Joe Maller.com

Barefoot running stress fractures: A theory

Stress fractures are ridiculously common among runners, but this post will specifically address the apparent rash of metatarsal stress fractures afflicting minimalist and VFF runners, including myself.

First off, the term “barefoot” needs to be clarified. In every case I’ve found the runner wasn’t actually barefoot. We were all running in minimal shoes: Vibram FiveFingers, Nike Frees or something similar.

I noticed several consistencies among runners’ accounts of their injuries:

  1. Running in Vibram FiveFingers or other minimalist shoes, not barefoot.
  2. Running faster than normal (races, speed work, or just having too much fun)
  3. Mostly older than 35 years old (past the age of peak bone mass)
  4. Injury occurs months after transitioning to minimalist or barefoot running

So here’s my theory:

The majority of stress fractures affecting minimalist runners are not impact-related, but rather result from overloading weak metatarsals with increased toe push-off. These injuries arise several weeks or months after switching to natural running because the runner’s muscles strengthened faster than their bones.

Metatarsals are most susceptible to injury because they’ve been immobilized and weakened by conventional shoes. The second metatarsal, being the longest, endures the most stress.

Skin protection offered by VFFs and minimal shoes likely increases the risk of injury, friction on bare toes would have limited activity before the bones could have been hurt.

Barefoot & Minimalist stress fractures: A theory Pushing off with the toes places an enormous amount of stress across the midfoot. With the metarsals acting as a lever, the forefoot is pulled down and back against the ground with enough force to throw our full body weight forward. This motion also creates substantial sliding friction under the toes. Bare toes, no matter how calloused, would not be able to withstand this friction and would limit activity before bones could be overstressed.

Anecdotal evidence

As I’ve been researching this, I’ve found a lot of stories similar to my own:

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  • Belinda

    I believe I now have a stress fracture too after 5 weeks of running in a pair of Vibram 5 finger shoes. I have been running for many years and started with only 20 min every 2 days in the shoes and felt quite comfortable running up to an hour in them after 3 weeks but started doing speed work in them in the 4th week when the injury occured. I am 35 and have never had this injury before but have always had foot pain in conventional shoes. I am frustrated as it is the time for duathlons and I can only cycle right now.

  • Joe Z

    Happened to me too, several months after “transitioning”, while training for 1/2 marathon- I probably increased mileage too quickly. Definitely agree with the theory of the muscles getting stronger before the bones do, and that the fractures are not due to impact, but rather the muscles pulling too hard on the bones, before the bones have enough time to get stronger. I am also over 35 years old.

  • Mitch Y.

    Same story. Third metatarsal fracture, slightly displaced, running in Vibrams. 3 mile run @ about 7:40 pace, which is not extremely fast for me but is faster than I was running in them before. I had been using them for about six months and worked slowly up to a four mile run about November of 2010. Because of weather conditions I was unable to do more than a few two mile runs in them between Nov. and Feb. 18, 2011, which was the day I broke my foot. FWIW, most of my running in Vibrams was on pavement. I’m interested in hearing what other information you receive on this subject. In particular, I’m interested in what folks did after this experience – did they go back to minimalist running and what sort of results did they have? I’m still healing up and am unsure what to do when I can resume running. I love running in the Vibrams, but not if I can only run once every eight weeks. I’m a 47 year old male, BTW.

  • Greg

    Also here. My second stress fracture on the metatarsals of my left foot in a year. This happened running faster than a jog but not fast in vibram flows and also the newer bilkas. I’ve decided these are more risk than return and plan to sell or most likely throw them away.

    • http://joemaller.com Joe Maller

      I don’t blame VFFs for anything except revealing how much damage we as a society have done to our feet. Re-introducing midfoot flexibility after 35+ years may increase the risk of metatarsal stress fractures, but that increase is only because we’ve immobilized our feet for so long. The same thing can and will happen in any minimalist shoe which allows natural foot motion.

      I’m not planning on racing in VFFs again soon. I don’t think I’m capable of holding back during the excitement of a race and I really don’t want to hurt myself again. I will miss the “mark of the tribe” aspect of VFFs though.

  • Jlinton

    This happened to me about 5 months ago, it is winter so I haven’t run much in them, I am nervous to start up again. I had been running in my VFF for about 5 months when after a long weekend hike and an injured knee decided to go for a run, I think I was going a little too fast and favoring my knee too much down the hill. anyway I am excited to get going again. how long has anyone else had to wait after to run again?

  • Danielle

    I only started running this past August, but started right away in Newtons. I am training for a half marathon, and while I slowly increased my speed and distance from August to December, I really started to ramp things up after that. I was dx with a third metatarsal stress fracture in January. I took 3 weeks off and felt better, so I started training again. I was doing great, until I ran a 5K and PR’d… and guess what? The stress fracture returned. It’s tough- I am a new runner, but I am not certain that it isn’t the shoes causing my injury.

    • Jason Potsander

      38 yr. old top age grouper male, been running for 26 years around 30-50 miles a week. Tried Newtons and in my 2nd week in wearing them I had a sudden pain in right foot 2nd and 3rd metarsals. Diagnosed with a fracture. It is totally the shoes fault. I want to burn them.

  • Slim

    if you are pushing off, you are running incorrectly. ( as far as barefoot running.) Take a look at barefoot running university. Its simply lifting ones foot, then letting gravity do the work as you “fall” forward.

    • http://joemaller.com Joe Maller

      Absolutely. One of the points I’m making is that bad form can lead to injury. Also, this specific bad form would have been limited if barefoot because the skin under the toes would have been injured before the bones were hurt. Minimalist shoes are wonderful, but they may protect your skin just enough that you end up hurting something else.

  • Jeff

    I have been running barefoot (unshod) and in minimalist shoes for upwards of 2 or more years now. In late September 2010 I started feeling the pain of a metatarsal stress fracture in one foot, at the time i had no clue what the pain was or what i did to cause it. I figured out that the pain would subside when I stopped running and would gradually get worse the more, longer and days per week, that I ran. So I started researching and found that metatarsal stress fractures are common among runners. In November after a half marathon race i could barely walk, so I decided to take off several weeks and see if my foot would heal. It did, after at least a month off of no running all the pain disappeared and I started back running gradually and easy.

    So as of mid December my foot was in good shape and I was picking the mileage back up. I ran until mid January, 2011, when the other foot met the same fate… I was on a run and climbed up on a 5 foot retaining wall to get around a mud puddle in the path i was running on. I jumped down on the other side and landed very hard on that foot, I was wearing VFFs. I finished the run and noticed the twinge of pain on the top of my foot. The next day everything seemed fine no pain was apparent so i went for a run, it ended up being a fast run at 6:30 pace or so, and by the end i had to limp in.

    I have logged a lot of miles barefoot and in minimalist shoes and I have noticed a lot of change in my feet since then. I have gone from a 11 to 10 shoe size from my arches rising so much. The old shoes that I have laying around were way too tight on the mid foot, I had to loosen the laces a considerable amount to have them fit comfortably. My foot-strike has changed dramatically and cadence is much higher.

    What I am trying to figure out is if there is a link between high arch due to barefoot running and metatarsal stress fractures. I have read that people with natural high arches are more susceptible to metatarsal stress fractures. When you first start running barefoot your foot muscles are week and arches low. After a few months the muscles in your feet get stronger causing your arches to rise. It seems plausible that the steeper angle of your metatarsal bones cause by rising arches puts more stress on the bone than before. The rise in arch might happen too fast, not allowing bone density to increase to handle the new stress resulting in fracture.

    Jeff 24

  • Paul D.

    Joe – I can’t thank you enough for this post as I’ve been looking for this exact information and your hypothesis makes complete sense given my situation.

    I began minimalist running in July 2010, starting out with the Nike Free Run+ as my only shoe. Within two months, I had built up enough mileage in them to do the Chicago Half Marathon comfortably and without any injury.

    By this point, I had completely caught the minimalist bug and bought a pair of VFF Bikilas and was rotating them in once or twice a week with low mileage (2-3 miles max for the first month). When running in them, I had the expected calf pain and some minor top of the foot pain that was easily addressed with regular ice foot baths. After two months, I was comfortably running up to 8 miles in the Bikilas with no issues on a variety of terrain.

    As winter approached, I was becoming frustrated with the heel-toe drop in the Frees as I felt like I they were now adversely affecting my form. To prep for the Chicago winter (which was nasty this year), I bought a pair of zero-drop GoLite Amp Lites, which I used with YakTrax Pros in the heavy snow, as well as a pair of Terra Plana Vivobarefoot Evo IIs for cold weather, but light snow. I was able to maintain a steady 20-ish miles/week from December 2010 through March 2011 using a combination of these two shoes – growing to like the Evo IIs the most, which currently have 200 miles on them.

    Last week, the weather became warmer and I decided to bring the Bikilas back into the rotation. On Saturday, April 9th, I went on an 8 mile run in the Bikilas (along a soft, asphalt path) and as I finished, I felt pain in my left foot. The pain increased over the next 12 hours to the point where I could not put any pressure on it. I’ve now been in an air cast for the past five days, having been diagnosed with a stress fracture in my fourth metatarsal. The doctors in the ER and the podiatrist I followed up with clearly felt that running in “silly barefoot shoes” were to blame and that they’ve seen a rash of stress fractures in patients who’ve run in them.

    What’s most interesting to me about your theory is that, looking at the wear patterns on all of my shoes (with the exception of the GoLites), there is significant wear in the tread of the left toe – to the point where on the Evos, it is almost worn through. The right shoe has normal wear across the entire tread. So, it appears as though I have been pushing off with excessive force from my left toe.

    Over the past week, I’ve been struggling with what to do when my foot is healed. I’ve been enjoying running in the ultraminimal shoes so much, that I don’t want to go back – but have been considering new shoes like the Altra Instinct, which are zero drop, but have cushioning. However, reading your article has made me think it might make sense to actually go the other way and do some very basic, truly barefoot work to adjust my form so that I’m not pushing off of my left forefoot so much.

    Very interested in your thoughts and thanks again for this post!

    Paul D.

    • Paul D.

      Joe – I’ve added a related post to my blog (http://bit.ly/hSv6T4) which includes photos of the wear patterns.

      • http://joemaller.com Joe Maller

        I don’t know if you saw this, but this post has a picture of the wear pattern on my Bikilas after about 30 miles: An expensive lesson in bad running form While I’m not nearly back up to the mileage I was doing, mostly due to caution, most of my miles have been totally barefoot. On a few of the first runs I ended up with blood blisters under the two toes that had the most wear in VFFs. Thankfully, I’ve corrected that, pain is a very effective teacher.

        • Anonymous

          That’s amazing – pretty much the same wear that I had. Curious – was it only on your left foot? While my foot heals, I’ve been looking into ways to correct the asymmetrical running pattern that I appear to have. Wondering if, as you suggest, losing the shoes may help to correct that as well (following Barefoot Ken’s advice, of course).

          Thanks again.

          Paul

  • Cmichaelo

    I’m 49 and I’m not sure what the injury actually is in my left foot, but it is injured to some extent, even though I have not seen a podiatrist yet. Because walking on bare feet around my house or in the VFF cause a pain, though very small and no problem tolerating it. There are no visible signs on my foot that anything is wrong. Using regular sneakers there’s no pain whatsoever. It happened about one week after I transitioned to running with the VFF on a treadmill. I ran 2 times with no problem. 3rd time, there was a pain afterwards. 4th time, the pain was still there, though went away after 5min of running, but then showed up after the run. And now I’m not running at all to encourage healing. In the past I had run with big-fat-sole sneakers like the Nike 360. Now, I didn’t exactly transition into running with the VFF. I just started running like every 2nd day for about 2 1/2 mile at a pace of 7.5 mph. I normally do 9mph in regular sneakers and never had a problem with my feet. I have to say that running with the VFF caused a completely different running style for me that was incredibly liberating. I really had to stall myself not to go further and faster. I could immediately tell that I could run longer and faster. I’m a tall guy at 6’4″ and a somewhat pronounced heel striker and I’ve had reoccuring problems with my left knee. The VFF however automatically caused me to land on the middle of my foot, I’d say even significantly so. It felt great. So I really wanna go into this direction. Can anyone recommend a proper transitioning to flatfoot running? Like, I’m thinking that just walking around in the house in bare feet might be a good gentle start. And secondly, using minimalist sneakers for everyday walking around to/at/from work, gardening, etc. I totally get it that our feet are so weakened from the big-fat-stiff-soles shoes I wear every day. So I wanna build up my feet slowly now. But how long does it take to grow stronger bones in the feet? Anyone got some advice?

    • http://joemaller.com Joe Maller

      First, take it easy and heal up. It sucks and takes a while. I wish I knew the answer to how long it takes, but I’m right there with you. Stress fractures are skeletal overuse injuries, they’re a sign our bones are strengthening, they just need more time than we’ve giving them.

      I try to go as close to barefoot as possible all the time. It’s easier now with all the new normal-looking minimal shoes. Every step is a chance to walk a little better; softer, quieter and without sliding. Running and walking are different, but the increased awareness has helped my running too.

      If you haven’t gone totally barefoot yet, you really should. No matter how perfect we think our form is, putting skin on the ground reveals all kinds of things we didn’t know we were doing. And it feels amazing.

      Barefoot Ken Bob’s new book, Barefoot Running Step by Step, is worth reading.

  • Tkresler

    I was 35 when it happened to me. Increasing my mileage in VFF Sprints to train for a half marathon lead to a right foot stress fracture in my 3rd metatarsal. I healed up, started running truly barefoot more, and fixed my form. Amazing.

