... and I think I broke my foot.

[Puddlefish]

So, after months of training with a heavy pack in the NH hills, I've been hiking the last few days unburdened in flat Florida just doing easy 10 mile stretches. The outside arch of my foot started with a dull ache and promptly grew to actual pain. I'm self diagnosing a micro fracture in/on the metatarsal at the moment. I'll go see a foot doctor when I get back home in a few days. Just icing/elevating currently.

I've read that initial x rays don't show micro fractures, but later x rays do show them, after the healing starts. Anyone have any experience with this type of injury? Advice for what to expect, how to deal with the doctor to save money/be efficient? What kind of exercises I can can continue to do without stressing the foot?

[Praha4]

From what you described (pain in outside arch of the foot), this may be anterior tibialis tendonitis...I had that injury on a section hike in fall 2014, it was debilitating, was forced off the trail. Came on from overhiking too many miles too soon, wearing trail runners with lousy support in the sole (too flexible), and hiking on hills and rocks really stresses the tendons and connective tissue in your ankle. I've learned much since then on foot injuries.

See the podiatrist or doctor, get xrays, they can tell you what is going on.

[Puddlefish]

From what you described (pain in outside arch of the foot), this may be anterior tibialis tendonitis...I had that injury on a section hike in fall 2014, it was debilitating, was forced off the trail. Came on from overhiking too many miles too soon, wearing trail runners with lousy support in the sole (too flexible), and hiking on hills and rocks really stresses the tendons and connective tissue in your ankle. I've learned much since then on foot injuries.

See the podiatrist or doctor, get xrays, they can tell you what is going on.

I've had tendonitis elsewhere, and this feels different to me. That was a more constant pain that I could feel with minimal muscle movement, this doesn't hurt unless I'm actively putting weight on it.

I'm mostly annoyed because I have been super careful about slowly increasing my activity over the last year, and I ended up hurting it when I scaled way back on the difficulty level. Using Merrel Moabs, which are fairly sturdy and supportive. It's frustrating having to wait for the appointment and a qualified diagnosis/treatment plan!

Bah!

[Hangfire]

Foot pain can be pretty tricky to figure out, I had bouts with it back in my running days (years ago) then for about 3/4's of my thru hike in 14. Dull aching pain mid foot that never got me off the trail but worried the heck out of me the entire time as I was sure it would develop into a full blown fracture and send me home. It seemed to improve most when I got a new pair of boots then after about 350-400 miles it would start barking again...frustrating. I did talk to several hikers who actually did get a stress fracture in previous years and almost all of them said it hurts like hell, sharp shooting pain kind of stuff.

You're doing it right, rest, ice, elevation, and if that doesn't work go see your doctor.

[MuddyWaters]

Ill say right now , that going to a doctor is a waste of time and money. They wont do a thing. Except charge you, maybe put you in a walking boot for a few weeks.

Which you can do yourself.
Immobilize for 4 weeks.

You can buy a new boot on ebay for a fraction of what you pay at an orthopedic outlet. Or a used one for $10.

[Water Rat]

Hard to diagnose over the internet, but definitely start with rest, ice, and elevation. Grab a pair of cheap crutches and stay off that foot until you feel like it is ready to be walked on in a walking boot, or go to the doctor if you feel like there has been no improvement with rest.

Can you flex and extend your foot without pain? If so, stick with non-weight bearing swimming during the healing process. This will keep you from having to rehab the stiff tendons and muscles later. It will also help with the healing process (as long as you don't overdo it!). Start slow and increase exercise as your foot allows.

Good luck - I know how frustrating the healing process can be!

[pauly_j]

I'd agree with the tendonitis theory. I broke a metatarsal in the middle during an MMA class (I can only assume by whacking a stress fracture) and walked around on it for 3 weeks (it was a full break, not a fracture). A couple of years later during a half marathon I had to hobble the last 3 miles. I was absolutely positive I had done the same thing on the other foot. Had exactly the same pain on the outside arch, which continued for a couple of weeks after. I had an xray a couple of days after the race and it showed nothing and was told it was the tendon.

Rested it and stayed off it as best I could and it was golden after a couple of weeks. If there's nothing pressing about getting it diagnosed, I'd suggest you keep off it and monitor it and (as other have said) get some more supportive footwear.

