Stress Fracture Foot Injury

[David Shawl SOC]

Hi,

 

Has anyone had to deal with one of these? I work out at the gym regularly (usually treadmill and lifting weights), but when I took a month break this past December for vacation, getting back to a routine was tough. I wanted to start out slow with the gym so I wouldn't over do it, so I gradually got back to my usual routine over a 2 week period. I usually stretch, run for 2 miles on the treadmill, and then lift weights. About 2 weeks ago I was beginning my first mile on the treadmill and I noticed pain in my left foot about 0.3 miles in and I ignored it at first. Within a few minutes it became unbearable so I stopped at about a 1/2 mile. I took the rest of the workout easy doing lighter weights and when I left to go home, the foot pain as I walked was so painful I had to limp all the way home (15min. walk).

 

I kept thinking I sprained my foot because I was still getting back into the routine of fitness. I took it easy for the following two days and when the pain remained, I called a podiatrist. He examined my foot and diagnosed a stress fracture because there was sharp pain when he applied pressure with his finger on my "5th metatarsal" bone on the outer left edge of my left foot. He said that I should take it easy for the next 3 weeks and take about 1800mg of Ibuprofen a day for 2 weeks. He also recommended a special insole that I then purchased. It's been about 2 weeks and I still have some soreness in my foot whenever I'm walking. I haven't tried to run, but I feel that it could lead to prolonged pain if I do. I have been still going to the gym, but using a bicycle machine instead of the treadmill.

 

Has anyone had to deal with this before? I hope this heals up soon so I can fly my rig!

[Afton Grant]

Hi David,

 

I have had a stress fracture or two myself. Not from operating, but from other high impact activities. With the help of my doctor as well as martial arts training (ironically the cause of the fractures), I began to pay close attention to the manner in which I move. I looked closely at the way I walked, ran, jumped, kicked, etc. By doing that, I was able to identify a few "errors" that I had to learn to correct. For example, how my foot landed when I ran. Was it centered, heel to toe, or was it at a slight angle? How were my knees positioned when I squatted or lifted something? Directly over my foot or off to the side?

 

Anyway, with some very small corrections, I have been able to avoid problems since. If I do begin to feel an unexplained pain anywhere, I'll quickly try to figure out what I am doing to cause it. Your body is built to support itself, as well as a significant amount of additional weight quite nicely. However, it has to be used properly.

 

Your insoles should help keep things aligned. A few operators will swear by custom fit orthodics, and based upon their testimonials and research, they sound like one of the most important parts of their kit - in the same ergonomic category as a well fit vest.

 

If you haven't already, look up Chris Fawcett's research on Steadicam posture. It goes into great detail some of the body mechanics I briefly touched upon here.

 

Best of luck,

Afton

[RobVanGelder]

And change from treadmill to stepper or the ski-style trainers (Langlauf), where you can train your upper body as well.

Specially the Langlauf machine I find much better, a more all round workout where your whole torso,front and back is in motion too, and since you don't actually land on your feet/toes every step, the impact on all bones and joints is less.

 

In my opinion, weightlifting is not that important, but strengthening your back, belly, and legs (don't forget the hamstrings) is what you need mostly.

The Langlauf and stepper is for endurance.

 

So many time i see people training in such a way that they look impressive above the waist, but standing on tiny little under-developed sticks. Looks good in long pants but totally useless, imho.

[WillArnot]

I sustained an injury to the exact same 5th metatarsel on the outside of the foot. Complications and a domino effect ensued, exacerbated by over-correction with custom orthotics by a highly decorated podiatrist.

 

I am one who swears by orthotics, but learning the hard way GET A SECOND OPINION! I am now in a set of orthotics from a very smart podiatrist who is also an Ironman triathlete and understands the stresses that I described in my work. These high tech graphite orthotics are slowly but surely relieving the damage that was done by the first podiatrist and orthotics.

 

If you have an athletic / high arch type of foot, arch support is paramount due to the heavy loads that our feet sustain. Without this support, the arch of the foot is severly challenged to prevent collapsing under the burden of our rigs. The 5th metatarsel is a hinge for a couple of key tendons that both terminate in the arch of the foot, as well as an anchor / termination point for a couple of others. The key tendons involved are the Peroneal tendons (brevis & majoris) and they run around the ankle bone and into your calf musculature. These tendons are also closely related to a more common injury, that of planar fascitis which is all about the arch of the foot.

 

I learned about this because I started to get unbearable pain around the ankle area that prevented me from springing off, like jumping, changing direction suddenly (steadicam), going down stairs - not up, and certainly running. Notice how pumped your calfs can feel after doing steadicam. There are serious forces at work in the lower leg that need to be paid close attention to.

