Stress fractures?

[jlb2012]

just a few questions for ya'll:

is there any difference between good boots and good trail runners/shoes wrt probability of a stress fracture in the foot?

what is a good preventative - extra calcium (Tums) every day? other ideas?

for a stress fracture of a bone in the foot (ex one of the metatarsals) how does one know when its ok to backpack again

what other areas besides feet does one need to be aware of as possible stress fracture sites?

[orangebug]

Many questions with many things that should also be considered. For instance, age, gender, physical conditioning, nutritional status, history of prior fractures, etc.

The question about metatarsal arches isn't one you can answer. For instance, a fifth metatarsal fracture can either be fairly trivial (several weeks in a space boot) or very complicating including possibly months of no weight bearing.

I have no idea if anyone has compared trail runners against boots regarding fractures. My hunch is that boots would compare poorly, but possibly due to the heavier weights carried by those keen to use boots.

Calcium deficits are common due to diet and increased calcium movement due to muscle use, bone formation and change due to stress. There are many ways to supplement calcium, including TUMS - but probably more efficiently with cheese, jerky, powdered milk and such. If you were a person over 40 sitting around town, you'ld be advised to have 3 equivalents of dairy daily. I'd easily double that for a thru hike or a long section hike. I'd expect that you would reach an equilibrium around 3 months, but that is only conjecture.

While feet a common areas to expect stress fractures, I'd be a bit more concerned with your tibias - shins.

[gravityman]

just a few questions for ya'll:

is there any difference between good boots and good trail runners/shoes wrt probability of a stress fracture in the foot?

what is a good preventative - extra calcium (Tums) every day? other ideas?

for a stress fracture of a bone in the foot (ex one of the metatarsals) how does one know when its ok to backpack again

what other areas besides feet does one need to be aware of as possible stress fracture sites?

I'm not a doctor... well... actually, I am, but in Physics, so it won't help that much with this conversation...

However, we thought that my wife had stress factures when we hiked in '01 (turned out to be Neuroma's. I think a facture would be less painful and so we researched them. Also we are runners, so we know a few things about it...

Pretty much the only way to prevent stress factures is to BUILD SLOWLY! You have to get your body use to the stresses. The body will respond, bone density will go up, ligiments will strengthen, muscles will grow (these are the real key to not getting injured!) and the chances of repeatative stress injuries go down. That's why marathon training usually starts 18 weeks out, and slowly builds up, start with 3 miles and taking 12 weeks (3 months!) to get to 18 miles in a single run. Now, runners are much more likely to get these types of injury than a hiker, because the stresses from running are far greater. But you still need to build up to larger miles. Most people won't get stress factures, but soft tissue damage is much more likely, painful, and might even take longer to heal.

Running shoes will help with the stress fractures, as they absorb a lot of impact. But with backpacking, impact really isn't that great. It's the repeatative stuff that gets you. The slow running of a tendon over a bone. Or pointing your toes to the sky ever step, putting a lot of stress on the front shin muscle (this pain often gets misdiagnosed by laymen as shin-splints, but it really is just where the muscle attaches to the bone - very painful injury). But running shoes will also help because your muscles won't have to lift as much weight. However, if the shoe isn't stable enough, you can get problems in the foot from your foot having to work too hard to keep your balance if the shoe is too "mushy".

Anyway, complicated stuff... I'm sure there are other people that have more to say. My only and best advice is to build up to hiking. Do a routine before you get to the trail, and then start slow and build up to larger miles. I would say a good rule of thumb is no more than 12 miles the first week, and don't do a 20 for the first month. Different people can handle more miles if they have a better base to start with.

Just my opinion.

Gavity Man

[bluebird]

You said.........

"just a few questions for ya'll:

is there any difference between good boots and good trail runners/shoes wrt probability of a stress fracture in the foot?

what is a good preventative - extra calcium (Tums) every day? other ideas?

for a stress fracture of a bone in the foot (ex one of the metatarsals) how does one know when its ok to backpack again

what other areas besides feet does one need to be aware of as possible stress fracture sites? "
__________________

My response....

Wow! You're pretty stessed out about stress fractures! I wonder if you have a history that includes this?

Your question about GOOD boots versus GOOD trail runners and the probability of stress fractures is tough to answer. There are so many variables involved with predicting an injury. If you are healthy, and in average condition you could still aquire a stress fracture just from hiking. You could step on a rock incorrectly or land hard accidently.

