Why Minimalist Running Resulted in a Stress Fracture & Why I’m Still Doing It

There actually is a piece of footwear that causes strangers to stare more than vibrams do, and this fall, I wore it for 6 weeks.
I also had a “going out option” for when I wanted to look even cuter: No lie — the podiatrist called it a “going out boot”.

Over the summer, I was training for an October half marathon in Vibrams. This didn’t end up being the smartest thing a new minimalist runner could do — if you’re curious, here’s the post where I decided to accept that I was injured and stop running so much. After 2 wasted months (and many wasted dollars) of the podiatrist not trusting my google-diagnosis of “Stress Fracture in the Outermost Metatarsal” (which ended up being 100% correct) and having him inject me with cortisone numerous times, the MRI revealed a little stress fracture & I was instructed to wear the Boot for 4-6 weeks.

It wasn’t a surprise that I got injured. I was running a LOT on feet that had only been vibram-running for about 5 months. It takes a while for everything in the foot to get strong enough for “barefoot” running.

I recently came across a very interesting Podiatry Today article titled “Tacking The 10 Myths of Barefoot Running” (I highly suggest you read it if you’re intrigued by this movement) that confirmed my suspicions as to the cause of my injury. It listed “Barefoot Running Myth #1” as the following:

 Barefoot running leads to stress fractures. Without a doubt, the most common concern with barefoot or minimalist running is the development of a stress fracture. While there have been documented cases of this in the literature, stress fractures occur as a result of a change in activity without gradual adaptation and are not directly related to the shoegear or lack thereof. We actually should see a decrease in the likelihood of stress fracture given the change in stride and cadence that one acquires while running barefoot.

Stress fractures occur secondary to overuse without the body having adapted adequately as proven by Wolff’s Law. In fact, if we adhere to Wolff’s law in theory, we should see weaker bone trabecular patterns on those wearing cushioned running shoes due to decreased intrinsic muscle strength, resulting in a proportional decrease in the force acting on the respective bone.

This is 100% what happened to me. I should have adhered a bit better to Wolff’s law.

I’m running again, now, but slowly — I lost a LOT of running endurance and fitness by not running for 4 months (duh). Since my foot does still hurt sometimes since it’s all weak and lame, I’m not running as minimally as I used to — I’m switching between these two shoes, running on the vibrams until my feet hurt, and then switching to the New Balance Minimus, which are still pretty minimal. I included a “normal” sneaker in here for comparison. Notice the difference in the heel height of the Brooks shoe & the NB shoe. Check out these old posts if you’re interested to read more about the differences in running in vibrams verses shoes.

Vibrams & Barefoot/Minimalist Running

You Should Just Go Try On Vibrams

A Vibram Five-Finger Update

The NB shoes are good for right now since they provide a little bit of padding under the foot and force me to remember to land gently. Because they have such a small heel (the heel is only 4mm higher than the forefoot, verses the average 14mm of traditional sneakers) they let forefoot running be natural. And they’re still pretty flexible, despite being sneaker-like, and have a nice ground feel. 

Anyway, basically I’m just really excited to be on the other side of this injury, and I’m still running in Vibrams for all of the reasons that I initially started to run in them. I am really only running 1-2 times a week right now, and I can’t go much more than 4.5 miles, but. Man. It’s fun. And I’m excited to keep going, and i’m psyched to be sans-boot.

Options, in order of minimalism (and preference)

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9 Comments to “Why Minimalist Running Resulted in a Stress Fracture & Why I’m Still Doing It”

  1. Good on you for sticking with barefoot running despite the setback. I took it slow in the beginning but had alot of trouble with my achilles. As you stated, moderation was the key and now I’m right-as-rain. I wear my Merrell’s everywhere. Nice going out boot, LOL. Just a thought, have you tried to eat in a Paleo manner. This may help you to retain more calcium to improve bone density. In any case great blog, and good luck. Cheers.

    -Justin

  2. Sarah, I’m glad you are doing better, getting back to running, and taking it slowly at the beginning.
    Keep up the great work!

  3. Good luck with your running, if you can run offroad / trails you’ll find less problems from minimalist shoes because the earth “gives” and then you can work your distance back up. I like trail running since I have some old knee injuries from football that come back to haunt me now and then when I spend too much time on hard pavement.

  4. I’ve just been diagnosed with a stress fracture too, and I run (ran) in the Merrell Glove since October. Felt like I was just getting out of the calf tightness every time I ran, to end up with a bum foot. In that same great grey boot (no going out boot option was provided!).

    What are you doing now? I’m trying to figure out what to run in when I’m all better. Love the feel of minimalist shoes, hate the stress fracture. No problems ever before in any other neutral shoe. Not sure if it’s worth the risk to try a 4mm drop 1st. Suggestions?

    • Hey Beth:
      I actually JUST got a shoe that I’m really excited about: The Altra Instinct.

      http://www.altrazerodrop.com/webapp/wcs/stores/servlet/Product_-1_15151_18952_69005_176939

      It’s zero drop, with no traditional “support” and a roomy foot bed, but it has a bit of cushioning (but is still firm) under the foot. Same barefoot style (well, forefoot, forward running), but less of the foot meet pavement impact that is probably what led to our stress fractures. I just got them on Monday, and have only run once in them (about to go out soon, actually), but I love them and highly recommend them. Other brands (new balance, saucony, probably others) are coming out with zero drop stuff, but I didn’t like the fit of those ones as much as I like the fit of the Altra shoes–they hugged my foot too snugly.

      Anyway, these shoes aren’t in running stores really that much yet, and they run a little short, so I recommend ordering half a size up (they have a good shipping/return policy), and, unless you have freakishly wide foot like I do, ordering the womens-specific shoe — it actually has some differences other than size and color than the men’s, which is rare for a women’s running shoe. http://www.altrazerodrop.com/webapp/wcs/stores/servlet/Product_-1_15151_18952_69007_177103

  5. Hey Sarah!

    Thanks for the post. I hope you get this seeing as this post is about a year old! I broke my foot the exact same way (half marathon on an unknown stress fracture in Vibrams) last October. Since then, I have had another stress fracture next to where I broke my foot. After that, the doctor basically took away my 5-Fingers 😦 It was a very sad day for me! I am working my way back into the groove with some 5Ks and am using a pair of Brooks, MAN do they feel heavy! I loved my 5-Fingers because I have very bad knees and in them, NO Pain! I never thought I could be a runner until I discovered them.

    I am now sick and tired of the “heavy” Brooks and am not enjoying running as much. I am also not able to go as far. I am searching for something in between the 5-fingers and regular sneakers, minimalists if you will. What do you recommend specifically?

    Thanks!
    Erin

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