really helps in prevention.

    Buena suerte in staying Stress Fx-free!!

  15. Naomi (onefitfoodie) says

    so great that you dont have stress fractures!!!

    i am a runner & nuetral foot

    i would say to make sure to stretch those legs! it is easy to go about your normal running and never stretch out, but stress fractures can come from having very tight muscles!

    MMM i want some fudge babbies!! 🙂

  16. Daria @ Daria Can Cook says

    I’m so happy for your sake that it wasn’t a stress fracture!!! I had a stress fracture in my pelvis (!) back in my serious running days and it was miserable.

    The best things you can do to avoid stress fractures are to stay on soft surfaces, which if I remember correctly, you do, and to not overtrain. The 2nd one is harder! But it can help to take some cross training days or to run a mile or two less than usual every now and then.

    I hope the new shoes help the tendonitis! It might help too to roll your foot around on a tennis ball. This loosens up all those tendons and muscles that usually get neglected when we stretch. Just take a tennis ball and roll it around under your foot as hard as you can stand. It might hurt at first but the more you do it the easier it gets.

  17. taleoftwovegans says

    Not a runner, a dancer, but I had a stress-fracture scare earlier this year. No fun! 🙁 But I did the same thing you did-got myself all hyped up over it by googling symptoms instead of waiting for a professional opinion.
    Best of luck conquering your tendonitis!
    -K

  18. Averie (LoveVeggiesAndYoga) says

    So happy that it’s “just” this prob and not a stress fracture. I am not one to give advice on the subject b/c since moving to AZ I have been putting off calling a sport med doc but I need to. My right food is swollen, tender, and flares up. I think it’s really severe plantar fascitis (bottom of arch in foot super tender) and it wraps to my heel on the outside. Outer lower ankle gets all swollen. Does this by any chance ring a bell with your symptoms? I need orthotics. We are switching health insurance in a month or so and then I am gonna do all this. And shoes…OMG I have blogged TWICE about the importance of good shoes. Dont be cheap on em and to replace freqently! Like every 3-4 mos if you’re a true runner.

    oxox

  19. River (Wing-it Vegan) says

    Yikes! I’m sorry about your Achilles Tendonitis but I’m glad it wasn’t a stress fracture! I have no idea what kind of feet I have. Lazy feet? 🙂

    Thank you for your super sweet comment! You rock, and I promise never to blog about plain cold noodles!

  20. Kaitlin says

    Just a suggestion, to help optimal healing I’d look into going to someone certified in Active Release Technique to remove the adhesions caused by the tearing of the Achilles tendon. I know a handful of runners that have improved their performance (and pain/injuries) with A.R.T. Go to activerelease.com to learn more about it and you can locate those who are certified that live nearby!

  21. vanessa says

    Hi Katie,

    Boy, can I relate. As a result of having severe anorexia for over a decade, I recently found out that I have the bones of, like, a 90-year-old. Not only that, but I have fractures in my hips and feet. I don’t know if I’ll ever be allowed to run again. Now, I’m a busy bee, so to now be told to stay off my feet or end up with fucked up joints forever is TORTURE! So, I feel for you, and am glad you don’t have fractures too!

  22. leslie says

    i have custom orthotics because my left foot supinates and is also shorter than my right, which caused me major knee problems. my biggest piece of advice would be to make sure the doctor who makes the orthotics knows what he’s doing. i know that sounds like strange advice, but i had to get my orthotics adjusted three times, and it was incredibly, incredibly frustrating. so do some research on the doctor (a running store in your area can probably recommend someone).

    the doctor should make a plaster cast of your foot – it’s much more accurate than the other method, which is stepping into a foam box. ask if you can keep the cast – it will save you money and guesswork in the future, since the orthotics only last a couple years.

    also, it can take a good 2 weeks to break them in, and that period can be pretty uncomfortable at first, so remember to be patient. a few weeks of taking it easy is nothing in the grand scheme of things!

    glad it’s not a major injury – i know how devastating that can be! you’ve got such a wonderful attitude to have taken so many lessons from this!

  23. nic - the auspicious squirrel says

    Katie – I hope your ankle feels better. I get pain in my arches, so a great foot stretch (for everyone because we wear shoes all the time) is to sit in hero pose, but instead of having your feet flat on the mat, lift your feed so that your toes are tucked under and your bum is on your heals… it’s a great foot stretch. 🙂

    Here’s a great picture I found…

    hero pose –> http://media.onsugar.com/files/ons1/192/1922729/34_2009/471effd7ae1926a2_tricep-550.jpg

    ~nic

  24. Jenny R. says

    :O do not scare me like that Katie!!!!!!!!!!!! thank goodness you’re ok! I couldn’t run for so long last year b/c I pulled my achilles…but nothing scary like that happened. Please don’t hurt yourself further or I will be forced to cyber smack you and then send you this fabulous ointment for sore muscles/tendons that my herbal medicine teacher gave me ;P
    p.s. I used to be a salesgirl at nike and I gotta …half the time we just make things up about people’s feet lol

  25. MarathonVal says

    I overpronate, so I do’t have any specific advice for you. But I do think that orthotics help – I have a custom-built pair for my “regular” shoes, and I use SuperFeet inserts in my running shoes, which I swear by.

    Also, maybe someone will be nice and buy you a free massage – tell them it’s good for you, it’s the truth! 🙂

  26. elizabeth says

    yay for no stress fractures!!!!
    i have a neutral foot
    word for getting a pedicure pre-podiatrist visit
    i have been thankfully, injury free but it looks like you’re getting some great advice!
    good luck!

  27. Kate says

    You scared me there for a second! Phew! I’m glad your feet are still fine for running! Hahah. Just make sure you don’t over-do anything. The smallest little injury can really explode into something a lot worse if you push it too its limits.