 

Afton has a great point that if you feel something try to address it right away and figure out what is going on. I have learned an amazing amount due to rehab and the injury. Often stretching can be a critical part of the strengthening / rehab process and preventative solution. Can't stress it enough. But some professionally guided PT (physical therapy) is often needed to target tricky tendon type things. ie. very different from muscles. In pursuing the Peroneal tendonitis and calf musculature, this led to the bigger muscles in the upper leg and hip flexors. My IT bands have a huge amount of imbalance. Learn how to isolate your IT band vs your ham strings. Perhaps the most fundamental difference would be doing your basic touch your toes stretch with straight legs together. This would target the hamstrings. Then do the same stretch with your legs crossed. This will start to work the IT band. To exaggerate the IT band stretch lean towards the leg that is in front. So if the left leg is in front, reach out towards the left.

 

It is all connected obviously, so as I targeted rehabbing my foot I became aware of all the issues all the way up my legs into my hips which are particularly stiff. I will wager that unless you are Yoga junkie or naturally built like a noodle, if you have been doing Steadicam for more than 5 yrs, you can't sit cross legged comfortably or without your knees up at a 45 degree angle. Tight hips. Pigeon pose is great for loosening this up.

 

Also the eliptical trainer or step machine are great. Anthing that promotes equal firing of muscles on either side of your body. Think core, glute, front AND back of legs and strong calfs. Climber machines for the upper body that incorporate the back and stomach are fantastic for what we do, but remember our legs are at the "root" of it all. I swim alot too. Kick routines in the pool are great. Also part of what helped get me running again was running in the pool. I train at a pool that is 4-5 ft deep the whole length, perfect for this.

 

I come from marathons and distance running, but now cycling has become a great way to practice healthy balance in physical form (where steadicam is very one sided) without pounding on the body by running. It is a great way to strengthen the muscles and tendons that support the knee without over stressing them. Ultimately David, the 5th metatarsal can be the start of alot of things, so pay attention and get some custom orthotics and a 2nd opinion. Arch support will immediately relieve some of the strain on the 5th metatarsal.

 

I will be in Boston for 6.5 weeks starting end of Feb. Get in touch.

 

Will

[Robert Starling SOC]

Your insoles should help keep things aligned. A few operators will swear by custom fit orthodics, and based upon their testimonials and research, they sound like one of the most important parts of their kit - in the same ergonomic category as a well fit vest.

 

Hi David,

 

Will, Afton and others are right on target. Custom orthotics helped me with some repetitive stress issues I had/have as a competitive cyclist. For me the issues were telegraphing and manifesting in other areas around my knees and hips but originating in my feet / shoes oddly enough. Until I looked into it I had no idea it was interrelated but riding 200-250 miles a week eventually caught up as I'm sure it would operating with the extra weight of a rig adding 20-50% total body weight to your frame. I've moved on to custom carbon fiber cycling shoes now but still use orthotics in my daily footwear.

 

Once you do a "fit kit" which is basically very soft foam in a box where the Podiatrist makes impressions of your feet, you can have multiple sets made relatively affordably. The soles of my feet were tender the first few weeks with the customs due to the proper realignment of the footbed but my feet, legs, hips and back are all happily working together now.

 

All the best!

[David Shawl SOC]

I greatly appreciate everyone's input on this. I figured that I wasn't alone in this ordeal. I'm doing some research on custom orthotics and plan to call my podiatrist next week. He told me that my foot has a hammer toe so it puts even more stress on the bones. I also feel like I need better arch support in my shoes.

 

My foot is doing better and the pain has lessened, but I still don't want to risk anything. I have a few projects coming up in a few weeks and I want to be prepared for them. I am also going to approach my workouts differently. I love this forum and you guys are great!

 

-Dave

[chris fawcett]

Here?s an interesting article from which I quote extensively in Steadipos 2 pages 13 & 14.

 

There is currently much debate outside of Steadicam about the biomechanics of sport shoes. The common notion of cushioned shoes providing protection from injury is perhaps on the verge of being overthrown. Independent (of shoe manufacturers) studies are tending to point to the disadvantages of cushioning in shoes, for two reasons. One is foot stability: cushioning allows the foot to float and adopt attitudes that may not result in the best transmission of weight from the leg into the ground. When planting the foot in soft shoes, or onto soft surfaces, the tendency is to plant harder to find stability. When planting the foot in hard shoes, or barefoot, the tendency is to retract the leg ?catlike? to dissipate the impact. The resultant shock-wave traveling up the body appears to be greater when wearing soft shoes. The second disadvantage is that the stretch receptors in the muscles that connect the 28 bones in each foot supply information?via spinal reflex?to the muscle systems that stabilise the joints of the leg, are disabled to some extent by the foot?s not coming into contact with anything solid. The result is that a greater force travels up the leg, and is transmitted into joints that are less prepared to receive it. One current study estimates a 123% increase in injury due to soft, versus hard, sports shoes.

 

Some long-distance runners (including marathon runners) are currently switching from cushioned shoes to pancake-soled shoes. The idea is to give the kind of calloused protection that a barefoot runner might have without interfering too much with a naturally-selected system. On making the switch, the runner generally experiences about 2 weeks of foot and shin muscle pain, and occasionally cramping, before the support musculature is built up again. I did much the same thing after experiencing foot problems that I thought might end my Steadicam career. From operating in expensive motion-control trainers, I changed to lower, more stable shoes, and the problems vanished.

