From the Research
Running with a stable asymptomatic nonunion after a Lapidus procedure is generally not recommended without clearance from your orthopedic surgeon or podiatrist. While some patients with stable asymptomatic nonunions can eventually return to running, this should only be done after a thorough clinical evaluation confirms that the nonunion is truly stable and not causing any problems 1. Your surgeon will need to assess your specific situation through physical examination and imaging studies like X-rays or CT scans. The decision depends on several factors including the location and extent of the nonunion, your pain levels, joint stability, and overall foot function.
Running places significant stress on the first metatarsocuneiform joint (where the Lapidus procedure is performed), with forces up to 2-3 times body weight. Even a stable nonunion may deteriorate with these repetitive high-impact forces, potentially leading to pain, progressive deformity, or arthritis. If your surgeon does clear you for running, a gradual return protocol is essential, starting with walking, then progressing to walk/jog intervals, and slowly building distance and intensity while monitoring for any pain or swelling. It's also important to note that nonunion of the first MTC joint occurred in 10.3% of patients in one study, but only 1 foot was symptomatic requiring revision 1.
Some key considerations for returning to running after a Lapidus procedure include:
- The stability of the nonunion
- The presence of any symptoms such as pain or swelling
- The overall function of the foot and ankle
- The potential risks of further injury or complications. A study from 2015 found that the modified Lapidus procedure with rigid cross screw fixation, meticulous joint preparation, and shear-strain-relieved calcaneal bone graft resulted in a union rate of 97.3% 2. However, this does not necessarily mean that running is safe for all patients with a stable asymptomatic nonunion.
Ultimately, the decision to return to running after a Lapidus procedure should be made on a case-by-case basis, taking into account the individual patient's specific situation and the potential risks and benefits of running. It's essential to prioritize morbidity, mortality, and quality of life when making this decision, and to carefully weigh the potential risks of further injury or complications against the potential benefits of returning to running.