Case Study - Left 5th metatarsal pain after running

JP - Left 5th metatarsal pain after running

BACKGROUND
33 year old male, previously a rugby player (prop).
2-3 months ago started training for the NYC marathon (coming up in 2 weeks, 6-11-16)
Started getting pain 2-3 weeks ago in left foot after a long run.
Previously torn right calf (10-12 years ago) **potentially favours or puts more pressure through L foot/leg habitually because of this**

PRESENTATION
Pain (ache) usually lasts for 2-3 days but improves with rest. There is no bruising but some swelling, as well as no sudden incidence of impact or injury to the foot.

Going from a sport based on grass (low GRF, reactive surface) to one based primarily on roads (high GRF, non-reactive surface) will have huge impacts on the body. After years of conditioning the body to a sport that requires high power (primarily) to one that requires high endurance means making gradual adaptations to not only musculature, but also body mass and bone density (Wolff’s Law).

DIAGNOSIS / REASONING
Due to the nature of the injury/pain, it is indicative of a severe stress response due to the change in physical activity (surface, intensity, volume, load, etc.). If left untreated, continuing the existing exercise program may lead to this becoming a stress fracture.
 

TREATMENT PLAN
Hydrotherapy - aqua-jogging (gravity free) to maintain fitness and continue physical adaptations to running (without the impact and GRF on your bones and other tissues). Also, to prepare for the marathon in 2 weeks.