curriespencer,
Pain on the top of the 5th metatarsal with running can sometimes be caused by upward movement of the outside of the foot. This can happen due to a forefoot varus alignment which causes greater pronation of the forefoot dropping the inside, and pushing the outside up. Of course there is a lot of shoe interplay here either helping or hurting this process. Sometimes a simple metatarsal pad can be used to support the forefoot before getting into more involved orthosis. As always, review your training progressions to look for errors in over-enthusiasm. Rest will help and I hope you are down the road soon!
Cheers,
Pete

Hi curriespencer,

Maybe this has already (apparently, at least) healed for you. I hope so. After having same symptoms for some weeks, I had some troubles recognizing it at first attemps with professional advice. It’s been around 10 months and I am still recovering, even using regular shoes. Pain is almost gone but it rebounds quickly if I don’t take enough care. In the process I have learned a lot:

– Take care of your load, don’t accumulate too much suddenly. If so, avoid too much running on hard surfaces/shoes. (Maybe here Hoka One One, stability and cushioned running shoes can help: Arahi for road, Speedgoat for trail).
– Now, cushion is your friend. Even in your daily life.
– Maybe you are going to need some custom insoles.
– Apply loads slowly: try some 20-minute easy run and take 2 days to evaluate pain.
– If you can’t run, you still can do some bike (as you do). Maybe you can walk uphill (tradmill too), and even do some elliptical bike.
– Warm/cold contrasts can help, done daily. NSAIDs too.
– Do not walk barefoot, nothing, even at home. Seems like not, but it can even fracture the stressed bone.
– Corticoid infiltrations can even worsen this situation, as they get the fat surrounding your 5th metatarsal bone reduced, eliminating the “natural cushioning” of your foot.

Maybe it is a good time to go to a good chiropodist, specialized in running if possible.