  • Ian

    Are you finding that there are more people getting this injury with VFFs than with normal shoes?

    Your theory is based on “pushing off” but I see that you already know that you can run without pushing of and by using gravity as propulsion.

    What part of your forefoot are you landing on and what happens next – are you allowing the heel to come down or holding it off the ground. Gordon Pirie (ex world record at 1500m, 5000m and 20km) says to land on the outside edge of the forefoot and to let the heel come down to touch the ground to avoid strains. He ran like this for 250,000 miles in total with practically no injuries.

    • http://joemaller.com Joe Maller

      @93301adcdd3f8ceaf80d387b76573410:disqus Since the injury I’ve been running mostly barefoot and I think my form has improved. My landings were fine, I was just relying on toes for propulsion much more than they were capable of. (the holes under the toes of my VFFs should have been more of a warning). Also, I’m almost certain I first injured myself doing sprints. Sprinting barefoot is much, much different than sprinting in shoes. 

      VFFs don’t cause stress fractures. They do mask sensory feedback and allow poor form which can lead to injury, but it’s not the shoe’s fault. Besides bad form, I think a big reason we’re seeing a lot of VFF-wearers with these injuries is because we’re all running so much more.

    • Robert Osfield

      Hi Ian,

      “Your theory is based on “pushing off” but I see that you already know that you can run without pushing of and by using gravity as propulsion.”

      Just a little clarification from a engineering graduate.  

      Gravity is vertical force and cannot provide propulsion when running on the level.  The idea that gravity can provide propulsion to a running on the level is psuedo science promoted by those who don’t understand the laws of physics.

      If Gravity could provide propulsion when running on the level one would have to ask where the engery comes from? To trade gravitational potential energy you have to fall w.r.t force vector, so if your height isn’t being reduced then gravitational protential engergy isn’t changing.  I’m afraid you can’t get something for nothing.

      The reason why it isn’t neccessery to push off strongly is simply that the actual horizontal forces of areodynamic drag are tiny compared to vertical force of gravity acting upon you, as little as 1% for jogging speeds, even for world class sprinters drag is still small compared to vertical forces.  A strong push off is something that is typically something you’ll see with those that overstride, landing with their heel well infront of their knee on landing.  Eliminate the overstride and the amount of horizontal force you need to keep things in balance goes down.  Also if reduce your push off you have to eliminate the overstride otherwise you’ll slow down.

      Robert.

  • Rempel_1

    Hey Joe. I am an ultra-runner and a few weeks ago changed to New Balance minimus shoes. I am an “all of nothing” guy, and stupidly ran myself into a 2nd metatarsal stress fracture. Do you think switching to my regular Salomon trail shoes will help heal the SF or do I need to for sure take the time off even if I abandon barefoot/minimus running! I’m seriously going crazy, I usually run 100 miles a week, and the thought of taking time off kills me especially cuz I have huge ultra this summer that I’ve been preparing for all year.

    • http://joemaller.com Joe Maller

      @448488c9da83e035b8c8893c38d0056f:disqus Take a look at this post by sports chiropractor Jamie Raymond, about how he treated his own stress fracture. He didn’t use a boot and found that the only approved system to accelerate bone healing uses pulsed ultrasound to stimulate the bone with what is essentially directed non-stressing bone stimulation. 

      The point is that bones respond to stresses and become stronger. Stress fractures are overuse injuries where we got ahead of our body’s healing curve. 

      I have no idea how much those shoes immobilize your midfoot, but you need to give the bone a chance to heal. Better to take some time now than to re-injure yourself worse later on. Bones feel better long before they’re back to full strength, so be careful.

      Besides calcium, vitamins D and K2 said to be important for bone repair.

  • Pablo Paster

     I’m 31, run in VFF Bikila and Merrell Trail Glove, about 15 miles per week. I have been “barefoot” running for about 10 months. I have noticed acute pain on palpation on my 2nd metatarsal in my right foot after increasing mileage or running too fast. The first time I realized that it may be a stress fracture I took 2 weeks off and then ran in regular shoes for three weeks (still mid-foot strike) and then I was pain free. Last week I think I overdid it on some hilly runs and the pain is back, but not that bad. I will switch to regular shoes for a while and hope it goes away.

  • Mprestwich

    Mark (41) – I share your theory and offer one additional observation.

    I transitioned cold turkey from Brooks Green Silence to the Merrill Trail Glove 6 weeks ago. At the time, I was running about 15-20 miles per week with a long run of 10 miles. I split my time between running outside on dirt trails and a treadmill at the gym.

    After an somewhat fast 8 mile run last Friday on mostly asphalt (which was unusual) and continuing to grow my mileage during the six weeks, I took the following day off.  The next morning, I was 2.5 miles into a run on the treadmill when I had shooting pain in my left foot and stopped. According to the doctor that diagnosed my stress fracture of the 2nd metatarsal in my left foot, I transitioned too quickly and while adding mileage (from 15 to 20/week to 25 to 30/week). The doctor also mentioned I may have been using incorrect landing technique with too much emphasis/landing near the toes as opposed to striking mid-foot and then having the heal slowly drop/barely touch the ground (as one can find in .

    While I tend to agree that I may not have been using proper barefoot running technique, I also believe the treadmill may have contributed to the problem. Because the speed is controlled by the treadmill, I sometimes have to accelerate if I am falling behind.  I find myself running a bit more on my toes in those situations which places more stress on the metatarsals.  I think this may have contributed to my stress fracture.  

    I am interested in knowing if others have a similar observation.

  • Beau

    I’m 29 and I’ve been running in Vibrams for over a year exclusively logging upwards of 1200 miles.  While I have always been a huge supporter of the “injury prevention” that vibrams can bring when worn properly, I recently ran myself into a calcaneal stress fracture in my left foot after completing a 60+ mile week.  The fracture was felt only after 16 miles of a 20 mile run.  I had not changed my mileage, my pace, or my running schedule at all, but alas here I sit with the stress fracture – already took 4 weeks off, and at least 4 more to go.  The fact that it was calcaneal (heel) fracture is odd to me as I barely touch my heel when running now.

    My transition over a year ago was slow and methodical, it took away my shin splints, and allowed me to run pain free after a complete reconstructive knee surgery which has pained me for years.

    I’m not convinced it was the vibrams though and even if it was I’ve had far less pain running in them then I ever had before……

  • Niknjon

    Bought VFF. They felt so great and fast that 6 days later I ran a fast 10k in them. I got a near stress fracture in my 2nd metatarsal. SO BUMMED! Still want to go back to them, so I want to hear a solution!

  • Shelly

    Add my fractured 2nd metatarsel to the list of injuries incurred in the 2-3 month, over 35 yrs range!
    What a bummer when you are trying to improve only to be set back with many questions of what is best????

  • AmyG

      Exactly what happened to me!  I was training for a half marathon and doing speed drills in my Merrell Barefoot running shoes when I developed a stress fracture.  And I also have small bones and high arches

  • Chris Szumigala

    Somewhat similar story here. 52 yr old male, never been much of a runner, started running short and easy in VFF about 15 months ago, never more than a mile or two once or twice a week. About 8 weeks ago I switched over to Merrell Trail gloves and after a few weeks began to experience some top of foot pain on lateral edge so went and had an x-ray. The first film is 6/17/11 the second is 6/23/11. https://www.facebook.com/photo.php?fbid=2057303282017&set=a.1921291161799.2111758.1527676985&type=1&theater

    I’m now the proud owner of a 5th metatarsal proximal fx. 5 weeks in a cam boot then eval for surgery.

    • http://joemaller.com Joe Maller

      Wow Chris, I’m really sorry. I’m pretty sure you’ve got what is known as a “Jones fracture”. Do you run on trails? I’ve only read about these a little, but some related to an ankle injury or some unusual impact on the side of the foot. 

      Heal fast and come back stronger,

      • Chris Szumigala

        Thanks Joe! It’s right on the boundary for an official Jones fx. Nope, no trail running. The low mileage I do is either indoor track or treadmill with a very occasional asphalt trail. Doc seems to think it was a stress fx from running…

  • Brian T

    I’m 54 years old. Typically do about 25 miles a week on roads and bike paths, consisting of 4 to 6-mile runs. I switched to running in huaraches as soon as the weather warmed this March (I live in northern Vermont). I’d been running for the last 4 or 5 years mostly in minimalist shoes (Puma H Streets), including several marathons. The switch to huaraches felt fine, although my feet sometimes felt some minor aches. Two weeks ago, a couple days after doing a longer-than-normal run, I developed a strong pain in the top of my right foot, over the second metatarsal. I stopped running, limped when walking for 2 or 3 days, and am now using a rowing machine while things heal up.

  • CH4:D

    I respectfully disagree with your theory. I am no expert but plain old fashioned observation doesn’t make this a sound explanation.

    Your animation assumes that the load of your body is being leveraged by the forefoot and the metatarsals. In theory that may be the case. In action it is another story. You forgot to factor in that after you land, it is your upper leg (knees, thighs and hips) that leverages the bulk weight of your body forward NOT your foot. The forefoot merely pics up the remaining load. And one must also remember that once your body is in motion nominal weight would’ve been on one of your legs at any given time.

    Then again, without proper strengthening that may still be too much for the inexperienced barefoot runner such as myself. I did experience various aches and pains during my transition. What made it easier was that I initially bought my VFFs merely as a fashion statement. I was walking in it for a month before I got curious about running in them. I won’t lie though and say that I didn’t experience frustrations while running in them.

    • gkmike12

      Not to be a politician here, but it seems to me that both theories are sound.  It certainly could be a combination of the two.  

      Joe’s theory makes complete sense because the muscle tissue does build faster than the bone.  This would certainly add pressure to the metatarsals.

      After reading CH4:D’s comments, I agree with the impact theory as well.  I too was not letting my heal come down to aide in the impact.  I was focusing too much on the forefoot strike.  I can’t help but think this was a contributing factor to my recent stress fracture.

      One more comment… I fit all four of Joe’s observations in the article above.

      • CH4:D

        how’d you get a stress fracture anyway? I never imagined letting myself go that far.

  • http://www.facebook.com/profile.php?id=513635202 Phillip Stevenson

     I would like to point out something that I don’t think people have through about clearly. Why would you run in “minimalist” shoes that are ment to take you back to “natural running” when you are running on man-made surfaces. My preference for running is on trails in my MT101s which I guess are fairly minimal being light but they still have great rock protection but my main concern is why some one would do sprint work on concrete/tarmac in little more than a few millimetres of rubber (VFF). If you run on hard surfaces wear padding, it’s just common sense. And do minimalist shoes cause more injuries? My answer is yes if you don’t know how to run properly or use them in the wrong situation. We don’t see american football players with out pads do we. (No funny answers about rugby;)

  • http://twitter.com/niki_in_france Nicole Lacoste

    I got a stress fracture of the left cuboid while running in VFF.  I am 40.  I was in training for my first half-marathon, I was upping my weekly milage quite fast especially the amount I was running in the VFF. I was on a treadmill and doing intervals when it happened. I was doing very fast very short intervals – like flat out for 30 seconds, with 2 or 3 minutes to recuperate, on the 3rd or 4th sprint something in my left foot gave in.  It didn’t hurt, but I noticed it. I then ran on it for about a week, while it got more and more painful, and I got tendinitis as well, because I was surely compensating for the injury.  I am only now starting to run again 6 months later – the cuboid heals slowly.

    I agree with other posters – the muscles get stronger faster than the bones.

    • Jane

      Hey, a fellow cuboid stress fracture. I’m 4 months in to healing. How are you doing now? Was it now 10 months ago for you? Many thanks.

  • Chris Szumigala

    Soooo, am I the only freak with a FIFTH metatarsal fracture? LOL

  • Noah

    Noah, 27, 2nd metatarsal stress fracture/reaction, slowly upped my miles but I was running fast times after switching to VFFs and Trail Gloves about 6 months ago.

  • Bob Redding

    Hey Joe.  I’m one of the people you mentioned in your post.  Thought I’d give you an update.

    I took 3 months off while my SF healed.  And did a lot of reading.  I came to the same conclusion you have.  I did TMTS and was pushing off.  So I made a set of 10 rules for myself.  (posted in my blog)  I decided to run only completely unshod.  Strict 10% rule. Never run two days in a row.   No music.  No mileage goals, etc. Stop if ANYTHING hurt.   And I studied running form and worked hard to emulate good form.  

    That was July 2010.  I stuck to my rules for a good six months strictly and a little less strictly for the whole year for the most part.  I’ve only run in VFFs once, which happened to be today.  5 miles on the dreadmill.  Every other run was unshod.

    I’ve run 5Ks and 10Ks unshod and have run up to 8.5 miles, mostly in Lower Manhattan on sidewalks and streets and near my home in northern NJ.  I’ve learned a LOT about form, particularly about lifting my foot rather than pushing off.

    I’ve essentially had no further injuries.  I seldom have even any sore muscles (unlike when I ran with anything on my feet).  I still wear VFFs a lot. To work, at work, weekends when I can’t go unshod.   In fact, I hate normal shoes now.  

    My summary is that I think “safe” transition is best done completely unshod and takes even longer than most “experts” say.  And even then, incorrect form still puts minimalists and BFers at risk.  I’m pretty comfortable that I’ve “arrived” as a BF runner but I’m vigilant in listening to my body and pulling back at the first hint of pain anywhere.

