Runner's Foot Fracture: The Boot That Broke Her #shorts

Added: 2026-06-02

[00:00:00]Runners have a much higher price to pay for immobilization. That's part of the reason that it makes them such a terrible treatment for runners. So, to begin, I'm going to tell you a short story that will help drive home the point of how bad this can be. So, there was a patient I saw and we're going to call her Ashley. And Ashley was a young athletic patient in her late 20s who developed a case of sesamoiditis. And sesamoiditis is just inflammation and irritation to these two little bones underneath the big toe joint that are kind of like tiny little kneecaps, but she was running daily and her foot started bothering her. She developed actually not just sesamoiditis, but she eventually got a stress fracture in one of her sesamoid bones. And these little bones can be a serious problem, and so they have to be treated very aggressively. So, what happened is that Ashley didn't really respond very quickly to some of the simpler treatments, so she had to be placed in a fracture walking boot. But, unfortunately, she was on her feet all day for her job. She also walked from Telegraph Hill to downtown San Francisco and back every day to and from work. So, although she was protected and immobilized in the fracture walking boot, she was still on her foot all day.

[00:01:06]So, it actually took 8 weeks for the foot to heal. Now, keep in mind, she was in the boot all of that time. So, for 2 months, she was wearing a fracture walking boot. Now, the problem with this is that Ashley was really stiff and weak and uncoordinated after all that time in the boot. And additionally, she actually had some decrease in the bone density or the stiffness and strength of the bones in her foot just from being in the fracture walking boot for that 2-month period. Understanding all of this and knowing that she would be at high risk of re-injury, I made some custom orthotics for her to take the pressure off the sesamoid bones and support her foot as much as possible. I really wanted to make sure that she was going to be protected when she got out of the boot and started walking. So, now the next day I got a call I will never forget. So, Ashley was crying. She said, "Now, I know you told me that I should break in the orthotics gradually and that I had to slowly ramp up my activity, but it was just such a beautiful day and I'd been in the boot for so long. I just felt like I had to go for a run. So, I went to the marina and I ran 3 miles, but just before I got done, I felt this pop in my foot and it's been killing me all day. Now, it's even swollen and bruised. This obviously is not a good thing. So, when Ashley went for that short run on flat ground, even at a really slow pace, she actually broke her fourth metatarsal bone. All because her bones were weaker and she was stiffer and uncoordinated from all that time that she spent in the fracture walking boot. So, after 2 months of incarceration in the fracture walking boot, she had to actually go back into the fracture walking boot for another 6 weeks to get the metatarsal fracture to heal. Now, the problem with fracture walking boots isn't that it's a terrible treatment by itself,