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Running with a toe fracture. Is it safe?

Below you will see an x-ray of a 5th toe fracture (the pinky toe for those who don’t know how to count toes!!). It’s the most common fractured toe in the foot. Typically it gets “caught” on the corner of a table, chair leg, or bed and fractures at the base of the toe. The bone that breaks is usually the proximal phalanx which is seen in images that follow. I chose to blog about this because a common question from the patient is “why does my foot hurt, if I broke my toe?”.

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In this particular example, for which I have provided radiographs, the patient was concerned because her toe was fractured, but she had pain in the area of her forefoot which she didn’t consider her toe. If you look at the anatomy of the 5th toe, the first bone (proximal phalanx), is actually part of the foot, and the joint that connects the toe to the foot is before the actual “toe”. When looking at the foot, it would appear the foot is fractured not the toe. Looking at the pictures below, you can see the fractured bone is actually part of the toe.

fracture akron podiatrist 1fracture akron podiatrist 3fracture akron podiatrist 2

Should you still run with a fracture like this? Any fracture takes 6-8 weeks to heal from a physiologic standpoint. With 5th toe fractures, they typically heal quickly without much immobilization. In fact buddy taping the toe to the fourth toe will serve as a splint in conjunction with a cushioned shoe. I usually advise 2 to 3 weeks off of running with a mild fracture like this and will gauge the return based in the patients symptoms and a second set of X-rays. If pain is still present I do not progress them back to running.

So can you run with a toe fracture? Obviously the decision needs to be made by a physician. Other factors can play a role in the decision making such as displacement, joint involvement, and which toe is fractured. Before making running on a fractured toe, consult your physician.

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