 

The point of this diatribe is to suggest that perhaps further artificial protection is not what the injured foot needs. I can?t prove it?the evidence is still way too anecdotal?but I suspect it. Interfering with a system as fundamental as locomotion is bound to be problematic, and perhaps trying to solve an orthotic problem with more orthotics is like putting a plaster over a skelf (band-aid over a splinter). For example, over-pronation (the inward rolling of the foot as weight comes onto it) has long been recognised as an injury-causing problem common to runners?hence the introduction of the motion-control system in modern running shoes. The complication is that barefoot pronation has recently been identified as an natural impact-attenuating mechanism. It becomes a problem only when a squishy sole allows over-pronation. Making a squishy sole that somehow controls pronation is not the obvious solution.

 

Consult a qualified practitioner, by all means, but bear in mind that an expensive solution may benefit the practitioner more than you.

 

My 0.015378 euro cents,

 

Chris

[RobVanGelder]

Chris, I tend to agree with you, again on personal and anecdotal experience, definately not scientifically proven.

 

Many time an injury needs to be healing, while still working. Immobilizing a joint, muscle or bodypart is not always the best option for fast recovery.

 

This is my personal view, but I heard it from others too.

 

One famous instructor told during the workshop that whenever he feels some sore muscle/joint pain in his body, he will put on the vest and rig for a while and that puts all elements back in the right order.

I have similar experiences.

 

Again, not scientifically proven, but it is proven that tissue and bones recover faster when they receive mild excercise and stimulation.

 

Other than that, I always think that a body was made by nature and evolution in such a way that it could handle most movements and activities NAKED!

 

Of course, putting on a Steadicam was never in Nature's mind, so some precautions are needed.

But the early Homo Sapiens did not have any thing that even remotely looked similar to what we wear now.

Still they managed to make impressive monuments like piramids, Easter Island heads, etc. With mostly muscle power and wooden instruments.

 

In our over-civilized, over-insured, over-careful society, this is not possible anymore.

Many of us don't want it the hard way, thinking "softer is better"

In my experience that can be a wrong thought.

 

Anyway, you only have to go to some poorer countries and see how people manage to do their work with minimal technical support.

Sure their life expectancy is probably shorter too, but my guess is that they don't die much earlier of what they do, but because of less healthy food and not much medicines available.

 

 

another 2 cents, ehhh make that Thai Baht

 

:)

[chris fawcett]

Naked Steadicam!

 

Transparent posts!

 

Who says the forum is getting dull?

[james laws]

Poorly fitting shoes are a very common cause of foot injury. Shoes that do not fit accurately in the width, or that are tied too loosely or tightly can affect our feet as well. There are many Orthotic inserts or specialty shoes available to help alleviate pain and in some cases treat and reverse the damage done to the foot. You no longer have to leave your home to shop for specialty shoes. You can shop for specialty shoes online

[Matteo Quagliano]

I like the naked/nature thing but you have to consider that most of the time your walking is not on natural ground but artificial and as far as solid ground pop up in the history immediately after comes shoes (romans for example). To me some kind of shoes (like MTB or Skechers) recreate, as suggested from the advertising, a natural ground on artificial one,I'm not sponsoring anything just my feelings. Going back to the point discussed above, better natural but we're living in an artificial enviroment (think stages, streets, etc etc). thoughts?

[Janice Arthur]

David;

 

All this advise is great. These guys are surely great sources of information. I'd read and reread their input.

 

Here is my advise.

 

Get better then go for repeated walks. Go for long walks of at least an hour or two; a lot.

 

Its amazing what you learn about the mechanics of the human body by walking. I've gotten to the age where walking is very pleasurable.

 

What you learn after a long time of walking is how to make it more efficient; how to roll from heal to toe, how to pivot off your hip joint very efficiently and how your posture affects it all. Shoes, no shoes, etc. This is glossing over the bare minimum. Think deep thoughts on your walk; walk slowly, fast, faster and you'll learn A LOT about the mechanics of your body.

 

Its a workout of a different type so don't think its a waste of a workout either.

 

JA

[Brian Freesh]

I hope in the 3.5 years since Chris' post that David has made some amount of recovery! :)

[David Shawl SOC]

Even 3.5 years after my original post, I still appreciate the advice!

 

I have significantly changed my routine since then. I exercise several times a week, run, hike, practice yoga, and swim. My original post began when I exercised vigorously after several weeks of vacation and my feet didn't appreciate it. I've learned that even if it's just a little bit of exercise and stretching, it's important to keep your body trained....even on vacation!

 

Also, footwear is extremely important and even the greatest shoes may not last more than a year. On a side note, I have found yoga to be a great way to build a strong core, improve balance, posture, concentration, and importantly, how to breathe!

 

Thanks again for everyone's input!

[Janice Arthur]

David;

 

Great for you, didn't realized I'd gotten sucked into an old post.

 

I still stand by my walking idea to explore our body mechanics.

I imagine my walk like those walk across the country guys who have to be efficient over 10-20 miles a day for weeks at a time. That's something. As they say you can walk anywhere if you've got the time.

 

Yoga is wonderful.

 

Have fun.

 

JA