If it does turn out to be a break, for your reference I was in plaster from toe to knee for 5 weeks and on crutches. The bone will heal nice and thick around the break so as long as it's rested it should be fine.

Either way, it sounds like you need some better shoes.

[burger]

I've had tendonitis elsewhere, and this feels different to me. That was a more constant pain that I could feel with minimal muscle movement, this doesn't hurt unless I'm actively putting weight on it.

I'm mostly annoyed because I have been super careful about slowly increasing my activity over the last year, and I ended up hurting it when I scaled way back on the difficulty level. Using Merrel Moabs, which are fairly sturdy and supportive. It's frustrating having to wait for the appointment and a qualified diagnosis/treatment plan!

Bah!

First, I think you mean a stress fracture, not a microfracture. It might technically be micro in size, but they're generally referred to as stress fractures.

Second, the idea that supportive shoes insulate you from injuries is false. Lots of studies have shown that feel are very individual, and not all feet respond the same way to the same type of shoes. If you have a stress fracture, it could be that Moabs are just wrong for you. Or it could be something totally unrelated like a diet issue or a problem with calcium absorption (my sports med doctor said he had a patient once who got a stress fracture for that reason).

Third, I've had just about every foot injury known to man, and when I've had tendonitis, I never had pain when I wasn't moving or putting weight on the foot. But the stress fracture I had throbbed some (not a lot, just occasionally). So I don't think that you have a lot of ground to rule out a tendon strain.

Self diagnosis is a dangerous game. I've had a stress fracture, as well as lots of other foot issues, so I'm pretty sure I could self-diagnose a new one. But I wouldn't have been able to before.

[rhjanes]

I would suggest a vist and x-ray. Even if it is a stress fracture, at least you know. Agreed with above, about shoes and such preventing stress fractures and such. I orienteer. I have bad feet, have been in custom orthotics for years. Three years back, while Orienteering, in Moabs, I slipped on a root, foot caught a rock and P A I N!!!! I limped in. On Monday, my regular GP (doc) took an X-Ray and said it was inconclusive and said I could go for better evaluation at either the Podiatrist he recommended or the orthopedic/sports-med/foot specialist. ($30 co pay, worth it). I went to the sports guy, who said we'd have to take a wait and see approach. Fast forward about 3 years. Yes, the stress fracture healed, unfortunately, it decided to keep calcifying and actually grew a "horn" of bone out of the top of my big toe joint (the break) and then the bone around the female part of the socket, decided the irritation of the horn (hurt to put on shoes very tight by then) and started growing more calcium/bone, into the joint! So....my big toe movement was by then, about 20 percent. Back to the doctors and then surgery to remove all the crap. That was over a year ago now. The joint is still stiffer than the others, but the X-rays look great. I can hike and backpack.
So I would do a copay and at least get it looked at. x-rays show the bone, and if that doesn't show anything, then I believe an MRI will show the soft tissue for injury (my orthopedic doctors can do both, in the office, one-copay). And during that 3 years from initial injury to the surgery, I was hiking 3 miles a day, back packing, orienteering about 15 times a year....only when it got too painful, did I return to the doctor about it.

[Puddlefish]

First, I think you mean a stress fracture, not a microfracture. It might technically be micro in size, but they're generally referred to as stress fractures.

Second, the idea that supportive shoes insulate you from injuries is false. Lots of studies have shown that feel are very individual, and not all feet respond the same way to the same type of shoes. If you have a stress fracture, it could be that Moabs are just wrong for you. Or it could be something totally unrelated like a diet issue or a problem with calcium absorption (my sports med doctor said he had a patient once who got a stress fracture for that reason).

Third, I've had just about every foot injury known to man, and when I've had tendonitis, I never had pain when I wasn't moving or putting weight on the foot. But the stress fracture I had throbbed some (not a lot, just occasionally). So I don't think that you have a lot of ground to rule out a tendon strain.

Self diagnosis is a dangerous game. I've had a stress fracture, as well as lots of other foot issues, so I'm pretty sure I could self-diagnose a new one. But I wouldn't have been able to before.

Stress/microfracture is just different terminology for the same condition. I haven't ruled anything out yet, but until I see the doctor it seems the rest/elevation/ice treatment is the same for most conditions. I'm not really wedded to my self diagnosis, and even less so after your description of your resting vs. standing pain.