      

  • Danny

    Great article. Thanks for posting this. In my experience I would agree with your theory that it is due to too much toe-off. But, I would also say that many people with  minimalist shoes are also landing more on their forefoot (to cushion the shock of landing) which also adds stress to the metatarsils. I would almost be willing to theorize that this is the real culprit, because it’s a matter of impact upon landing and therefore has a multiple factor of body weight backing up the force to the forefoot. I’m curious to hear what other posters have to say about this. Thanks for bringing up the discussion. My hypothesis is that just because you run in minimalist shoes, doesn’t automatically mean you’re running correctly. Unless you learn to reduce your impact with the ground at the end of every stride, you’ll always be at risk for injury. It’s running technique, not shoes, that make the difference in injury-prevention.
    Danny Dreyer – Chi Running 

    • Robert Osfield

      Hi Danny, 

      I would recommend reading Dr Casey Kerrigen post on runblogger.com, http://www.runblogger.com/2011/07/metatarsal-stress-fractures-in.html. 

      Casey believes that impact forces are a not factor for most running injuries as the measured impact forces are actually relatively low, instead most are injuries caused by loads around mid stance and after when the loads are at their maximum.  This rather goes against the grain of what the shoe manufactures have been preaching for a long time, and what seems “intuitive”, but it’s what the research in the area suggests.

      Robert

    • http://www.facebook.com/people/Dan-Lutes/1389819412 Dan Lutes

      I agree with Danny, it’s not the shoes, it’s running technique that makes all the difference.  My second metatarsal pain has gone away (diminished) since I quit running in the VFFs and went totally barefoot.  It has been a slow transistion but I’m now up to 5 miles…completely barefoot and it feels great.  I fear I may have to slip the VFFs back on this winter (Indiana is pretty cold in Jan/Feb) but hopefully by then my form and soft landing will be perfected so that I can stay away from the noisy MRI machine!!  Barefoot Dan
      Follow me at:
      http://barefootdan.blogspot.com/

    • Xtina

      Danny
      I read your book and LOVEEEE how you taught me to run in this new ”happy” way!! I find myself running longer now and with less energy! CRAZY
      Your a GENIUS & my running Guru ;D
      Ive told soooo many about your technique & Book!
      My newest problem,  I kept running with my beloved FREE (Nike) shoes and RE-fractured my toe, “”again””!!!! I did it once a few years ago & never connected the FREE shoes with the fracture until I read this blog yesterday!!So I was thinking of going back to my old fashion heavy New Balances, which I ran marathons on…and run the beach barefooted when I crave that free feeling again.What are your thoughts please! Im honored to be able to ask you directly.
      I love biking & swimming while I heal, but its so not the same as pounding the pavement!!!!
      THANK YOU SINCERELY,
      CHRISTINA

    • DanielD230

      Danny,

      I learned some good things from Chi Running and also learned that you were wrong about some things in Chi Running.

      The good:  Chi Running has the runners lift their feet and let gravity do the work of pulling us forward.

      The not so good:  Flat footed landings.  We were made to land on our forefoot.

      If you don’t believe me, take the smallest jump you can and observe your body’s mechanics.  You’ll land on your toes by nature.  You’ll never land on your heels nor flat footed that way.  Perhaps you’ll see the truth of this some day, then I will have returned the favor by teaching you something  :-)

      Dan

    • Mick

      Just diagnosed with a stress fracture of the 5th metatarsal after running in VFFs for almost 2 1/2 years, and 2 years after taking Danny’s Chi Running course. Ever since those changes, my times have continued to improve, but in Chicago, where I was on track for a sub 2.55, I had to pull out at mile 8. Mileage has not been that hight, although intensity has, on top of running a 35-miler, a 50km and Comrades (54 miles) as well as Boston this year. And I also raced 3 x half-marathons, 2 x 10-milers, 3 x 5km and other assorted distances. I don’t believe the footwear is to blame. I do believe that I had allowed my form to slip and I was actually noticing that recovery times after hard races and training sessions was taking longer. When podiatrist examined my foot post-marathon, she highlighted that flexibility and range of motion in my injured foot was much worse than my right foot.

  • John Foster

    The greatest forces on the foot occur during the midstance period. This is evidenced by viewing any plantar pressure graph from a force plate. The centres of pressure are  dramatically different in mid foot strikers and heel strikers.
    Heel strikers typically show a more lateral pathway of the centre of
    pressures under the 4th and 5th metatarsals until late stance. As the
    forefoot pronates the COPs move medially under the metatarsal heads.
    This is the classic ‘S’ shape.
     Mid foot strikers land at the distal 5th metatarsal with pressures then showing a posterior and medial direction as the heel drops. At midstance with maximal plantar contact (and maximal plantar pressure) the centre of pressure then starts moving anteriorly along the same path as the 2nd and 3rd metatarsals during the propulsive phase. The pressure gradually lessens during this propulsive phase.
    This could explain the ‘possible’ increased incidence of 2nd met stress fractures in midfoot runners. My guess is that there is also some other aspect of running form which contributes.
    John Foster
    Running Specialist Physiotherapist

  • http://www.facebook.com/kellyjodixon Kelly Ulrich Dixon

    Yep…..I’m 8 weeks into a 2nd metatarsal SF.    I’ve been transitioning in to VFF’s since the beginning of the year and was in Nike Free’s since last September.   I had JUST ran my fastest 5k ever in early May and was getting ready to start increasing my mileage up (slowly) to start training for a half marathon in the fall.    For me I would say it was definitely the faster pace that the VFF’s was allowing me to maintain.  I was only running 10-15 miles per week..oh, and I just turned 45 in June so I think you are right on the money.

    • http://joemaller.com Joe Maller

      Thanks for the comment, sorry to hear you’re banged up. Though it took a long while to heal, my foot now seems stronger than ever,
      Heal fast,

      joe

  • Susan

    Hi Joe,
    Came across your site and your theory seems to make a lot of sense.
    I just wanted to add another Stress Fracture story.
    At 54 yrs and 7 weeks after transitioning to BR (with minimal shoes – SoftStar, not VFF’s) I have now joined the Stress fracture club.  I do believe my reason for this falls under your “just having too much fun” category.
    I typically do somewhere between 30-40 miles per week, which in the Summer
    also includes beach running (which is not always level ground)
    This is my first SF experience and I am into it now for 2 wks.
    Seems to be taking forever to heal. I have stopped running which is the hardest part. A bit worried about going back to BR although I completely love it and would love to continue. Hopefully this shall pass soon.

    Thanks for your interesting site
    Susan

  • Anonymous

    Im 17 years old and am recovering from 2 stress fractures on my 3rd and 4th metatarsals.  It was from using VFF.  I had them for about a month and was working out with them in calisthenics and jumping rope.  I think the jumping rope started it, then a month later i ran with them for the first time.  I only did 2 miles and felt fine during and after.  The next day or so it started to hurt when i put pressure on my foot.  It was swollen and bruised and felt like there was a kink in the middle of my forefoot.  I stopped walking normally and started walking only with my heel and the rest of my foot off the ground so i didnt put pressure on the balls of that foot.  I did this for about 2.5 weeks, and by that time it was starting to feel better, less pain but it was still a little swollen.  I forgot i was injured and walked on it without any pain before i realized.  I went to the foot doctor to make sure it was okay to start running again, she took x-rays and told me i had two stress fractures and it would be another 3-4 weeks that id have to wrap it and use a cam walker boot.  I have been wearing an elastic wrap and the boot for the past 3 weeks and the swelling is almost completely gone, i can see the bones that i hadnt seen since the injury.  I hope that its all better soon.

    do u know what types of activities i can resume after i dont have to wear this boot? like how long until i should be jumping again?  I have been doing a lot of pushups and upper body work and pilates, just yesterday i used the recumberant bike to work on some cardio

    • http://www.movethrurehab.com Bob Schroedter

      Sounds like you are a perfect candidate for a Physical Therapist who treats running injuries. Go to the APTA.com site and use their “Find a PT” search tool. Locate someone with an Orthopedic or Sports Specialization. Contact them and ask if they have experience treating running injuries. If you live in a Direct Access state you can see them without a prescription. Ask them and they’ll know. Good luck.

  • Julie

    This sounds very familiar. Just out having a good time in my Newton running shoes, then sudden pain, limped all the way back home. I’m guessing it’s a 2nd metatarsal stress fracture…will find out tomrrow. I’m a 55 year-old female.
    Julie

  • Ric

    I’m 32 and not a runner but I have been wearing some Vivobarefoot shoes since November and 2 months ago mysteriously broke my 2nd meta-tarsal for no apparent reason. I blame the shoes. I thought it was because the design of the pair I had were tight across the instep but reading this article imples other things might be going on.  It does validate that these are dangerous shoes to wear.
    Ric

    • http://joemaller.com Joe Maller

      It more validates that our feet have been weakened by a lifetime of neglect and need rehabilitation. Strong, healthy feet don’t just break for no reason.

  • Brandon

    I am 28, have not ran in many years, and started taking up barefooting, mostly in Vibrams, about 4 months ago.  I recently increased my mileage to prepare for a race coming up and started having top of the foot pain, turns out it was a stress fracture not sore muscles as I had originally thought.  I toned it down, iced, and such but the pain remained a bit, though not enough to keep me from running in a race this past weekend (in my VFFs).  While navigating around a drainage grate I came down with my right foot on an angled part in the road and the stress fracture gave way, as the orthopedist said.  I have a complete fracture of my second metatarsal on my right foot and I won’t be running, shod or barefoot, for a while…  so to anyone experience TOFP, trust me, take the time to heal before it gives way!! 

  • Fredrik

    I’ve got a stress fracture on the 2:nd metatarsal bone from probably running to fast in FF and Asics Piranhas. Did my first run on 10k under 40 min after aprrox 1 moth in the new shoes, so I have both been running faster and more often. OK first 2 month then the pain came. Now I limp and have to start over again. Don.t blame the shoes though, I was too happy about the good result and pushed my body to hard without listening. I’m loonging to put my FF, Asisc P or Newton Gravity back on again :-)
    I’m a 37 year young man

  • http://www.facebook.com/mslaurahamilton Laura Hamilton

    . Count me in. I started back in running in June after a break of several months for bad viral bronchitis. Wore my minimalist shoes, everything felt great. Got back up to 3 miles and was running that consistently, then one night I had a huge burst of energy and fitness and did 4.5 miles at my best speed ever.

    I was fine after that run, but my next time out I only did 2.5 miles before experiencing a sudden stabbing pain over my second metatarsal. I could barely limp home, and I hobbled around for days afterwards, iced like crazy, took lots of ibuprofen, was only able to walk while wearing MBT shoes (don’t flex at all, curved bottom, much like a walking cast!)

    When i felt better I started running again, and the pain came back, not as intensely as the first time, but still pretty bad. So no more running. I took it easy. Wore my MBTs all the time. A week passed and the pain was almost gone. Went camping and I was on my feet a lot in Crocs (bendy shoes) around the campsite, squatting down a lot, etc.

    When I got home I squatted down barefoot to unpack my suitcase, had all my weight on the balls of my feet for a minute or two. When I got up, ZING! Worst pain yet. Couldn’t put any weight on my forefoot at all. I could only step on the very back of my heel. Pain even with my MBTs on.

    Went to the podiatrist and he did an X-ray, it showed nothing. He seemed kind of clueless. I told him that I suspected a stress fracture of my 2nd metatarsal and he agreed that this seemed like the most likely diagnosis. So into a CAM boot for me, and I will be in one for the next 4-6 weeks to let it heal completely. Fingers crossed for no further re-injuries.

    Podiatrist recommended that I not wear minimalist shoes that flex so strongly across the forefoot, since I have REALLY flexible wide feet (grew up basically barefoot, in Florida, almost never wore shoes) and he said the lack of support for my floppy feet was creating too much motion in the bones and stressing them. He recommended that I get shoes that only bend across the tip of the toe area, not further down the shoe.

    I’ve always had trouble with typical running shoes…my feet go numb, the toe box is never wide enough, the padding is always weird and I feel like I’m falling off it. I was so thrilled to have found minimalist shoes, but now it seems that my feet can’t handle them unless I ramp up EXTREMELY slowly, maybe. But really, I was only running 2.5-3 miles a few times a week at most. It’s not like I went from 0-5 miles and was running every day. How slow is slow? And my feet are strong and healthy, I’m barefoot more often than not, so it’s not a matter of developing foot conditioning or musculature. I’m not sure what to do.

  • http://www.facebook.com/mslaurahamilton Laura Hamilton

    BTW, I’m 41.

  • Julie

    Question about foot strength. I have been a yogi for 9 years began using barefoot runners 6 months ago, very slowly. I am a freak about injury, and the importance of our feet. Have not had any foot problems, I know my feet are strong, I’ve been working the muscles for years. Do any other yogis out there have input on usIng these shoes? Less injuries? Curious?

  • Michelle

    I’d like to hear more about the “cases” you mention in this post. Adequate muscle strengthening takes several months. Good muscle strength is necessary to protect the bones and ligaments from undue stress. A safe transition from traditional running shoes to minimal or barefoot should take 6-12 months. Did each person in the above cases make this slow transition, including diligent strengthening and stretching?
    I’d be interested in more information you might have to answer these questions.
    Thanks, Michelle

  • Amy from Atlanta

    Yup! I’m a 40-year old female who incurred a stress fracture of 2nd metatarsal bone while using VFFs for only 3 WEEKS. I tried to ease in to them as instructed but may have jumped the gun and ran up hills. Walked other than hills. Also spent all day in them for those 3 wks and gardened in them as well. Actually suffered stress fracture while running in reg sneakers but I think the damage was already in place. 6 wks no running so I’m swimming laps a lot more. REI took the shoes back, no questions asked.

