Stress fracture or tendonitis?

[Syscrush]

I've got a pretty significant amount of pain/tenderness on the top of the first (i.e. big toe) metatarsus of my left foot. It hurts to bear weight, although not terribly so, and it's moderately tender to the touch. It's not swollen, discolored, or warm to the touch.

I was assuming that this is tendonitis or some similar overuse injury, but I did a bit of hunting around and from the broad range of mild symptoms I've read about, I'm wondering if there's a chance this might be a stress fracture. It seems like a stress fracture of the 1st metatarsus is uncommon - and it also seems like all of the info on this injury is coming from people selling orthotics or pads to help heal/prevent a condition that's almost impossible to diagnose.

Soooo... I'm 95% certain that I'm dealing with tendonitis here, but is there any way to rule out a stress fracture without a visit to the doctor?

And more to the point, does it matter? The treatment is just rest to let it heal and ice to ease the pain either way, right?

I'll admit it - I almost hope it's broken because that would make a great excuse for my crappy time in yesterday's GoodLife HM, but I'm not eager enough for a fracture diagnosis to actually make a trip to the doctor unless I'm pretty confident that it's necessary.


I really doubt that there's a fracture here. It doesn't hurt to have my weight on the ball of my foot (even isolating it to my big toe) but it does hurt to try to curl my toes back.

Thoughts?

[ultraslacker]

see a physio... they can tell you which it is.

if standing on the sore foot and leaning forward doesn't increase pain, then I doubt it's a fracture.

also with a fracture you should be able to pinpoint the exact spot of injury by pressing with your fingers (you'll know when you hit it!).

[eme]

see a physio... they can tell you which it is.

if standing on the sore foot and leaning forward doesn't increase pain, then I doubt it's a fracture.

also with a fracture you should be able to pinpoint the exact spot of injury by pressing with your fingers (you'll know when you hit it!).

I was able to do this when I had tendonitis in my fifth metatarsal. A bone scan ruled out a stress fracture for me (I had stress fracture like symptoms).

[ultraslacker]

but then the pain was in the tendon, not the bone, right?

[eme]

but then the pain was in the tendon, not the bone, right?

It was where the tendon was pulling on the connection point to the bone.

[Syscrush]

if standing on the sore foot and leaning forward doesn't increase pain, then I doubt it's a fracture.

I'm really thinking that way too.

Bodyweight on balls of affected foot = almost no foot pain. No load on foot at all extending toes back = plenty of pain.

Also no swelling, plus the location (that 1st metatarsal is a brute!) have me more and more convinced that this is a tendon issue.

Too bad, I was starting to look forward to telling folks that I ran a HM with a broken freaking foot! (with apologies to Kurt Angle).

[ultraslacker]

for what it's worth, I had no swelling with either of my stress fractures, but the pain/sensations were very distinct... to the point that I *knew* they were stress fractures before getting them checked.

[fe.RMT]

Bodyweight on balls of affected foot = almost no foot pain. No load on foot at all extending toes back = plenty of pain.

That screams extensor hallicis tendonitis to me. Have you had new shoes lately? Sometimes this happens from pressure to the top of the foot (i.e. shoes too tight or a new pair of shoes that hit the foot in a place it didn't used to)

[Syscrush]

That screams extensor hallicis tendonitis to me. Have you had new shoes lately? Sometimes this happens from pressure to the top of the foot (i.e. shoes too tight or a new pair of shoes that hit the foot in a place it didn't used to)

Thanks. It felt like I had my shoe too tight when it started, but I don't believe I did.

The problem started during/after my first HM in VFF's - I extend my toes a bit farther in that footwear than in any other shoe because a stubbed toe in those things SUCKS.

Anyhow, I'm gonna give it a few weeks of rest & ice, probably some NSAIDs once my stomach settles a bit, too.

[Syscrush]

This one healed up fine after 4-6 weeks or so. Almost certainly just tendonitis.