for those who love the outdoors

2 May, 2024

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BEST FOOT FORWARD - recognising and recovering from a metatarsal fracture.

A foot injury is never good news for a hill walker; but when my injury became ever more painful and prolonged, due to professional misdiagnosis and mistakes made on my part, it was hard to believe that I’d ever be tramping the trails again. Metatarsal stress fractures are quite common amongst athletes, long distance runners and hikers, so here’s hoping that other active outdoor enthusiasts can learn from my experience.

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MY LEFT FOOT (not the film!)

My left foot has never been quite the same since it got trapped in the mangled metal of a car crash nearly twenty years ago. On a long hike, the permanent ligament damage I sustained often comes back to haunt me.

So, last September, after returning from a wonderful walking holiday in Ischgl, Austria (highly recommend!) I assumed that the pain in my left foot was simply my old injury. Normally, when this happens, I ice the foot for a few days, take ibuprofen and wait for the pain to go away again. Only this time, it didn’t.

WHY ARE YOU LIMPING?

About a week later, when a friend asked, “Why are you limping?”, I hadn’t really realised that I was; foot pain was just such a regular part of my life. Over the following week, however, the pain intensified, and my limp became more pronounced.

Still believing it was nothing more than ‘my left foot syndrome’ and would disappear any day, through my ignorance (and a bit of stubbornness), I continued necking painkillers and went ahead with a pre-booked walking weekend in the Shropshire Hills. Within a mile of setting off uphill, however, every step I took sent an acute burst of pain through my left foot, I winced but kept going, dragging my left leg behind me like Captain Ahab on The Pequod .

Eventually, however, I had to admit defeat and return to the hotel. When I took my boot off, I saw just how red, hot and swollen my left foot was.

“That's much worse than usual, I think you need to see a doctor,” my husband pronounced, returning from the bar with a large bag of ice.

He was right, but we all know how hard it is to get a GP appointment these days. Plus, upon my return, I learned that my elderly mother had fallen, which then involved a series of 200-mile round trips to help her out – I don’t have an automatic car, so painkillers were needed just to allow me to press the clutch!

“BUT I’M NOT HENRY THE VIII!”

It was another 3 weeks before I eventually saw a GP. I told her how I’d gone from climbing Ben Nevis to barely managing to walk around the supermarket without limping in pain. She took one look at my swollen, discoloured left foot and pronounced – You’ve got gout!”

My initial response was, But how can I have gout? I’m not Henry VIII!” He was the only person I knew of who had suffered from gout.

It happens to some post-menopausal women,” she replied nonchalantly, starting to write out my prescription.

Gout medicine is no run-of-the-mill medication; I realised this when the pharmacist said he’d ring me to check I was alright.

That evening, I spent many hours with Dr Google, and it soon became apparent that my symptoms were a much better match for a metatarsal stress fracture

  1. pain and swelling on top of the foot or outside of the ankle
  2. tender to the touch at the site of the fracture
  3. the foot is usually red and swollen and may show some bruising
  4. pain that worsens with exercise and even walking and everyday activities may be painful
  5. difficulty putting toes flat on the ground

Although I had my doubts about the gout diagnosis, I dutifully took the ‘dangerous’ medicine for five days.

Of course, there was no improvement whatsoever because I didn’t have gout!

So, I made an appointment with a podiatrist this time; I figured that if they examine hundreds of feet a week, they’ve surely seen every foot condition under the sun. This time, when she saw my foot, she gasped, “How have you been walking around on this for the past six weeks?”

“With difficulty and a great deal of pain!

You’ve got a stress fracture in metatarsals 2 and 3.

“So, it’s not gout?”

No! You need to go to the hospital and get an x-ray. Today.

‘IT’S DEFINITELY FRACTURED’

At the x-ray clinic, the radiologist confirmed, “Yes, it’s definitely a fracture, but it’s already 70% healed. You should’ve rested it at the start, I’d normally give you a protective boot and crutches to take the weight off, but it’s a bit late for that now.”

Not particularly helpful! Evidently, a stress fracture can be so tiny (yet still incredibly painful!) that it may not be visible on an x-ray until it starts to heal. So, even if I had been sent for an x-ray at the start, it may not have shown up; although my symptoms and hiking history should’ve been enough to diagnose a stress fracture.

Now that I knew exactly what was wrong with my foot, I clicked on Amazon and purchased a ‘metatarsal compression sleeve’ – big mistake! On my first trial walk, the foot was fine to begin with but then pain returned with a vengeance forcing me to limp back to the car. I hadn’t realised that the compressions sleeve had made the front of my foot go numb and when I removed it, the blood came rushing back, causing indescribable pain!

It felt like a huge step backwards. Would I ever be able to do a long hike again?

SUCCESS AT LAST!

Disappointed and despondent, I returned to ‘the hiker’s best friend’- my podiatrist - who gave me sympathy, exercises to speed-up my recovery and some orthotic insoles to reposition my left foot.

After weeks of agony, limping and a ridiculous number of painkillers, I am wearing the insoles in my Meindl ‘Comfort Fit’ walking boots and steadily building my mileage back up.

It’s only now that I’m able to hike again, I realise how the pain and limitations of the injury had affected my wellbeing. I’m usually an optimist, but when pain is your constant companion and you can’t do the activity you love, it’s hard to remain upbeat and I’d been getting grumpier by the day.

I still experience some discomfort in my left foot, I’ll probably never be completely pain free, but it’s manageable. I’m hoping that by the summer, I’ll be back up to 10-12 mile hikes and my eventual aim is to complete a long-distance path like The Dales Way.

LESSONS LEARNED

  • Don’t ignore post-hike/run foot pain that doesn’t disappear in a couple of days, a stress fracture can creep up on you over days or even weeks.
  • Implement RICE immediately – Rest
  • Ice
  • Compression
  • Elevation
  • Insist on an x-ray if pain and swelling persist.
  • Don’t be stubborn (like me!) and continue with the activity that caused it.
  • TAKE IT EASY – stress fractures often occur when the level of high-impact activity is suddenly increased, I went from a couple of hikes a week to hiking every day on rough Alpine terrain.
  • Don’t think that Amazon always has the answer - SEEK PROFESSIONAL ADVICE



Tracey Calnan

National Outdoor Expo

Whether on two legs or two wheels, I am never happier than when I am outdoors and active! Although of a certain vintage when my body sometimes protests, my heart says 'you're never too old for adventure, carry on!'

Speed may no longer be my default setting but stamina (or stubbornness?) often prevails and the hills are still calling my name...

More articles from Tracey Calnan

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