Matt’s Guest Blog: The Time I Was 90% Sure I Broke My Foot

The first 3.8 miles of my workout with the City Sports Run Club were a lot of fun (read more about it here), but things went downhill pretty quickly in the hours after crossing M & 23rd St. NW.

It wasn’t anything unusual; I caught the wrong part of a crosswalk curb-cut and twisted my ankle. This happens. It’s definitely not the first time I’ve dropped my foot unsteadily on a surface and tweaked my ankle/knee. I didn’t fall and was able to continue my stride into a post-twisted ankle hobble. Within 6-10 steps, the initial shock and pain had subsided and I felt good enough to keep running at a normal pace. I finished the 0.4 miles of the run with a little tightness in my ankle, but nothing out of the ordinary for a tweaked ankle.

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“The Incident”. Looks like the GPS watch was struggling to keep a steady line through M Street…

When I got back to City Sports, I grabbed a water and hung around for about 10 minutes to cool off. That’s when my foot started feeling weird. It wasn’t my ankle, it was my 5th metatarsal – a bone I had fractured pretty badly 7 years ago. I took off my sock and saw a large, localized purple lump on the outside of my left foot with an odd cut right in the middle. My heart sank because it looked a lot like bones I had broken in the past. I was still able to stand and walk without much pain, so I had some hope to hold onto. I Metro/walked home with an increasingly strong throbbing sensation but no direct pain.

I got home and consulted Kathleen and Mike. At this point the bruising was darker, felt like a bone fracture, hurt to be touched, but could bear weight. Honestly, I was 90% sure it was a hairline or chip fracture. I took Kathleen’s walking boot from one of her injuries and spent the next several hours with my foot iced and elevated.

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Tuesday night: ~3 hours after

This is when I mentally prepared myself to defer my Richmond bib until 2014. It was frustrating to think about because I am actually excited to run 26.2 miles. Even a generous 6 week bone recovery would make participating at Richmond very difficult.

I woke up Wednesday morning to very similar conditions as Tuesday night. A lot of swelling (can’t forget the ankle took a beating in this episode too) and more defined bruising, but it could still bear weight without any pain. I scheduled an appointment with Dr. Lazar of Capital Podiatry for Thursday morning (ironically located about 200’ from City Sports). Dr. Lazar was rated as a top podiatrist by Washingtonian Magazine, so I was very relieved to know I could trust my upcoming diagnosis.

On Wednesday night, it still looked a lot like a break. I felt pain when I touched the area and when my foot experienced any lateral forces. At this point, I was thinking 75-80% chance of a break. The throbbing, bruising and swelling still looked really concerning.

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Saturday morning

Thursday morning, it looked worse, but felt better. I dropped my chance of a bone break down to 50-50. I honestly couldn’t tell if it was broken or not at this point.

Dr. Lazar examined the foot and said the placement of the bruising looks like an injury to the cuboid (where the metatarsal meets the mass of small bones that connect to the ankle). It sounded like injuries to the cuboid are typically chip fractures given the sturdy shape of the bone. He was a bit concerned given my history of a broken 5th metatarsal.

 

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Cuboid in green. Right foot shown.

Dr. Lazar spent some time time manipulating my foot, flexing it in different directions, poking it with tools and finally taking an X-ray. Going into the X-ray, he wasn’t thinking it was a break considering I didn’t feel any pain during his foot manipulations.

THANKFULLY the X-ray came back negative. He saw no indication of any chipping, fractures, etc. with the cuboid or surrounding bones. He said I had a pretty intense bone contusion, but got by break-free.

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Thursday morning foot vs. X-ray. Amazing how visible my 2006 5th metatarsal fracture is!

 

My treatment is 6 days off of running, Celebrex for a week to decrease the swelling, a topical pain-relieving gel and a foot brace. I’m not a big fan of the brace. It seems to put too much pressure on my midfoot causing me some pain in my arch when walking. Needless to say, the foot brace has not been used since mid-Friday.

I’m taking off running until next Saturday and will only run an abbreviated 6-10 miles based on how my legs feel. I’m not concerned about getting in my 19 and 20 miler before the marathon.

In the hours I spent coming to terms with deferring my marathon bib, I did some research for spring marathons and convinced myself to consider a couple (which are unfortunately on the same day). The RnR USA race offers a full marathon option and Virginia Beach hosts a half/full Yuengling Shamrock Marathon. As of now, I’m not sure which race and which distance I’ll do. I’m tempted by a race sponsored by Yuengling.

Speaking of beer, after 2 days of apprehension and anticipated disappointment, Thursday’s beer was definitely necessary. Nothing says comfort like a favorite from home (Magic Hat) in glassware from my new home (DC Brau). In this variety pack, I prefer Magic Hat’s hI.P.A, but the Séance (below) is an alright fall choice.

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Cheers to good news!

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3 comments

  1. […] next morning, my left foot started to hurt in the same spot that I hurt in October (the title is now a little ironic). Every part of my body was pretty sore, so I decided not to […]

  2. Hi there, how long did it take for you to go back running? I have a bump in the same area and tingling of the last two toes…I have to see a podiatrist. Mine is either a cuboid or 5th metatarsel fracture. I usually jog 3miles between three to four times a week.

    1. mattkruczlnicki · · Reply

      I suspect you read the post-marathon blog entry which describes how I very well may have fractured my foot during this ankle rolling incident (https://marriedandmarathoning.wordpress.com/2013/12/30/matts-guest-blog-post-how-to-runrichmond-and-get-booted/). Though the x-rays were inconclusive all of the evidence pointed to a stress fracture, so my podiatrist treated it as such. I was put in a walking boot in the beginning of December and stayed it in for about 7 weeks.

      I wanted to try to get back in shape for some early spring half marathons, so I did physical therapy beginning in late January to rebuild the hip/glute/leg muscles which were weakened while immobilized by the boot. You’d be surprised how quickly and dramatically muscle strength is lost when booted. PT isn’t necessary but given my goal of getting in half marathon shape by March, PT was my best shot.

      Though I was strong enough by early March, my cardio wasn’t there yet and I would have risked further injury in running a half marathon ~5 weeks after getting out of the boot. I remember feeling confident by late March/early April however didn’t race until May.

      All of this comes down to how aggressively you treat the immobilization of your foot and how urgent you are in your recovery process. Everyone is different but from beginning to end (end being when I felt like I could run a half marathon), I’d say it is a ~3.5-4 month process.

      In response to your issues, I never felt the tingling in my toes, so I’m not sure what type of problem that could indicate – stress fracture, nerve issue, etc. Definitely get in to see a podiatrist sooner rather than later. If it does require a boot, those are much easier to deal with in winter months than summer/warm weather (lots of sweat!).

      Best of luck to you!

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