Can I run with Hardware On board?

I got a great question from Vitor about his hardware, the message is:

"Hello,

I had ankle surgery about a year ago following a motorcycle accident, and got a metal plate and some screws (don't know how many exactly). I used to run before the accident and surgery, but I only ran twice recently and stopped because I was afraid I might be doing something that might damage the bone because of screws and plate being there, although I didn't actually feel any pain while running. I've just imagined the screws damaging the bones with the running impact and stopped running. In a month I will have surgery to remove these metal plate and screws. Do you think I should wait until after the plate removal surgery to run?

Thank you very much!"

I responded:

Vitor, this is a really great question. When you have open reduction internal fixation (ORIF) the metal plates and screws serve as "stress risers" in the bone, which means that the bone is having to attenuate more force around the screws than they otherwise would have to if the screws were not there. Ultimately, these stress risers lead to local fractures. Additionally, the plates prevent the bones from flexing, bending and twisting. These are natural actions of the skeleton during the gait cycle especially during running activities which increases the impact loading over walking quite dramatically. The consequence of this is that other stress risers will also develop as the bone responds to the new stresses in new locations, and the result, you guessed it, fractures.

So the long and short of it is this, get the hardware removed, and then allow at least 6 if not 12 weeks to pass before you run again in order the bone to fill the screw holes. ORIF is unfriendly to runners!

Hope this helps,

Neil