  • http://twitter.com/stevenjoseph stevenjoseph

    Hi Im a male 28 years old, seem to have bruised my second metatarsal, started running on vff for a month. I upped my training and was running up hill when my feet started paining. I don’t think it’s broken or cracked because there is only slight swelling still and the pain seems to be subduing. Right now im limping around with elastic bandage around my foot. 

  • Agostas

    why are you pushing off your toes instead of lifting the foot?

  • ttothemc

    I have what I know is a stress fracture in my left foot. X-Rays were negative, but the pain has been constant and severe for 3 weeks. I am supposed to return on Friday for “the boot” if things have not improved. I have been wearing minimal shoes, stepping down since January. I am 36 years old. My latest shoes are the New Balance 101 trail running shoe. I have been doing boot camp 3x a week in them and running short distances on the off days with one long run (7-11 miles) per week. I run mostly on soft surface multi-use paths in Colorado. On Aug 20 I ran 11 miles in Chicago and then later that day wore 5 inch heels and danced the night away. I was fine the following day. The next day couldn’t walk. I backed off for a week then ran 3 legs of the Colorado relay at my fastest pace. Not too much pain, then went back to boot camp and bammo! Now I can barely walk and it hurts ALL THE TIME. I miss running, I miss wearing heels. Truly bummed.

    Is the boot going to help? When I do get back to running, do I go with the minimalist shoe or go back to the stiffer, more supportive running shoe?

    • ttothemc

      now I am ready to start running again and am scared…do I go back to my New Balance 101s? Do I buy conventional shoes? Sorry, but true barefoot running does not appeal to me…I like my feet pretty :) I just want to get back where I am enjoying running and running fast which I never did in conventional shoes. How do I start? How do I ramp up? How do I avoid this injury? Advice…anyone?

  • Andrew McKenna

    34 years old. Merrill Trail Glove minimalist shoes. Pain at end of a speed session then took a wee break to rest foot. Started a 10k a week later only to drop out after 1k with what turned out to be a 4th metatarsal stress fracture. Been running regular minimalist for 4 months.

  • Vanessa

    I am a 35 year-old female who thought I had finally found the secret to running injury free!!  I have been running almost exclusively in VFF’s for 6 months.  NEVER have I felt so fast and free in running.  I had gradually increased my distance with my weekly long run being 12 miles.  Recently, I noticed pain deep within the upper part of my foot.  On a recent run, it got worse, and I am now sidelined until when??  Has anyone had any luck in actually recovering from a 2nd Metatarsal stress fracture?  How long did it take? 

    • Robert Redding

      Absolutely!   I’m on of the original people mentioned in Joe’s original post.  I had a 2nd metatarsal stress fracture in April 2010.  I started running again, exclusively barefoot, in July 2011.  I was patient, set rules for myself, and followed them strictly.  It was a long road.  But this past Sunday I ran the Philadelphia Rock and Roll Half Marathon completely barefoot.  And loved it.

      I highly recommend you consider leaving the VFF’s at home and going completely barefoot.  The VFF’s mask the ground feel and make it too easy to run with imperfect form.  Whenever there is the slightest discomfort I know I have to adjust my form until it goes away.  (or stop altogether)  

      Good luck!

  • Matheuwright

    does this mean i should not wear my new vibram five finger running shoes during my cross country races!?  i am 17 and i have greatly enjoyed running in these toe shoes! i would hate to have to give them up.

  • Karen

    So I have a different stress fracture dilemma…

    I’m 27 years old, 110 pounds, and I’ve been officially diagnosed with “lower than average” bone density.  I have very high arches, and I’d always been told to run in “super supportive shoes” with custom orthotics.  (I know, totally the opposite of how our feet evolved.)  Thus, I run in a pair of very supportive Sauconys.

    I had a stress fracture of my fibula (close to the ankle) in summer 2010.  After 2 months in the boot cast, I took a very gradual and disciplined approach to ramping up my training: I started with 1/4 mile/week only, and gradually added less than 10% mileage per week, mostly on dirt roads.  I would only run 3 days/week max, and always completely rested the day after a run.  I was able to run injury-free for 10 months, completed my first half marathon in 1:40, and completed a half ironman triathlon.  Everything was going great…until that dull bone ache started again.

    As I expected, I was diagnosed with ANOTHER fibula stress fracture in the exact same spot.  I pulled the boot out of the closet, and I’m now 7 weeks into a stress fracture that isn’t showing any signs of healing.  I may need to get a bone growth stimulator, which I’m told may take up to 8 months.  Argh – so frustruating!

    Anyway, my question is whether BF running / VFFs will help me avoid these stress fractures in the future.  I have a pair of VFFs I use for kayaking, and I had hoped to transition into running in them.  I have a tendency to heel-strike, so I was hoping that the VFFs would improve my running technique, allowing me to absorb more shock with my foot rather than my leg bones.  However, I’ve asked 2 orthopedic doctors, and they both tell me that given my higher risk of stress fractures, I should wear a shoe with more cushion.  They say that minimalist shoes may work for some people, but people with low bone density should make sure they have plenty of cushion in their shoes.

    What are your thoughts?  Has anyone else had stress fractures of tibia/fibula, either in minimalist shoes or before switching to minimalist shoes? 

    I’d love to figure out whether running in my VFFs would improve my running technique and reduce my risk of stress fractures, or whether they would make it even more likely that I’d get another stress fracture.

     

    • http://joemaller.com Joe Maller

      I’m very sorry to hear about your injuries. 

      The short answer is yes, I believe running naturally, barefoot or in VFFs/minimal shoes will help. 

      The longer answer is that it’s going to take a while. Fibular stress fractures are usually related to extreme muscle imbalances through the ankle, especially in the peroneal set on the outside of the calf and down into the foot. The high arch is a symptom, as was the recommendation of super-motion-control shoes. Rather than strengthening your feet to correct the problem, you’ve been given devices which have encouraged your body to go further out of balance.

      It takes a long time to rebuild our feet. I’m almost two years in and still working on strengthening my big toes and ankles (connected). However, after a few months I was able to run every day without knee, hip or back pain. (Yes it led to the injury on this page, but if I’d been smarter about form and going truly barefoot, I could have avoided it)

      There are a bunch of dietary things you could do to improve your bones. Specifically, make sure you’re getting enough magnesium and vitamin K2, get some sun (Vitamin D) and eat good fats. Avoid whole grains.

      Here’s a good starting point on nutrition for healthy bones.

  • Wakemon

    Hi,

    I just discovered that my pain is stress fracture.  The x-ray shows the 2nd metatarsal is clearly in 2 parts.  I recently ran combo few barefoot runs and some Five Fingers.  I can say that I was “getting” how to run barefoot and had got so excited I ramped from like 10 miles per week to 25.  Also, I had picked up pace.

    I’m trying to understand best course of action and what my options are.

    thanks,
    John

  • Kim

    I went for a short run in my 5 fingers on tarmac (previously run on tracks in the woods) I was also trying to increase my tempo to the recommended cadence of 180bpm. When I got home I felt an unusual ache in the back of my right foot around the 4th metartarsal bone area. 3-4 weeks later the pain has, if anything got worse (have not run on it) I’m a physio and can’t think of any other possibilities than a stress fracture of the 4th met. – so gotta find better ways to let it rest and repair. 

    Have absolutely not given up on barefoot running. 

    • Kim

      http://www.sjukgymnasten.se (I work with troubled feet in sweden)

    • http://joemaller.com Joe Maller

      Which end of the 4th metatarsal? Pain around the metatarsal-cuboid joint near the base of the 4th and 5th mets is often related to weak or unbalanced ankles. Check the peroneal tendons, especially peroneous longus up behind the ankle. Good luck, hopefully it’s just something that can be worked out by a few months of strengthening. 

    • Peter Limb

      Hi Kim. I’m a physio myself. Got a newly fractured Jones from playing kinect Xbox with my wife kicking my s!

      2 Quick questions if u don’t mind:
      1. Any chance you may have done any jumping as part of your strength training?

      2. Are you a so called ‘over pronator’ and land hard on your forefoot, without the heel absorbing some impact??

      Peter Limb

  • George, Boulder,CO

    I started running semi-minimalist in New Balance MT 101’s for about 6 months. (with a couple of true barefoot outings) I liked it so much I switched to Merrell trail gloves which I wore for 3-4 months, when out of nowhere one day on a trail run I had a pain in my heel area that forced me to walk by the end of the run. After a few trips to Docs and PT’s I had an MRI that showed a pretty major stress fracture in my heel! I had thought I was running mostly on my forefoot. I was becoming a minimalist fanatic and thinking big structured shoes were evil, but after 27 years of running injury free (except for shin splints the first year I started – I’m 52 now) then getting hurt after going minimalist, I’m thinking maybe conventional shoes aren’t so bad.

  • Brittanysue1012

    I am 24 years old. I switched to minimalist shoes this past year and then to vff about a month ago. Friends who had got them, both on their 30s told me to start out slow because they both got metatarsal stress fractures. I ran 3 miles in a treadmill with them no problem so I thought I was fine
    . then ran 6 miles and was in pain with a metatarsal stress fracture. I never had it x-rayed or saw a doctor because from what I read you can’t see it on a normal X-ray for 2 weeks and even then all you can do is rest, ice, compression, elevate. But my pain was textbook metatarsal stress fracture definition. A month later I switched back to my minimalist shoes and switch off running and walking to try to ease into it again. Theres sand off the beach on the sidewalk where I run whic makes it difficult and I think I was pushing off with my toes alot more than usual… I developed severe arch pain which I researched as maybe plantar fasicilitis? I don’t know what to do now my body is falling apart like it never has before and I’m only 24…

    • Sdvega2

      From what I know (and I’m not a doctor), stress fractures in the cuboid bones (between your ankle and the metatarsals) can cause serious arch issues, so that’s a possibilty. Either that, or you may be developing PF, which can be staved off by really good calf stretches and rolling with a “quad-baller”. That said, in my experience, I ran almost 90 miles in my NB Minimus before I got a stress fracture. There’s really no substitute for a long, slow transition. I’ve also read that it’s better to start barefoot running THEN transition to the minimalist shoes, as when you run barefoot, you’re more careful and guided by body, foot pain to go slowly and carefully.  

      • Robert Redding

        A LONG, SLOW, TRANSITION.  If there is ONE thing that I learned (and I think most people miss) its that transition takes much longer than you expect.  It’s been 18 months since my stress fracture and I believe I’m still transitioning.  35 years of running in shoes takes its toll and the bones and ligaments and tendons take much longer to adjust than the muscles.

        And the second most important thing is that the best (by far) way to transition is to run completely barefoot as much as possible.  There is no such thing as a “barefoot shoe”.  Minimalist shoes should be worn as little as possible until you can run comfortably and injury-free with no shoes at all.

  • Unrunner

    Hello – I know there are mostly runners here, and this is a good place for opinions.
     I am out of the game forever.
    I had stress  fractures in my feet and I have worn Vibrams , but only for walking.  The problem for me is nerve damage, which means I do not feel pain.An MRI picked up 5 stress fractures in my foot two of which will not quite heal.  My question to all of you is; did your stress fractures appear on standard X-Rays or not andor was a MRI to see them?ThanksThe Un-Runner

    • Sdvega2

      My cuboid stress fracture did not appear on a standard x-ray. Docs used a bone scan to detect mine – radioactive material is injected through an IV, then images are taken a few hours later. The first doc who viewed the images was a neurology radiologist who showed the images to me. He admitted he wasn’t an ortho, but clearly pointed out the pooling of blood in the injury site; however, he did say he wanted to consult the ortho radiologists the following day, as no fracture could be seen on the images. The next day I received a call from my Podiatrist saying I had a stress fracture. My guess is that the orthos based their diagnosis on the history of the injury (I’m a distance runner who was running in NB Minimus), and the location of the blood, etc., as it was impossible to see the actual fracture. For detailed imaging to actually view the fracture, I believe an MRI would be needed. 

  • Kilftp

    I am 43 years old, switched to VFF’s after running 30+ miles a week, a 25k and a marathon.  I had worn them off and on at places like the beach, and just walking around  but not really for running.  I took some time to build up, even though I was comfortable running 20+ mile long runs in traditional shoes.  4 months later I was running in the 4-6 mile range in them, I suffered a stress fracture of my 2nd metatarsal, I felt the pain at about 1.5 miles into my run. 
    The X-Ray didn’t show the damage but an MRI did.  Follow up X-Ray about 6 weeks after the injury showed it was healing very well, almost complete. I am close to starting to run again, perhaps even today, about 2 weeks later.  I don’t think I will run in anything as minimal as VFF’s again, maybe some of the New Balance shoes that have a little padding, or the new Brooks Pure shoes. 

    • http://joemaller.com Joe Maller

      These sorts of stress fractures result from shoe flexibility, padding isn’t a factor. Shoes that allow the whole foot to move can potentially allow mechanical loading that isn’t possible in conventional shoes.

      Glad to hear you’re healing fast

  • Will

    Just joined the club after a central park run in vffs. I have run in them exclusively for the last 2.5 years. I was breaking in my second pair as the first are now truly barefoot in several spots. The new pair are not yet broken in and they affected my form. The second metatarsal is now a satanic ball of fire.

    Thank to Joe and others for the knowledge here. I now know the deal…

  • Unrunner

    So are we in agreement, to some degree, that these great and cool shoes are no good for running and probably ok for walking and trailing?