    I actually under-pronate quite a bit too. I wear orthodics EVERY TIME I run and I try to wear them most everywhere else too, for fear of injuring my feet again. I have had plantar fasciitis and a stress fracture and both of them force me to stop running for a couple months earlier this year.

    Now, along with my inserts, I make sure to replace my shoes regularly so they don’t get too worn down, I stretch daily, I give myself a day of rest on the weekend, and I make sure to LISTEN TO MY FEET. I sware, when my plantar fasciitis started it felt like almost nothing, but within two days of continued running, it turned into a full-fledged injury. Now I take action at the first sign of pain instead of “waiting it out”, which is generally not a good idea.

  28. Melinda says

    I still hate running and I mostly power walk, seriouslly. I tend to move faster than some people running. but I did buy a nice new pair of running shoes while I was at home. Maybe one day I will decide to run. In the meantime my bike showed up today and I am looking forward to that.

  29. Heather Eats Almond Butter says

    Katie,
    While training for my first marathon, I got a stress fracture in my pubic bone…which lead to a severe groin pull…which lead to years of running with custom orthotics. My dad is a chiropractor, and he took a mold of my foot and ordered them for me. They were free, and so I never asked any questions, but they did seem to help.

    As far as the tendonitis goes, sounds like you have some inflammation issues. I would ice after your runs, do plenty of stretches (a really good one is to sit up with your bum resting on your calves, and sit back on your heels. Make sense?) Perhaps get a massage once or twice a month. Can make a huge difference if you find a good therapist, someone who specializes in deep tissue, neuromuscular, or active release therapy. Tell them to concentrate on your calf muscles. Also, try Polly’s Yoga for runners and yoga for triathletes. Good stretches for the legs.

  30. Vaala says

    I’m an over-pronator…well, technically I do a bit of both (yep, it’s possible). Got great shoes so don’t need othotics but I’ve had the stress fracture scare…got a mysterious lump on my leg that hurt a lot. Saw a sports doctor who took an xray but couldn’t find anything. I physically couldn’t run though so had to take a few weeks off (that’s when I took up spin and am now addicted!). It taught me that cross-training is important and that’s when I finally found great shoes that fitted me right (I was also given the wrong shoes by one sports shoe store but have since found a great store that really knows its stuff). Glad you went to the doctor quickly ’cause you really never know and it’s so much better to get it checked out soon.

  31. Heather Eats Almond Butter says

    Oh, and if you do that stretch, make sure to keep your feet flexed when you sit back on your heels. 🙂

  32. Jess says

    I’m so glad you don’t have a stress fracture–PHEW! I hope your feet start to feel immensely better 🙂 I am an underpronator! I work on strengthening my legs and have custom orthotics (TOTALLY worth the $$$!) and everything is great 🙂
    <3 jess
    xoxo

  33. trustingmyintuition says

    that’s good you can still run! Be careful though! I had posterior tibial tendonitis, and I am a underpronator (supinator), but the doctor told me i severely overpronate and prescribed me custom orthotics. I wore them for about a month when I got back to running again after a few months off, and they caused me knee and ITB injuries. I know everyone is different, and they do work for some people, but just really tune in and listen to your body! Also, good call on getting the shoes you used to run in again. Always do what works best for you, and the people at running stores and doctors are only there for advice. That is another very important lesson I’ve learned through my injury…I trusted these people, but only you know your body best and you don’t have to do what they recommend. I wish you the best of luck!!!!!!

  34. buffmuffy says

    wow great post and sorry about the foot!
    very interesting.
    i want to go to a running store and check out my feet.. what is supopronation? or whatever you called it lol.
    BAH TEASE with the fudge babies!

  35. Pure2Raw Twins says

    We both have really weak feet and ankles…it runs it our family, so we understand about appreciating your feet. When we were younger we had to get orthotics, wore them for years, then eventually found a doctor who told us to stop wearing them because we have to retrain our feet to walk properly again. Finding the perfect running shoe can be a challenge, we like the Nike Free, because we are learning more and more than you do not need all that support, cushion that regular running shoes give. Our feet our built to run on them. Oh ya we love a product called yoga toes…they stretch your feet, it feels amazing.

  36. broccolihut says

    What a relief that you do NOT have a stress fracture! I am an over pronator myself, although I have never been officially diagnosed as such. I def know that having the right shoes is essential though–I got a wicked case of plantar fasciitis a few years ago from ill-fitting kicks. Hope you find a solution ASAP!

  37. RunToTheFinish says

    yeahhhh love posts about running!!! I have been lucky not to have many problems with my feet, but I think it’s because I was willing early on to pay for the good running shoes that have cushion

  38. jenny says

    aw honey bunny! this sounds super scary but I’m glad your HAWT orthopedist figured the shizz out and everything is a-okay. Feet rock!

    love youuu! xo

  39. Andria (Veg is Sexy) says

    Katie, I had the opposite (but similar) problem. I kept getting really bad shin splints and everyone was telling me to get new shoes. Finally I went to get fitted at a Running Co store – turns out I have a “neutral step” but I was wearing shoes that were pushing my feet out to the side.

    Shoes are CRUCIAL, runners!!! Get fitted!

    xoxo

  40. runningwriting says

    I hope you’re going to be ok.

    I was told I underpronated so I got Asic Gel Nimbus, then told I was neutral so just got Kayanos. Found I preferred the Nimbus as the Kayano didn’t seem supportive enough. Then a video showed that I overpronate but “correct” myself by underpronating so now I have New Balance shoes for overpronaters.
    Now I don’t seem to get problems related to my shoes. Hopefully you will have happy feet soon too 🙂

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