Manual therapy and barefoot run training in the treatment of a fibular stress fracture in a marathon runner: A case report

Background: Manual therapy is a commonly used treatment modality. Its effectiveness has been described in the literature, though there is sparse evidence regarding manual therapy and lower extremity dysfunction as it pertains to distance runners. Barefoot run training has gained recent popularity and has been used in prevention of injury by improving run technique. Case description: We report the case of a 29 y.o. female who presented to physical therapy 4 weeks after diagnosis of stress fracture and 6 weeks before participating in the Chicago Marathon. After 6 weeks of manual therapy and barefoot run training, she was able to complete the Chicago Marathon in her goal time. Purpose and clinical relevance: This case demonstrates a novel treatment approach combining manual therapy and barefoot run training without cessation of running in rehabilitation of a fibular stress fracture. Correspondence to: Brett B. Clark PT, DPT, School of Medicine, Department of Anatomy and Neurobiology, University of Maryland, Baltimore, USA, E-mail: [email protected]