    • Robert Redding

      I wouldn’t say that at all.  There are thousands of people who run in these shoes with no ill-effects at all.  I’m one of the original people that Joe mentioned.  Now that I’ve fully transitioned to barefoot running (skin on ground) I don’t run in my VFFs often but I do run in them.  But with proper form.  I don’t push off.  I lift my feet off the ground.  This reduces the stress put on the metatarsals.

  • Jack

    Sudden pain in the top of my foot during a faster than normal pickup through the woods in VFFs at about 4 miles into an 8 mile run. I had transitioned into the VFFs over a period of about 8 months – with no problems and had been using them about 50% of the time. I didn’t get it diagnosed, but my 2nd metatarsal about an inch from the ankle joint was the spot that hurt most. I’m guessing stress fracture. I could run (with reg shoes), but it would hurt. Finally, after a few weeks, I stopped running, since it was not getting better. It’s been about 12 weeks and I’m back up to 40 miles a week without much pain. I’m 50yrs old.

    • Sdvega2

      Yes! Well this is a happy ending. As I understand it, stress fractures can be recurrent if I don’t wait long enough for them to heal adequately. I plan on staying off it (in the boot) for 4 weeks, then swimming and biking. 8-10 weeks expected before I can run. Probably closer to 10 since I have a cuboid stress fracture. 

  • Cynthia

    Cynthia Osborne (52)

    My second stress fracture in 5 months.  First was 2nd metatarsal while doing Welland Half-Ironman wearing Newton Gravity.

    My second break occurred this past weekend at the NYC Marathon.  3rd metatarsal. Also wearing Newton Gravity. 

    I will no longer be wearing this shoe!  If a shoe designed to propel you forward is actually forcing/causing  ‘undue’ stress on the metatarsals why wear them?  It took me two breaks to come to that conclusion.  Not to mention that I am a forefoot striker to begin with and wearing Newtons only accentuated that even more!!

    Highly disappointing. 

  • http://twitter.com/justin_horn Justin Horn

    I had a 2nd metatarsal stress fracture 2 weeks before the NYC marathon, had to cancel it. I had only run about 1.5 miles in my Vibram KSOs when my foot started hurting. Tried to keep going, but after a few more mins decided to walk it in. Later that night it was very painful. 2.5 weeks later it’s still sore, but getting better. I’ve run only about 20-25 miles total in my KSOs, but have been running in frees for a whiel now. I’m guessing I must have gone a little bit too much forefoot strike than I should have. 

    • http://joemaller.com Joe Maller

      Nike Frees still limit midfoot flexibility much more than VFFs do. Don’t rush your recovery, if you give it time to heal you’ll be back stronger than you were before. 

      • http://twitter.com/justin_horn Justin Horn

        Doctor said 3 months off completely then start back up slowly.  I’ve read that 4-8 weeks is usually good and 12 weeks is only for very severe cases.  So I think  I’m going to wait 8 weeks for sure and then see how I feel at that point.

  • http://www.facebook.com/people/David-Higenbottam/718031885 David Higenbottam

    I am not convinced about the push off part of your theory but I think you are on to something with your ideas about muscle strengthening before bone.
    Here is my story so far:

    I am 39 and had so far successfully transitioned to a mixture of barefoot running and wearing vffs. Both running on road and trail in Hong Kong. It is worth noting that in barefoot or VFFs (Classic) when running down hill I would have to keep the speed down because my feet would tell me to.
    Last week I got a pair of New Balance Minimus which are further along the spectrum towards a normal running shoe compared to VFFs. I got them so I could run faster on the downhills which I have been doing for the last week. Probably I had been enjoying the speed too much and going too fast too quickly. Anyway woke up this morning with a deep slowly throbbing pain in my right 5th metatarsal. I am hoping it is an early warning and will recover quickly! Will let you know :-)

    The point I want to make is that the more towards the barefoot end of the minimalist shoe spectrum you are the more protection your own sensory system protects you by generating pain which stops you pushing it too hard.
     

  • Ekinsja

    Yup… I ran/overtrained in the fivefingers, resulting in a broken (beyond stress-fracture) 4th metatarsal, distal to the ankle, proximal to the toe. Had to DNF on a trail race. Injury started after a half-marathon-length training run, followed two days later by a hill-sprint/interval workout, after which I felt some dull pain, like a bruise or minor pull. Ran two miles of the race, then had sudden increase in pain to the point where I couldn’t put weight on it. At a week after the race (the soonest I could get an appointment), the x-ray showed nothing. I continued to walk around campus in street shoes. Two weeks post-race, the x-ray clearly showed an offset break (see: https://www.facebook.com/photo.php?fbid=10150387206364826&set=a.477620334825.259712.662899825&type=3&theater). I’ve been out of “The Boot” now for a couple of weeks, but there is still mild discomfort proximal to the “toe joint”. Next time, I’ll limit my barefoot running to being truly barefoot, and not rely on the five fingers.
    –Jim

  • Jane

    I have a stress fracture of the cuboid. It’s four months since I did it and I’m still struggling with my walking – despite six weeks in an aircast boot. It was my second run in Vibrams. I’d had no advice on how long to run for in VFFs. I am or was new to running. I knew nothing about being cautious in Vibrams. I’d be interested to know how people know how long they’re supposed to run in Vibrams for? It seems like people with a running history are in the know.

  • Xtina Artistry

    I AM THRILLED to have found this thread. VFF runner for about 3 years..and i CONTINUALLY fracture my 4th met!!!!!
    I thought it was ME!!!!!!!!! I do not want to give up running.

    ANYONE try to add ORTHOTICS??!!! (my Podiatrist recommends but their $400!!!)

    THANK YOU!

    • Anonymous

      I’ve used orthotics in other shoes,….worthless!

      My feeling about orthotics or other devices insurance won’t cover, they are voodoo!

  • Sdvega2

    I sprained my ankle a few months ago, and when I started running again, decided to use minimalist shoes (NB Minimus). I instantly fell in love with them, and felt much more stability in my ankle using these shoes. 90 miles later (about 2.5 weeks of running), I had a stress fracture of a cuboid bone in my left foot. I just started wearing a boot today, and expect to do so for 8 weeks or more, per my doctor. Any thoughts on when I can start biking or swimming would be much appreciated. 

    • Xtina

      i started again about 2-3 weeks after being in the boot- but less intense biking & swimming…no problem ever except when I run (ugg!) i was hoping the old New Balance shoes will help.  It use to be my running shoe of choice.  Even though I hate to put my wonderful ‘Free’ shoes away.
       But I think i may have to!  … and just barefoot run on the beach when I want that ”free-flowing’ feeling!
      Good Luck
      I love this BLOG!!!! SO HELPFUL! and makes me, I’m not alone!!!
      ChristinaOn Dec 1, 2011, at 1:50 AM, Disqus wrote:

  • http://twitter.com/simonjcole Simon Cole

    Great piece and very compelling argument. I need to be careful as i fall right into this group

  • Ernst

    Suffered a third metatarsal stress fracture during cool down after a hefty sprint/hill trail training on Merrell Trail Gloves. I was reaching the end of my transition period to the TGs, as my calves where at ease now with running the new form (2,5 months). No cast, nice fracture, 3 weeks of rest at least…

  • Anonymous

    I have been confirmed as a neutral runner for the last thirty years.  I usually wear a shoe such as the Asics Gel Kayano.  I made a leap of faith and purchased a pair of Saucony Power Grids (Sep 2011) from the local store. Loved the wide toe box (previous surgeries).  On Oct 27 was running and felt something in my middle foot snap.  I have been diagnosed with a 3rd metatarsal fracture.  I can only equate to the shoes.  Going on now 6 weeks in the boot; no driving, no weight bearing…first injury of the sort ever.  I had been picking up my running from 10 to about 18 miles a week with some hiking in the local mountains (3-5 miles each).  I’m blaming the shoes. So I would like advice on what shoe has a big toe box (the Asics keep changing; getting lighter and narrower). 51 yrs old.  thin and in good shape.
    Thanks.

    • Sdvega2

      I wear New Balance Minimus – the wide version. They have a very wide toe box. 

  • Sdvega2

    I was diagnosed with a cuboid bone fracture after getting a bone scan. The bone scan only showed blood pooling in that area of the foot, but there was little detail in the image. I imagine the docs made the diagnosis based on my background of running on new NB Minimus shoes and putting a lot of miles on them right away (about 35 a week for three weeks). At any rate, I’ve been in a boot for about a week now, and when I take it off to shower, I feel NO pain at all in the foot. Just stiffness in the ankle due to a sprain a few months ago. My chiro said it’s possible it’s just a bone bruise instead of a fracture. Anyone have any experience with this who might want to weigh in? I’ve placed a call to the podiatrist to ask about it as well, but am curious to hear of others’ experiences. 

    • http://www.facebook.com/people/Anthony-S-Alonso/744127878 Anthony S. Alonso

      I am currently nursing a bone bruise injury in my left foot. I had an MRI done which showed the affected areas (two metatarsals) but no visible break marks. I found this article to explain some of the technicalities.

      http://www.ajronline.org/content/186/1/255.full

      I was told I need to not run until there is no pain at all, which could be anywhere from a 6-12 week period. I am on week 6 now.

  • Simple3720

    I transitioned from pavement to trails in April to Oct. 2011. I also moved from traditional runners to a minimalist trail shoe. I am now wearing an aircast for five weeks- stress fracture to 2 of my 3 cuneiform bones (the next ones up from the metatarsals). I was only running 2 to 3 times a week, gently and for a short time. But it was enough to do the damage. Pain took several weeks to appear, and I took a few months to take it seriously. Argh.

  • Tom

    I have a third Metatarsal stress fracture in my third metatarsel after running in my VFF.  I was about 3.5 to 4 miles into a 9 mile run when my foot to begin to hurt.  I have been running almost full time in my VFF since Oct 2011, I injured my foot December 21, 2011.  I had previously run a 12k in my VFF in November with no issues.

  • Stevie

    I transitioned to natural running exactly 6 months prior to my injury.  I moved into inov8 running shoes and took advice from the both the inov8 and newtonrunning websites, took it easy and built up gradually.  Prior to my transition I had completed a Moorland marathon in 4hr 35min, and consider myself of good fitness.  I was running distances of up to 15 miles after 4 months quite happily, and then due to weather and other factors was forced to run indoors for approx 8 weeks.  Although not a great lover of the treadmill, i was determined to continue my running.  My training was mixed with cycling and rowing.  Upon completion of 6 months training I completed a 1.5 mile best effort run to compare my performance to my running style 6 months previous.  The run was on road.  Although I completed a very respectable and pleasing time, around 100 m from the finish I suffered a stress fracture of my second metatarsal of my right foot.  I was wearing inov8 road X shoes, which I had trained in for over 3 months.

    This was 7 weeks ago and I am only just managing to walk without pain or a limp.  I am itching to run again but very cognisant of not making this terrible situation worse by running too early.  I am having to satisfy my exercise needs by cycling and swimming.

  • Fuche

    Joe, I had slowly transitioned into BF and VFF over six months without too much trouble. Them after two five mile trail runs keeping up with another runner (pushing my usual pace) with only a day between them I felt a sharp pain in my foot. Turns out to be a second metatarsal stress fracture. I’m 42 years old. Pretty much seek to fit your profile…

  • Greg

    54yr old male. Been running for 5yrs with minimal issues.Started slowly adding mileage in VFF Bikilas 1yr ago. No problems for 11mo and suddenly developed a stress fracture of the 2nd metatarsal. Was averaging about 12-15mi per week in the VFF and never over 6mi at a time. I’ve been in a boot type cast for 6wks and wondering if I will be recovered well enough to train properly for Boston! I liked the theory of minimalist shoes but am thinking they were a mistake for me.

  • http://jamesbrett.wordpress.com JamesBrett

    I suppose my injury is another to add to your list.  I’m a 34-year old male, and have been a runner for most of my life.  I began my transition to minimalist running some 20 months prior to my injury.  For most of that time I ran 15ish% of my total weekly mileage (25-30mi) barefoot, and the remainder in cheap pairs of water shoes / aqua socks (due to the running surfaces where I live in rural Africa).

    I suffered a stress fracture in the second metatarsal of my right foot while doing speed work in late September.  I chalked the injury up to the following changes, which all occurred within the month or two before the injury:

    – I was visiting the states for a time and, so, was running on harder surfaces.
    – My visit to the states (and the restaurants there) also made me about 10 pounds heavier.
    – I switched from my water shoes to New Balance Minimus Trails.
    – My speed work was getting more intense at the time (5:30-5:50 1/2 mile repeats).

    I tried to run a week later, and it was more painful than the initial injury.  I’ve not run since (today is Jan 12), but I intend to begin running again this week.  Here are some questions I’ve got?

    1.  How slowly should I begin running again?  [I’ve planned to do 1 1/2 miles x 3 days very slow.]
    2.  Most of the surfaces I run on do not allow me to go barefoot — at least not while moving any faster than a crawl (and even then there are lots of sharp rocks, big thorns, and cow manure).  The water shoes I was wearing tear up too quickly — hence my purchasing of the NB Minimus shoes.  What should I wear to run in?
    3.  Is it possible / when will it be possible to run really fast in minimalist shoes or barefoot? If shod, how will I know when my bones are strong enough?  And you mentioned that barefoot running will not allow that much friction.  What’s the answer?  Do I have to give up running fast to stay with minimalist / barefoot?  I’m looking at a 1:30 1/2 marathon or so.

  • Suzain66

    I am training for a half marathon, and while I slowly increased my speed and distance from August to December, I really started to ramp things up after that.