My advice to you is that if you ARE in average condition then to select a good boot or trail runner based upon YOUR comfort wearing them with the pack weight you intend to use. A GOOD boot typically gives more lateral and ankle support than a trail runner. A trail runner has is made to absorb impact that a 'runner' will experience, typically with a lower weight pack. Research your selections!

In regards to your question of WHEN to backpack again after experiencing a stress fracture, again the answer is elusive. You need to consult a doctor or evaluate it based upon your experience. Its interesting as many a military guy/gal will tell you that they've run 15mi courses with full packs and stress fractures! Ultimately its YOUR call.

In regards to your question of 'what other areas can you experience stress fractures': The answer is any where you have a bone. Shin bones and feet are the most common but ribs and arms, in particular the funny bone area, are susceptible areas.

My overall advice to you is that if you are in average condition or better and do not tend to get stress fractures as a common event then to stop stressing over them! Select a boot or trail runner that you are comfortable in and get your feet on trail!

Bluebird '01

[Robbie Benson]

just a few questions for ya'll:

is there any difference between good boots and good trail runners/shoes wrt probability of a stress fracture in the foot?

what is a good preventative - extra calcium (Tums) every day? other ideas?

for a stress fracture of a bone in the foot (ex one of the metatarsals) how does one know when its ok to backpack again

what other areas besides feet does one need to be aware of as possible stress fracture sites?

I don't know the difference, except, the boot will give ankle support. I am fighting tendinitis in ankle, been this way about 6 weeks. Am planning to Section Hike in April, my very 1st time on the AT.. I have hiking boots and trail shoes. I like my boots for hilly terrain and trail shoes for less strenuous I would kinda like to know when it would be ok to backpack again.

RB

[Footslogger]

HOI ...Do you have a stress fracture or are you trying to prevent one ?? I work in an orthopedic/sports med clinic and we see/treat our fair share of stress fractures of the foot (metatarsals mainly).

Good arch/ankle support is the best way to prevent them from occuring ...other than hiking at a level/intensity appropriate for your age and conditioning of course.

Once you have a stress fracture you're best to limit weight bearing activities until it is fully healed. The foot flexes and there is downward "flattening" pressure on the longitudinal/transverse arch as you apply weight and take a stride. There is a fairly high probability that you would continue to reinjure the foot and prolong or prevent healing all together if you hiked with a heavy pack on rough terrain.

That said ...if you currently have a stress fracture and are determined to hike I'd suggest something with a rigid sole and firm arch support, regardless of whether you use a boot or a trail shoe.

Hope that helps ...

'Slogger
AT 2003

[Spirit Walker]

I think the when question depends on how much pain you are in. Jim hiked the PCT with a broken toe - there was pain, but it was within his limits. (He has great tolerance for pain.) It wasn't until he was 1500 miles up the trail that he even realized that it was a break. By that time he was used to it. I've known others who hiked with broken bones in their feet. They complained a lot, but it wasn't bad enough for them to leave the trail mid-hike. I've also known some who couldn't hike at all and took months to heal - probably because they started doing too much too soon. YMMV

[SalParadise]

I got a stress fracture hiking the Trail last year, just under my pinky toe. Frequently changing your insoles would be one of my suggestions. I hiked in my Superfeet too long and they had lost all of their cushion. It probably also goes without saying that the weight on your back also plays a part. I've become a Jardine disciple since, because I'm worried about getting one again on my second trip.

I'd also tell you that switching brands of insoles fixed the problem, because it did for me, but that very slight change in my step soon after wrecked my knee, so I wouldn't personally recommend trying that solution.

[Smile]

...... start slow and build up to larger miles. I would say a good rule of thumb is no more than 12 miles the first week, and don't do a 20 for the first month. Different people can handle more miles if they have a better base to start with......

Just my opinion.

Gavity Man

Just to clarify, you meant no more than 12 miles per day for the first week, right? Just want to make sure ;-)

[Skyline]

I had a stress fracture two years back to back until I started using Superfeet insoles in '97. Coincidentally I started lowering my pack weight from over 60# down to just under 40#. The combo worked--no more stress fractures.

[SalParadise]

thanks for the info, Skyline. I'm actually switching from Superfeet to SofSoles, but they'll both probably work fine. Especially good to know that the weight change really does make a difference. I'm going from 50# to 30#.