I have maybe four hundred miles on my mid height moabs and have loved them. I recently switched the insoles to superfeet greens in that pair, but I left those behind in NH. I more recently bought some moab low heights with the original insoles and have been slowly breaking them in with the intention of taking them on the AT. I had zero pain or discomfort prior to the flat land walking on dirt/sand. So basically, there are a few variables between shoe heights/insoles/terrain that may have caused this.

I'll see the stupid doctor and see what they suggest.

[wannahike]

Walking on sand in Florida is much different than walking on a hard path. Your feet flex and stretch more in the sand and it works your lower leg muscles different. Hikers can come to FL from another trail and think it will be a breeze because it is flat and then find that walking on sand is so much harder on the legs. Easier on the cardio system though.

[Puddlefish]

Walking on sand in Florida is much different than walking on a hard path. Your feet flex and stretch more in the sand and it works your lower leg muscles different. Hikers can come to FL from another trail and think it will be a breeze because it is flat and then find that walking on sand is so much harder on the legs. Easier on the cardio system though.

Agreed. The hard sections of the trails were pretty much boring easy, but the sandy sections slowed me down. I had planned on some beach hiking next just for some extra conditioning, but got hurt before I got the chance. At least it's warmer than 6 degrees!

[Harrison Bergeron]

You're 51. The first thing I would suspect is Plantar Fasciitus. The fact that it doesn't hurt until you put weight on it is the giveaway, and mine started exactly like you describe, in the arch rather than the heel. Now my whole left foot hurts when I first stand on it so bad that I walk like Walter Brennen for a few seconds every time I get up. It radiates from my arch to my heal, but gets better as I walk on it.

Moab's are fine sneakers for town and work great as a hiking shoe for kids and athletes. I wear them myself. But if you're a typical old guy, I bet your feet would appreciate real hiking boots for the trail. Practically the only time my plantar's doesn't hurt is when I'm hiking in my Danner 453's.

And what Muddy said about doctors is exactly right, both for Plantars or a break. I've been through both and the treatment is the same -- here's your pamphlet, here's your boot gadget, stay off it a while. Seriously. I broke my foot in a motorcycle accident once so bad they had to cut my boot off. They xray'd it, declared it broke, gave me a boot, and charged me $100. Many years later, I went to a podiatrist for my plantars. He xrayed it, declared plantars, gave me a boot to wear at night and pamphlet about stretching exercises that I was already doing, and charged me $100. So I asked him, "How about a prescription orthotic"? He took out his pad and wrote on it the word "orthotics". What a waste of time and money!

[Coffee]

I think that the key is to find a doctor who understands SPORTS MEDICINE and doesn't cater only to sedentary elderly people. The goals of active people like runners and hikers are vastly different from someone who simply wants to be able to stand up so they can move from the couch to the fridge or to the car.

[Puddlefish]

I think that the key is to find a doctor who understands SPORTS MEDICINE and doesn't cater only to sedentary elderly people. The goals of active people like runners and hikers are vastly different from someone who simply wants to be able to stand up so they can move from the couch to the fridge or to the car.

Great idea. You pretty much described my area. It's an elderly population with elderly based services.

[perrypt2]

Pain on the outside of the foot at the base of the 5th metatarsal (where the bone sticks out a bit) is a common site for a stress fracture. Initially rest and ice is helpful. Stiffer shoes help support the foot. If you can walk without a limp then you don't need crutches, a cane, or walking poles. As many have stated, the doctor visit may not be definitive. Pain should be your guide. It is not anterior tibialis since that tendon attaches on the top and inside the foot .

Sent from my SCH-I535 using Tapatalk

[Goatgas]

Walking on sand in Florida is much different than walking on a hard path. Your feet flex and stretch more in the sand and it works your lower leg muscles different. Hikers can come to FL from another trail and think it will be a breeze because it is flat and then find that walking on sand is so much harder on the legs. Easier on the cardio system though.
Try Myakka state park for a work out lol. The feral hogs have destroyed most of the trails, and makes for an intense ankle/ knee and back workout (wrenched my left knee doing it) its so rough that if you don't use trekking poles you will probably not be able to stand for long. did 26 miles in 4 days. It was brutal. have done part of the AT before. the AT was like a paved highway compared to Myakka state park trails. going to do Torreyya next.