  • Suzain66

    I am training for a half marathon, and while I slowly increased my speed and distance from August to December, I really started to ramp things up after that.Küstenpatent,

  • http://www.kroatisches-kuestenpatent.at/ Küstenpatent,

    Started slowly adding mileage in VFF Bikilas 1yr ago. No problems for
    11mo and suddenly developed a stress fracture of the 2nd metatarsal. Was
    averaging about 12-15mi per week in the VFF and never over 6mi at a
    time.

  • Cherie

    Cherie
    46 years old . Started running with Vibram, loved running in them on the treadmill then after about 4 months when I started uping my distance and speed I ended up with stress fracture of 2nd metatarsal did 4 weeks in a boot 3 weeks in a cast now back in a boot and I still feel it. I am so disappointed I don’t know if I will even be able to run anymore.

  • Rebecca

    I am 27, female, switched to VFF shoes about 9 months ago but, because of the initial calf pain, only started running regularly in them about 6 months ago. I typically run about 15-20 miles/week, on a variety of outdoor surfaces, mostly road pavement (I try to avoid concrete) and gravel trails. 

    I began having severe pain in my right arch, right about in the middle of the arch length on the inner side of the foot, and I think I can feel a small bump there. I also previously had pain on the top of my foot, but that has since gone away. This typically affects only my right foot, I believe because I had knee surgery (patella tendon did not break, but actually broke the bone on the lower leg where it attaches, and had to be pinned back into place) 15 years ago and figure my right leg moves slightly differently than my left (my right foot, for example, is slightly turned outward with each step). 

    The pain is most severe 20 or so minutes after a run, and generally after any resting. But I’m stubborn and haven’t stopped running, and I can count on the pain literally disappearing 2-3 minutes into each run. I’m not sure what’s going on but I don’t want to stop running; I don’t go to a gym so it’s literally my only available form of exercising besides bicycling (boring!). 

  • Simeonaldren

    Hi Joe, could be another one for you. 44 years old, recent convert to VFF’s. Injured foot after 30 minutes fast run. Felt great at the time, but been struggling to walk for 10 days now. Will be seeing the doctor after reading all the similar stories. Regards, Simeon

  • Georgenancy

    I have been running in Nike Free 3.0, have had two stress fractures. First one not too bad, still able to run. Second one stopped me and I limped home. Love my Free’s but not the stress fractures. Both fractures in right foot, second at base of second metatatarsal. Podiatrist said is is very rare to fracture at the base. Have tried to back to regular running shoes, hate, hate them. I have very large bunions on both feet, I was able to run in My free’s with no bunion pain. I’m a 47 female, 5’8 only weighing 120 , what do I do now???

  • http://twitter.com/jeffreycarver jeffreycarver

    I don’t know if it was a stress fracture, but I ran in vibrams for a while and developed a pain on the top of my right foot, in the middle, around the 2nd and 3rd metarsals. It persisted for a few weeks.

  • Anonymous

    I am guessing since not everyone who wears VFF’s get injured, its likely do to your running technique. You have to pick your feet up, and not push off. If you were told land on your forefoot, then you are likely pushing off. Try running more flat footed, with pressure on your midfoot, and focus on lifting your foot and not pushing off.

  • Suntasticday1

    I think the issue is with running technique that people are landing too much with the forefoot and pushing off.  I used to do this and had all sorts of problems.  I’ve switched to mid-foot strike and much better now.  I also go out running completely barefoot at least once a week to continue to work on my technique

  • Brandon P Simmons

    Hello my name is brandon simmons and I ran my first marathon last week in a par of Merrells miniaml shoes. So far the tops of my feet have been pretty painful. I went for a 2-3 mile run yesterday and I could barely keep going due to the soreness in my feet. I spent the whole day limping around camp and I was just wondering what you think it could be and how soon til Im back to normal

  • Emily

    I’m 37. Switched to minimalist shows about 5 months ago. Currently have a stress fracture of the 5th metatarsal in my left foot.

  • Ralph Shippam

    Delete

  • http://www.fosamaxfemurfracturelawsuit.com/fosamax-problems/ fosamax side effects

    I hope that studies will be done on your theory so that it can be deemed useful.

  • http://www.facebook.com/profile.php?id=540598610 Valerie Young

    Hi Joe! I found your page after googling “barefoot running metatarsal pain”. I have just started transitioning to barefoot after a disastrous half marathon last year in Nike Pegasuses that left me damn near crippled (shin splints, IT band stuff, wanting to amputate my knees etc…) I read “Born to Run” and decided to try running again, barefoot. I think the mistake I have made is running on my treadmill WITH toe socks or compression socks on my feet. Without the socks I can only run .75 miles before the skin under my second and third toe feels like it’s got Indian sunburn (the kids “game” where you rub someone’s skin until it burns) and at .70 I know I’m stopping at .75mi. My solution was to put on socks. BIG MISTAKE. I should have listened to my skin and only run as long as my skin would let me. The problem was that I wanted more. I wanted to run more, longer. I want to train, not just prance around for a few minutes. Now I have pain that feels like bruising when I push on the area about 2 inches back from my second toe on the top of my foot. I’m out of commission for at least 2 weeks I think. I think your theory is right, I’m 35 and I don’t think I allowed my feet to strengthen enough before hitting longer distances. When I (re)start training again it will be completely barefoot so as to self-limit my training.

  • cat

    I stepped on something while running in the process of a turn in a cul de sac-broke my 5th meta-never would’ve thought-shoes?

  • Astewart7

    I am not a runner, but several months ago I bought a pair of Merrell Pace Gloves just to walk in.  I noticed a difference in my walking immediately.
    Three weeks ago, I stood up to answer the door and broke my 5th metatarsal and have been in an aircast since then.
    My bone doctor asked about shoes and I told him that I was wearing barefoot type shoes, but not vffs.  He told me that in the last year he has seen more foot breaks and most of the people had been wearing vffs or something similar.
    After I get out of the cast, I still intend on wearing mine because I do think they promote a more natural gait and they are much more comfortable than regular shoes, but I do agree that conventional running shoes have made feet weaker.

    • http://joemaller.com Joe Maller

      Not just running shoes, all shoes. Thankfully our bodies do recover and our feet do get stronger. I don’t have any clinical measure, but a year after my injury, my feet have strengthened considerably. 

  • Virginia

    I’m a 52 year old female with about 20 years of fairly serious running / training under my belt. After being away from almost any running for almost a year for reasons unrelated to health, I started wearing minimalist shoes pretty much daily for a month, then started running again–slow jogging 30 minutes or so, in Vivobarefoot shoes, about 3 times a week mostly on packed dirt trails. I thought I was being pretty moderate, and tried to keep my stride short, but apparently not enough, because here I am with point tenderness over my second metatarsal.

  • Guest

    You’re full of baloney…….it’s the outer edges of the feet that take the FIRST impact  The point of barefoot running among other things is that weight is more evenly distributed and is not concentrated in one area.  One needs to ensure the right running form and if you’re pushing off with your toes, that’s an incorrect way of running in bare feet/VFFs.  I suggest you read “Born to Run” and reevaluate your so called “theory” as per above.  

  • Yeatslyt

    Hi my name is Lisa T. I got a stress fracture on my second toe running with VFF. Before the stress fracture my calves were becoming tighter and tighter I think mostly from running hills. This stopped me from being able to run hills. Between my knee and foot I would get nervy shooting pain. I haven’t run hills for about 3 months. I didn’t transition very well into minimalist and I was also training for a marathon with them. They gave my such a nice sense of freedom at first, another reason I didn’t take my time.

    • Yeatslyt

      To add my age…I’m 39.

  • Donnaj64

    I ran my first half in Feb. took some time over to recover from IT band issues. Started back with just some short distance runs. In March I ran a fast 5K, midway thru had a horrible pain on the top of my foot, I finished the race but, sad to say I am now off for up to 8 weeks. Stress fracture in the 3rd metatarsal.. I was running in Reebok Realflex. I am now looking for a better shoe that will take the cushion the impact. 

  • http://linsfitnessjourney.blogspot.com Linnea H

    33 year old Crossfitter–I regularly run wearing Vibrams, but if I’m going fast, it’s short, less than a mile, and I rarely run more than 3 miles at a slow pace. Until this weekend when I ran a 5K, in my Vibrams, at a PR pace and, you guessed it, fractured my second metatarsal.

  • Mark G

    I too am having some issues – 39 year old male, running off and on for at least 20yrs, minimal and barefoot since 2006 in early version of Nike Free. Decided to get more serious about running at the start of this year after an impromptu extended barefoot session I loved. Even though I’d been running minimal and barefoot for years, built up slowly and, when I introduced Fivefingers, took that slow too. Was only averaging 25km/week in sessions up to about 8k. All was fantastic until I got pain in my left foot which I thought was just top of foot pain. Went and saw a gait specialist who helped me correct my barefoot form. Again all was good for about a week when suddenly I get pain in right foot. I see my physio this week but suspect metatarsal overload, if not a stress fracture or fracture.

    My question is: will a shoe that provides cushioning but encourages good forefoot/mid foot form, like a Merrell Bare Access or Hoka One One likely to be something people like us might utilize for the best of both worlds?

    • DanielD230

      Yes.  On unnaturally hard surfaces like streets and sidewalks cushioning in the forefoot is appropriate.  The Gracie BLIS (Barefoot Low-Impact Shoe) will be out this summer and is designed specifically for this.

      Dan Duarte

      • http://joemaller.com Joe Maller

        No, your leg is the cushion. Padding and protection are a personal choice, they’re not necessary at all. 

        • szili

          agreed, Joe.. Barefoot Ken Bob says to SPECIFICALLY run totally barefoot on concrete and asphalt. Lawns and sand are not as prevalent in nature as hard sun-baked savannah hardscrabble or rock. It surprised me too! as i thought as Daniel did.

  • Stlblw4d

    Yes, sounds familiar.  44 year old female. I have always been a forefoot runner, but switched to newtons for more cushion in the forefoot area.  About a month ago, started having top of foot pain, got an xray and didn’t show anything but my surgeon cautioned me that could be stress fx and if I went ahead with my half marathon as planned, I could possibly go ahead and break it all the way.  Well, I went ahead with my Muir woods half marathon a couple of weekends ago and felt it about mile 4 (of 14 mile trail run).  I finished out the race because, well, it hurt less to run on my heel than to try to walk on my entire foot. Next morning, I knew something was definitely wrong, went to the ER and xray showed proximal fx 2nd MT.  I happen to be an Orthopedics RN and I work on the foot team so all three of the surgeons recommend trying for it to heal without surgery first; I got a vit-d blood level drawn which was within normal limits which is good news for the probability of my bone healing on it’s own.  I also got a bone growth stimulator under my cast ( the electrodes are placed on the top and bottom of the fracture site, then tunneled up through the cast padding where the device is strapped to my cast on the outside).  I also have ordered some Mobi legs crutches they are supposed to be the newest/hottest things.  I’m getting around quite well on reg. crutches, but palms of my hands getting sore by end of each day and tips of the crutches already wearing out.  My new crutches should be delivered tomorrow let me know if you care to get a report /update .  I’m doing leg lifts on my back and on the floor, and pushups to try to keep in shape; also, using crutches throughout the day is a workout. 

  • Stlblw4d

    Also, my surgeon told me that people that are inherently built the way I am are more prone to 2nd MT proximal fractures; that is, people with longer than “average” 2nd toes.  If my fracture heals “as is” , I will have effectively shortened my own toe by fracturing it, which would be good “in the long run”. 

  • http://injury-compensation-zone.co.uk/compensation-injury-by-box-cutters box cutter injury compensation

    It is challenging to deal with injuries later on but the person who is mentally strong is able to deal with it easily that is why in some cases it is impossible for the people to deal with the loss but one can get in touch with professional to deal with such losses………

  • Fred

    Joe,
    I have been easing into minimalistic running over an 8 month period and run about 150mi per month. Since about a month I only run on VFF and Saucony Hattori. After an 18 mile run in my Hattori’s I started noticing a mild pain halfway the second metatarsal, which I feel under the ball of my left foot when walking barefoot and sort of like a bruise when pressing on it about mid-top-foot. I also need to point out that I’m 36 yo, my left knee often hurts (not at all when running) after sitting in awkward positions and I overpronate mildly (but have normal arches).
    To avoid further problems I reverted to running in Saucony Kinvara for a while, I hope the problem goes away with R.I.C.E.
    I also would like to mention that my foot shape has changed compared to a year ago. They look ‘beefier’ and my big toes are straightening, whereas before they pointed somewhat inward.
    Rgds, Fred

  • http://www.comfortor.de/footproblem.html Ankle Arthritis

    But who will try to run when there is already fractures? I personally don’t think so as i got fracture and after its been treated it has never pain me.

  • Dev

    The exact same thing happened to me. In the course of a week I ran a training pace 20km on Monday, and on Sunday the same week I had a half marathon race, which I expected to finish in under 2 hours (first race ever, too). Around the 15th km I felt a sharp pain in my left foot, so I took off my huaraches (that’s what I recently started using) and continued to run/walk barefoot through the pain. It turns out I broke my second metatarsal on my left foot. Now I’m in a cast for the next three weeks…So I think this is a sound explanation of what was going on. I feel that this has taught me a lesson in patience.

  • Soma

    I’m a 48 year old female, transitioned to VFFs a year ago (got a tibial stress fx doing that too rapidly). A week ago I did my second half marathon in them, and was doing well until mile 11, when I felt tired and decided to take them off. I’ve done this in training runs before, and it always gives me a little boost. I did the last two miles completely barefoot, and right after I finished, could not bear weight on my left foot. Second metatarsal stress fx, and I can see from this thread that I have a lot of company! Can’t wait to hit the road in my VFFs again! And will keep trying to add in some barefoot. It’s true, it’s easier to get injured in a race, because there’s so much more adrenaline and you push yourself to go as fast as you can.

