Saturday, September 5, 2015

Cuboid Stress Fracture

So I have alluded to the fact that I'm injured. Its true. #Noinjury2015 was short-lived. Or half-lived. Mostly lived?

(PB - never.gets.old.)

After I ran Gold Coast Half, I had some foot pain in both feet. It lasted only a couple of days, and I felt nothing after I took a full week off exercise. I then proceeded to run for two weeks at around 24-24 miles each week. All easy miles.

The only thing I did differently was try to break in my new trail runners, which I attempted to do intelligently: short runs, and using my trusty Mizunos for every second run. Admittedly, my new shoes were not very cushiony, and I didnt use my ordinary insoles. But I reasoned that my other measures were sufficiently cautious.  

The Monday before the hike, I ran an an easy 6-miler (after two full days off hanging out in Melbourne!) and pulled up with some pain in my left foot. It felt suspiciously familiar. Like, really familiar. Like, I told my husband that it felt the same as when I had my cuboid SFx in the other foot.

But you know, I had a hike in Italy to do. I rested until the hike, and figured that if it was soft tissue it would be ok in a few days. If it was bone-related, hiking wouldnt be toooo bad because walking is a much lower-impact activity than running.

So. Turns out that neither of those calculations took into account (1) the mostly vertical nature of the hike, nor (2) that I would get reasonably competitive with several of my colleagues and race them up some of the mountains.  Basically, I didnt factor in my own wilful ignorance and incorrigible ego. Mum and Dad, aren't you so proud?

After returning from the hike, my doctor said none of this story "sounded" stress fracturey (totes a medical term). And I was negative on all the bone manipulation tests, (which is a fancy way of saying they poke your foot until finding the bit that hurts, and then poke it as hard as possible). 

But given my history, and my type A-MUST IMMEDIATELY KNOW WHAT IS WRONG WITH ME personality, the kind doc gave me a script for an MRI. 

A few days later at 9:30pm (because he is unfortunately all too aware of my need to know thing) the doc emails me my MRI result. 

A cuboid effing stress fracture. Thats right. Another one. In my left foot this time. Almost exactly the same place.

Here they both are in all their weak-ass, stress fractured glory:
Harden the eff up, cuboids.
My doctor couldnt quite believe it. This injury is really uncommon. Last time he was so excited about seeing it (once) he was going to write it up in a medical journal. Heaven knows what he'll want to do with this one ... a travelling circus? In any event, Im trying to convince him that I should get some sort of medal and/or serious discount for being such an exciting sports-med patient.  

Frankly, the most frustrating thing about this injury is how difficult it is to pinpoint the causes of it. If only there were a medical practitioner whose practice was exclusively devoted to the cuboid bones! In my completely non-medical opinion, it seems to be a weird area of the foot to be landing on as an over-pronator. Its possible my shoes/insoles suck (and yet I ran many 50+ mile weeks in my Mizunos with no problems). Or my training sucks (I was running half my usual mileage - all easy -  after a full week off!) Or my bone density sucks (low-normal as a lovely gift from my eating disorder days - but not too bad for the most part). With my other injuries, I can point directly to mileage/speed increases, or nutrition problems that appear obvious with a bit of hindsight. But here, nada.

Because no single factor looks like the primary culprit, my doctor wants to get me a blood test for Celiac disease. Celiac can apparently prevent one's body from absorbing calcium and other nutrients. Sounds a little hippy dippy to me, and heaven knows I reeeeeally dont want to have to have to join the "gluten free" crowd, but Im kind of tempted to try it out, if only to get some answers. 

Whatever the reason, it could be worse. It was diagnosed quickly, and its a very small crack. I narrowly avoided having to wear a boot, and I only have another two weeks off it until I can try running. I am able to lift weights and cross train (though my motivation to do either is at an all-time low - which Im fine with).  

And going forward, maybe Im just gunna have to be a low-mileage (gasp!!) runner..?


  1. No way! I can't believe it! So sorry! What could be the cause? I almost wonder if there is some non-running related injury from a long time ago (Jumping a far distance? Like off a roof?) that damaged both, and you only recently felt the weak area.
    I am a pretty low-mileage runner myself, and despite the two hip surgeries, I actually haven't been injured much at all. Just those two hips, with all the associated misdiagnoses and associated injuries that went with it. Oh, and I had a stress reaction in my tibia as a new runner, but of course by the time I went in to see the doctor it had healed by rest (duh). Otherwise, no real overuse injuries, so I'm sure low mileage can be protective, if a klutz like me can stay rather healthy.
    Crossing my fingers you don't need to go gluten-free. And that your bones get strong again.

  2. PS. I recommend Bone Up by Jarrow for supplementation. It's in an easily absorbed formula/

    1. Thanks Gracie - I'll see if they have this in Aus.

      I guess it could be acute... there is no doubt Im clumsy enough. Just seems like it might've made an appearance before now?

      The other thing is rethinking/relearning what constitutes "low-mileage". I used to think 50 miles per week was low mileage. I'm trying to get into the mindset of understanding that that is a LOT, and truly low mileage (for a hobby runner) is something more in the order of 20-40. Maybe 30ish?

      xx Penny


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