  • Lauferin

    got a dull pain in the second metatarsal area of my left foot after doing speedwork and too many miles too soon in VFFs and barefoot. im used to running through pain so i ignored it, did a couple of races as well as continuing to train in normal (cushioned) trainers on long runs. started to experience something closer to real pain. i havent run for about a month now, it spikes up if i run on it, sometimes uncomfortable to walk on. nothing showed on the xray (Im told stress fractures dont always). as an aside, how long does anyone reckon it’ll take to heal given that i ran on it for more than a month before giving it a rest?

  • Kevin-purcell

    Yep, the above is me all over!  Had worked up to a 10K distance in about 3 1/2 months in VFF, ran it well, ran another 10K race 3 weeks later.  The first 3K i ran at a fast pace, felt pain for the remaining 7K, should have stopped but stupidly didn’t.  unable to weight bear soon after finishing. At A&E the next day they x-rayed it and said it was strained, would be okay in 5 to 6 days. 3 weeks later still limping I got it x-rayed again, small stress fracture in 2nd metatarsal!

  • Barbara

    I’m a 64 year old female runner who has been running in vivobarefoot runners since January 2012.  Love the freedom they offer!!!!  I did a 20k easy non technical trail run in them and felt good (before this run, the longest I had ran in them was 12k – I guess too much too soon).  I ran short runs for the next few days and then did a 10k hilly run and at 7k into the run I felt pain in the 2nd and 3rd metatarsal area.  I had an x-ray but it didn’t show a fracture which is quite normal I hear and am going for another one next week.  In the meantime, I am wearing a walking boot as I can’t put any weight on the foot without there being pain. No running for me:(    It’s crazy though – I can hike up a mountain in regular running shoes with no pain!!

  • Danielle7213

    Hi All, just learned from podiatrist that I have a stress fracture in the 2nd metatarsal in my left foot.  I’ve been running in the VFF for 18 months without a problem. Aside from the months spent getting used to them, I was also pain free.  Loved them because they improved toe and leg cramps.  I’m 34, female, and have been running since my teens.  I’ve never had a broken bone before.  Just before I got this injury I made a two changes that might be significant, but I just don’t know for sure.  (1) Running on asphalt.  I ran on a treadmill most of the winter, then soon as weather here warmed up, I hit the trails.  I was running on an asphalt trail when I first noticed my top of foot pain. (2) I went of oral contraceptives in March (about three months before this injury).  I am hearing this could have changed how I absorb calcium, rebuild bone, etc…

    One other weird thing – the top of foot pain that was my initial symptom, started in my right foot initially.  Doc confirmed I do not have a fracture in my right foot.  At the onset of TOFP, I thought I had tendonitis, so I started following the stretch regimen recommended on a few websites.  The pain improved and went away in my right foot.  I continued to run in VFFs.  Couple weeks later, the pain started in my left foot.  This time I was not able to walk or climb a staircase comfortably.  I was limping and so went to the doctor, where the stress fracture in my left foot was confirmed. 

    I’m in a boot not for six weeks and have been told I can use a gym bike wearing boot or swim, but that’s it.  training for the summer for fall half is not going to happen.  When I am able to go back to running, I am worried I cannot run in the VFFs anymore.  Podiatrist recommended Asics for my high instep. 

    That’s my story, hope it helps someone avoid this.  Any advice for myself is very welcome also.  Thanks, D. 

  • Etaaroa

    I’m 28 yr old female and I just started running in Luna Sandals about 3 months ago. I should mention though I’ve been running since junior high and after reading Born to Run I changed my stride to running on the balls of my feet a little over a year ago.  So I feel like I’ve been transitioning slowly.  I was doing great for about 2 months when training for a 1/2 marathon, but about a month before the race I started getting a little pain where my second toe meets the foot and up through the top of my midfoot and also some pain in my calf on the same side.  I would lay off for a few days and it would go away.  During the 1/2 marathon last week I was doing great, on pace to get a record time, but then my calf froze up with a cramp around mile 11.  I just barely made in through the last few miles, but after the race I notice that not only my calf hurting, but also my foot in the same area that was giving me problems.  I couldn’t walk without a severe limp for several days, but now a week later, it seems to have gotten a little better. 

    After researching, I’m guessing that I ended up with a second metatarsal stress fracture and I’m also wondering if the cramp in my calf wasn’t caused by me somehow compensating for this minor injury.  So I guess it’s not only the older runners that get this injury! 

    If anyone has any suggestions about what to do to help this injury it would be much appreciated.  I’m hoping I don’t have to stop running for too long as I have another race coming up.  Maybe try running in shoes again until it clears up?

    • szili

      Hey,
      You are the first one i saw on here in Luna Sandals! Me too.
      I am a 39 yr old male.

      How is the foot, since you posted 6 months ago?

      I am worried about stress fractures now, and have been having slight pain on the top sides of my feet. (before that just calves rock hard)

      All i can say is the fact that you are such a good runner in shoes will make your transition to barefoot running EVEN harder as Barefoot Ken Bob says. You really gotta give yourself more time.
      For example i have been running for 10 months barefoot and just recently ran 3 miles a month ago and now 6 miles a week ago!

  • http://daisycrisp.blogspot.co.uk/ Elliebatliner

    Ellie, 47. 3rd Metatarsal stress fracture. Been running in Merell minimalist shoes for 6 months. The fracture happened 30 minutes into a longer than usual run, over uneven ground. Would like to know how to avoid it happening again

  • goran

    51 year old male, new runner, VFF. 2nd metatarsel stress fracture after 2.5 miles.   I’d been working up from .5 miles over 2 months, and It was the first time I ran that distance easily,  .

    After a very long recovery, with a crookedly healed 2nd met, I started running again in old NB and minimalist shoes, working up from .5 miles to 3 miles, adding only .1 miles per week, and running 3 times a week.   Then I read about recover runs, and switched to running 3 miles, 1 mile, and 3 miles on consecutive days, once a week.  Stress fracture of the 3rd metatarsel in the same foot, after 3 weeks of recover runs in NB Minimus style walking shoe.  BTW my performance improved quickly with the recovery runs.

    Re. stride:  for me any heel contact results in hip, knee and back pain, so I learned to run with no heel contact whatsoever.  My stride is highly loping, with large stride, and I had difficulty shortening my stride.   Impactless running with a large stride had become quite comfortable, so I gave up trying to shorten my stride.   

    Both injuries were while taking statins.  The first injury healed only after I stopped taking statins, and I started taking statins again a few weeks before the 2nd injury.

    Today I just ran .8 miles after a 2 month recovery from injury 2.   This time I’m determined to: shorten my stride, and pick up the cadence, run either in my old NB cross trainers, or barefoot on a track, not do any recovery runs for the first year.

  • Chris

    I have ran in Nike + shoes for over a year they are my favorite. I just got out of a 4 week cast, 2 broken bones in my foot. I believe this is why and I have bought different shoes to plan my return to running. I run 8 miles a day and have for years, I do not know why it took so long to break, I did not increase speed or distance. I did change my landing because of a sore Platar tendon. This could be why I guess. I have a very high arch and these shoes have no support but I still love them. Just sayin!!!

  • JerahT

    I believe that I recently developed a stress fracture in my second metatarsal as well. I finished an interval run and ran the last couple of sprints faster than my normal pace. Almost immediately upon finishing my run my foot began to hurt and swell and I couldn’t put any weight on it. I am curious about how long this takes to heal and if I should start running again in “running shoes” for a while before using my VFF again? The top of my foot is still swollen an bruised and I still cannot take a normal step baring weight on my right foot. I am antsy to run and I am curious if there is anything that I can do besides ice and elevation to speed up recovery? Thanks for any ideas or opinions.

    • http://joemaller.com Joe Maller

      I wouldn’t run on it. Better to let it heal quickly than risk making things worse and causing your recovery to take substantially longer. Without sugar-coating anything, assume two months, hopefully a little less. I learned to swim to keep myself sane during that time.

      As to what you can do, first, immobilize the foot for a couple weeks, until you can at least walk without pain. Bones get stronger in response to stresses, the trick is not to stress them too much.

      Bone health seems to depend on three vitamins: A, D and K2 together with minerals calcium and magnesium. Vitamin D gets minerals out of the gut, Vitamin A tears down damaged bone and K2 delivers minerals for building new bone. If possible, it’s best to get those vitamins from foods rather than pills. Though K2 can be lacking in modern foods and is worth supplementing.

  • Chris

    I have ran for years, used to run with the Nike 3.0’s, then they ripped and bought a pair of merrell barefoot runners. Cut the story short, I fet pain one day in my ankle and took it as a sprain. Rested etc etc

    3 Months later after still feeling discomfort when running, I went for an xray. It turned out I had a distal fibular fracture, from reading, this can be common by rolling the ankle but also if using barefoot runners your calfs are overloaded which takes away the protection or strength from your ankles.

  • http://www.facebook.com/people/Charles-Boehm/100001755169794 Charles Boehm

    I’ve been VFFing it for about 6 months. First 3 months just substituting them for sneakers at every opportunity. The recent 3 months I’ve been working up to running. At first the limiting factor was my calf and ankle muscles. I assume this was due to the drastic change in ground strike brought about by the realization that your heel IS NOT made to do what shoes have been teaching them to your whole life. Once those muscles were trained the muscles of my foot itself became the weakest link. Again, those muscles quickly became trained. Before VFFs my speed was limited by knee pain and aerobic endurance. Hard heel striking overtaxed the joint, and the jolting impact affected my breathing stability. My body may also be more efficient when running barefoot, but placebo effect can’t be ruled out. Now I’m setting personal bests of 22 something on a 5k (I’m fat, shut up), but my metatarsals are feeling it pretty good. At first I thought I was damaging the connective tissues, but the pain wasn’t localized enough and the injuries healed too fast. My only guess is that the stress is causing micro-fractures. I say that’s great. As long as I am humble enough to stop stressing the bones when they start to ache, and don’t push them any harder than next day pain allows, micro-fractures mean bone synthesis. Self solving problem. You must remember though, your feet are no longer shaped the way God made them. Your shoes have mutated your feet and those of everyone around you into a prosthesis mount instead of a transportation tool. Odds are you will never how healthy your feet might have been. I’m not saying we should be barefoot hippies (no offense hippies, dig the Jesus look). We’ve changed the world faster than our biology can adapt, and we have to wear something on our feet to compensate for walking on concrete and broken glass until a better solution can be found. Like robot brooms and teleportation booths. I advocate for going straight foot commando. If you have clean neighborhood sidewalk, strap on your 9 and run the block completely barefoot. Your skin will let you know how ready you are for BFR. Your callouses will probably develop at a rate more closely to that of your bones than your muscles, preventing you from overdoing it. Don’t forget that, unless your running in a circle, when you’ve had enough you’re only halfway done. Take a pair of cheaters in a backpack to get home with before bleeding ensues.

  • Jason

    After recovering from a hard lesson in shin splints that led to a stress fracture 1.5 years ago, I thought I had it all figured out…… maybe not? I’m a 39 year old male. I have been running about 3 months in my Newton Gravity’s and GRADUALLY built my mileage up to 5-7 miles per run, averaging 20 miles per week. All of a sudden, the 4th mile of a 7 mile run I thought I had a knot or something in the tongue of my shoe. I stopped to readjust, only to find the feeling (mild pain) on the TOP of my foot between my 1st & 2nd metatarsal (mid foot) increasing. When I stopped running to walk the rest of the way home, the pain went away. My next run, the pain showed up after 3/4 mile, so I stopped, however it does not hurt when I walk. I’m assuming I have a bruised 2nd metatarsal that could very easily become fractured?

    I waited two weeks and ran 1 mile yesterday. The results were: no pain in the 2nd metatarsal, but a slight sensation that the problem has not completely healed. I honestly don’t know what else to do other than rest, but one lesson I learned previously is: If it hurts, stop!!! Running is not supposed to hurt!

  • Myra

    My daughter was wearing New Balance Minimus and she has suffered a broken fibula. Can’t say if there’s any relation to the shoes or not.

  • Ron

    You hit the nail on the head with me. I am 57 years old. I have been fighting runners knee for 3 years. I did not run for about 2 1/2 years because of this. I cured the runners knee(whew, a whole another story) and finally started running again lightly with FFV’s about 2 month’s ago. I pushed to hard one day and did not notice any problems but felt like I came real close to injury if that makes sense. One week later after that run I went for a easy run and a 1/4 mile into it started to feel pain in my foot and after a mile I had to stop. I limped home and took my FFV off and my left foot was beat red. Over the next few days it swelled up pretty bad. I went to a doctor and had X-rays. No break showed up but it appears they normally don’t show up on X-rays. The doctors best guess was a metatarsal stress fracture. So I fit into your theory pretty good. Good job on the investigative work. I am not giving up FFV, but I need to learn to take it easy. That will be the toughest part :-)

  • http://twitter.com/Geohaz Jamie Love

    I’ve been running in my VFF’s for 2 years (I’m 32), 1 year exclusively (after a car wreck I could only run in my VFF’s). I was having a great racing season, training going excellent and was finally getting back to pre-car wreck condition. I was on PR pace at a 1/2 marathon and all of a sudden bam, foot started to scream, no warning, no hey, I”m here. Just throw me on the ground pain. 2nd metatarsal stress fracture. I’ve sprinted in these shoes, ran fast 5k’s 4 1/2 marathons and numerous rounds of speed work. I think it was the fast increase in speed I have just began to develop again after my injuries from the car wreck. I was feeling great, and all the doctor can say after looking over my training logs is it was just a wrong step. Maybe it was a long step? Who knows, I will never blame the shoes, but will blame that maybe i wasn’t ready for that pace in my bones, maybe I’m still slightly compromising and I don’t know? After all the speed work I’ve done in my VFF’S this shouldn’t have been what broke the metatarsal.

    I do link your theory to the fact that our body takes time to adjust to changes, even it if it pace alone. A slightly lengthened stride will stretch us a little farther, after 13 miles what will the consequences be?

  • RDB

    I am a 39 year old runner, running about 30-40 miles per week for the past nine months and 20-25 miles per week for the year prior. I usually run in racing flats, but in recent months had been running in Vibrams and barefoot.
    I had been running injury free for nine months in this manner, running about 10 miles per week in vibrams for two months, 20-30 miles in Brooks Racing flats.

    One week ago I ran a 21 mile long run and attempted to do so at race pace (6:52min/mile) in Vibrams. I completed my run as attempted, but woke up the next day with left dorsal foot pain over the second metatarsal, which has been subsequently confirmed to be a second metatarsal stress fracture.

    I am writing here to simply add anecdotal evidence to your risk factors, all of which apply to me.

    Thanks.

  • Beatrice101

    I am a 59 year old female. Based on my experience, I would say this theory has merit. I had worn barefoot shoes almost exclusively for a year (Merrells), hiked in them, worn them around town, to the gym, etc. Then I did a distance hike with a 12 pound pack. After about 300 miles I fractured my 2nd metatarsal. It was an accident, a “real” fracture, not a stress fracture. The injury occurred when I became careless at the end of the day— I was going downhill rather fast and probably stepped too far out, onto a rounded stone that was about the size of my foot. The front part of my foot sort of wrapped around the stone and as I propelled myself forward I felt the bone snap. But until then, my feet were in awesome shape during the hike—unlike when I previously hiked in hard-core boots, with the barefoots I felt NO foot fatigue at the end of the day. I believe the injury was due to a careless misstep, but now, at my age, I don’t know what to do. My doctor wants me to wear orthotics. I used orthotics a couple of years ago while hiking—after a few days, I threw them out because my feet hurt so bad, then went the barefoot route. I will be doing careful research on “barefoot” mechanics and am interested to read others’ experiences.

  • Emil Svedung

    I am a swede who made the transition into a barefoot running style this winter. Since a couple of weeks I have had à slight pain on the top of my right foot after each run. I wonder how you know if you have a fracture on your metatersal? Does your feet get swollen? My story is similar to many others who have posted here. I started with à pair of NB mt10 and has also à pair of vff KSO and I run with both. I dont run very much, about 15km à week. I started feeling the pain about 8 months after the transition. I have not had any other issues while starting running in minimalistic shoes.
    /Emil S

  • Duncan T

    Thank you! A very useful article. I have suffered a stress fracture on my third metatarsal about 5 months my transition to running minimalist. I am just 18 years old so I’m very surprised to have this type of injury. My injury occurred doing speed work (1 minute sprints up a hill, tarmac/road surface) which I have not done before and I’m pretty sure, in hindsight, I was going way faster than I should have. What I want to know is: How best to recover from such an injury? From people you’ve spoken to, how long before they started any sort of running again?

  • Marnix

    Hi Joe, my experience builds further on your anecdotal evidence for your theory and your points are spot on for me:

    I:

    1) am 42 years old

    2) used Nike Frees for about 1 year, VFFs for about 3 months when my first metatarsal stress fracture occurred

    3) like making every training a race (I know it’s dumb but I like it) shaving off a few percent of the speed each time

    4) am good in endurance from swimming and biking so my heart could easily keep up well with all this speed whereas my bones could clearly not

    5) had my left 2nd metatarsal stress fractured, when I finally got back to running within two weeks my body was telling me to go fast again which i did (on every run again how stupid) for about a week until my right 2nd metatarsal snapped …

    By the way, my fysiotherapist is stressing the need for better core and glute action which I think is valuable, but I firmly believe in your theory as the main cause of my recurring injuries.

  • CRR

    I just came across your website. I am 66 yo, weigh 195 lbs, 5’10” height, and have been “recreational” running 6 days a week, 4 miles per day, for 36 years – slow but steady. I have high arches, and consequent calluses and corns particularly on my left foot. The most serious injury I have had in 36 years is left ankle tendinitis for the past 4 years. I have been transitioning gradually to natural running shoes (VFF, NB Minimus) since the fall of 2011, hoping it would help the tendinitis. 5 weeks ago I spontaneously suffered a mid-4th metatarsal stress fracture, left foot, while running. I am concerned that this is at least in part due to the “natural” running. My podiatrist says my high arches lead me to run on the outside of my feet, hence the stress on the 4th/5th metatarsals. However, he says there is not enough evidence pro or con to blame natural running for such stress fractures. I have not read through the 170 comments to see if a similar experience is among them, but would like your input as I start my rehab next week. Thanks..CRR

  • carmack

    I run in VFF 3 months, I’m 35 years old. I use VFF in one half marathon, now got second metatarsal stress fracture. Already have rest 2 weeks, still pain, when it will fine?

    • http://www.facebook.com/ron.wiltse Ron Wiltse

      I got the same thing. My doctor said 6 weeks and wear shoes with ridge soles. I waited 10 weeks to run and began slow in shoes. I would not run in pain.

  • Tony J

    I’ve always been very active in running, cross-training, martial arts, bike riding and intense jump roper. I started wearing New Balance Minimus shoes 3 years ago and LOVED them for my short runs and cross-training. Since then I had a bad case of plantar faciitis which lasted 8 months and I’m getting over a complete fracture of my third metatarsal. I’m 36 years old and I never had any foot issues until I started wearing minimal style shoes. I will continue to wear them but not for any running and anything high impact. There really is no reason for me to justify all these injuries to become a more “natural” runner/cross-trainer in my mid-30’s. I’ve done well so far so no need to put my body through more stress after having a successful lifetime of being athletic.

  • Cindy

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  • Carlos

    I believe its technique not the shoe.
    My first runs with vff´s were hard i couldnt run more than 30 min with them.
    I did 2 30 min easy runs in them for 5 weeks until i transitioned completely to them. (Bikila Pavement Spyridon Trail)
    I run 30+ miles each week with no problem.
    As i have gathered more experience in them my gait has evolved to a semi float while landing midfoot.
    I never push off with my toes i “lift” my foot as lightly as i “land” on it.

    I am currently at the speedwork part of my half marathon training program and when i´m running at tempo pace or faster i focus on faster cadence in my strides and i also noticed that even tough is somewhat tiring lowering my butt while sprinting aids in lowering the impact and laverage from your toes at takeoff and landing because it makes your glutes absorb more of the impact.

    I see lots of peple sort of “jumping”, pumping overstriding etc when they try to pick up their pace. That mistake can be covered by reg shoes, maybe VFF´s need you to be more careful with your technique.

  • Guest

    Spot on! Been transitioning to minimalism with Brooks PureCadence for 6 months including marathon. Bought the VFFs after that and have done a couple of hundred kms, up to 20kms at a time and a 14km race (new PB). Just today I pulled out of a 10km race after feeling like I had been shot in the foot at km 7. Stress fracture 3rd metatarsal. Male 30yo.

  • D

    I moved to Nike Frees 18 months and to VFF in Sep. Feel a pain in my metatarsals now if I cross 10k

    • http://joemaller.com Joe Maller

      If you’re in the northern hemisphere, take it easy. The lack of sunlight (vitamin D) seems to affect people much more in winter. My original injury (long-since healed) was in January and you can see the season reflected in comment dates too. Emails connected to this post always pick up around January as well.

  • http://www.askdiana.net/ Sarah Lee

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  • Raghu

    Hi Joe,

    Thanks for the above theory!!

    I recently went through the stress fracture which you have illustrated above(Arch Fracture). After 4 weeks of rest to my foot I removed the Air Cast yesterday but I still have sever pain. Many of the Physios whom I visited couldn’t find any kind of fracture but one Orthopedic told me that there was a Stress fracture and gave me the Air cast he suggested 3 weeks of air cast and 3 weeks of scrape band.

    I’m out of state currently and I cannot visit the same doctor, the doctor whom I visited here at my place tell they cannot find any fracture and suggested to remove the air cast. Since I still feel the pain can you suggest if I have to consult the doctor again or wait for one more week to check if the pain will be gone?

  • rachellemadrigal

    I really dont like to read blogs. But when I found your post, I started to like it. I found it interesting and informative. Thank you for the effort in posting this kind of information.

    Jax
    http://www.imarksweb.org

  • Sara

    I am not a runner at all, but my husband got interested in barefoot running and soon started wearing barefoot shoes for walking as well as running. I caught the bug and started wearing a pair of Lems shoes several months ago as my main shoes. I generally do not do a lot of exercise. Over the last week, I did much more walking than usual and on one particular day, did much more walking than intended due to a bus not running! Yesterday, while just moving around the house, I started feeling pain at the top left of my foot as I walked, directly under my shoe strap, and I didn’t understand what it was because I had no memory of any injury there and the shoe strap had never bothered me before. My foot is slightly swollen and is tender and hurts most when I walk. I am limping. I haven’t made it to a doctor yet, but I think it’s a stress fracture.

    • Ron

      Hi Sara
      A little late to reply. It sounds like extensor tendinitis. I got it just from wearing bare foot shoes for a long period one day. As I found out later the tendons on the top of the foot become weak due to our shoes curling up in the front. When wearing the barefoot shoes the tendons are being stretched out which they aren’t used to. Add on top of that some rubbing of the elastic on the tongue area of the barefoot shoe and wallah Extensor tendinitis. You tube has some good stuff on stretching those tendons. You may have a fracture too. But I would put my money on the tendinitis.

  • Josh Bogle

    I started running barefoot (without any form of shoe) a month ago and it was fantastic until a few days ago the feeling of my foot being sore turned into pain when I touch my heel while running or walking. If I stay on my toes, there isn’t pain.

  • Jonathan Summers

    I broke my toe barefoot jogging on the beach. I feel like it was caused by a jam. It’s my second toe. It limits my movement now but I think it healed.

  • John

    Hi – I started running again 8 months ago after many years without doing much sport – I changed from a heel striker to forefoot striker and ran with normal running shoes on and off for 6 months (initial calf pain was very severe).
    I purchased Vivobarefoot shoes 2 weeks ago and attempted to transition gradually… (2min walk followed by 5min jog). I was careful not to run on consecutive days. On the third day I began to feel sharp pain commence after 5 minutes of jogging (10kph). Doctor believes it’s a hairline fracture – I haven’t been able to walk properly for 10 days… I will edit or update with results..

    • Ron Wiltse

      Hi John
      So sorry to hear about your metatarsal fracture. I heard a doctor say the bones take about a year to model to stronger muscles and activity. Bare foot running in my opinion should be a long gradual thing with rest periods of a week or two every so often. The forefoot running is the best way to go in my opinion. I fractured mine too running barefoot. To much to soon. I just run with shoes now but love wearing the VFF. I might try barefoot again but would go really slow. I am 61 so the body heals slower for me.
      Ron

  • E.A. Sullivan

    I first started cross country running from 0 previous experience at 15 with Nike Free’s and I got a 2nd metatarsal stress fracture after a few months. After I rested after that, I could run more in the Nike Frees but not so intensely and without a problem, notably without speed work and with some other cross training. Later, I got more structured shoes but I think they had a drop and I ended up hurting my knees and legs, and wishing I had my Nike Frees again, so I bought new ones. Since then it’s like, whenever I start up a more busy running routine, it’s only a matter of time before the fracture comes back. I should really be better about doing foot strengthening exercises and avoiding speed work and big hills up and down, maybe now will be my time to learn. Nike Frees are just my favorite running shoe, but I should do more walking in them to strengthen my toes and arches more. But yep, this is me!

  • Kunal Bhattacharya

    After I read this article I am convinced that proper gait in barefoot shoes are the cause of metatarsal stress fractures.
    I am diagnosed with one. I am a 33 year old underpronated runner (high arch).
    I have been running in shoes for the last 6-7 years.
    I read barefoot running cures this problem, so I ran barefoot in beaches and felt great (no pain at all) but I was afraid of going barefoot in the city.
    So I bought a pair of barefoot sandals. Tried to up my mileage by increasing 2.5KM (1.5 miles) every week.
    I was doing 17.5 Km in the last training run, no injuries at all. Finally it snapped.
    One day during a very short run after 7.7km (5 miles) I started hobbling with pain as if a stone had pierced my foot.
    I found no fault with the sole or the foot, threw away the sandals to run barefoot but the pain increased.
    Finally got diagnosed with this fracture. I don’t know how long it will take to heal I hope it is a month. Because I have got to run the marathon I was training for. Praying for the x-ray to show that it is healed by the next 30 days. Once healed I would go back to running shoes and take the posture and gait very seriously.

    • Ron Wiltse

      I heard a bone doctor say it takes about a year for bones to model/match to the increase in size or strength in the muscles. If you think about it our feet become weak by wearing shoes. Then when we go without them the the muscles and bones need to adapt to that. To much to soon is a recipe for injury. The older we get the more that needs to be addressed.

  • Kunal Bhattacharya

    Please read it as “im-proper gait in barefoot shoes”