Stress Fracture - My cautionary story to others

Hi - I'm not sure if anyone remembers me.  I used to post on here alot.  I'm 29, female, and very active - well, was very active... I was part of the RATW thread.  I was (am) an avid distance runner and used to log 40-50 miles a week.  I've done half marathons and love running more than I can explain to people unless they're distance runners as well. 

A little over a year ago I was advised to cut back on my weekly mileage when I started shedding weight and couldn't stay at a healthy minimum weight no matter what I tried.  So I cut back to 30-40 miles a week (hey - I tried...) and put on a few pounds (a good thing).  Then I started having all sorts of problems - muscle pains I never had before, knee pain & clicking....  I ended up pounding so hard on my feet because of all these other issues that I developed edema in the bone marrow of 3 of my toes.  So I took a few days off until the pain subsided enough for me to run again - I never let any of the issues or pains heal fully though. 

Then in mid-November my worst nightmare happened.  I had been having a nagging pain in the front of my left thigh that was getting progressively worse and intermittent pain on the outside of my hip.  The doctor said it was a muscle strain, ice it, yada yada yada, I'd heard it all before.  Then the following week I was on the treadmill and all at one I experienced an extremely sharp and debilitating pain in my left hip area.  It was so bad that my knee gave out and I stumbled.  I was able to right myself and thankfully didn't fly off the back.  I figured it was just the muscle thing and I could run through it, but after about 20 seconds it was clear that I COULD NOT run through this one.  I hobbled to the locker room and cried for about an hour because of the pain and also because I knew this was an injury that was going to put me out for a while.

I went to the doctor, got tons of pain medication & an MRI that showed I had a stress fracture of my hip (actually of the femural head, but its commonly referred to as a hip stress fracture). 

I couldn't walk for 2 weeks.  Then I limped, barely able to put any pressure on my left side for another 5 weeks.  At about the 7th week I was finally able to walk without an extremely visible limp.  Its now been 10 weeks since my injury & I'm still in pain.  It hurts when I get up and take my first step every single time.  Last week I finally was able to start trying to work out.  The advice from both my doctors on what exercises to do - If it hurts don't do it...yeah, thanks alot.  I can sort of handle the bike or elliptical and can finally do yoga.  But I still can't do anything that involves impact because it still hurts so bad when my foot comes down and the weight transfers to that hip.  I can't even walk on the treadmill unless its extremely slow.  It kills me watching other people run while I wonder if I'll ever be able to run 8 or 9 miles again... or even 5 miles..or 2...

So, moral of the story - PLEASE listen to your body.  I knew deep down that I should be doing more cross training and strength work, but I love running so I always found a reason to run instead of doing anything else.  And I continually shoved the thoughts that I wasn't training properly to the back of my mind.  I never let my injuries fully heal, only enough so that I could get back to running.  And people were always telling me I'd end up weriously hurt and owuld be sorry but I thought something like this could never happen to me because I was so fit and athletic.  I was very, very wrong. 

Hi! I'm new to CC, but I was excited to see other crazy runners on here.  The stress fracture thing caught my eye - I have had 2 (one in my tibia, the second time two bones in my foot).  Anyways, I'm trying to figure out how to balance adequate nutrition for marathon training and losing weight.  I am 5'9" and weigh 158 lbs.  I think that I would be less prone to injury if I weighed around 145 (plus I'd look a hell of a lot better in a bikini...)  So my primary goal right now is to lose weight, but I want to be able to do at least 30 miles a week, including a long run.  I almost passed out yesterday just doing 10 miles, in spite of having some GU after 6.5.  Any suggestions? 

I have actually had two stress fractures also, with my first one being the upper femur.  Sorry to say, it took over 6 months before I walked normal again, and even then I suffered to get back to running.  That was a couple of years ago after the NYC marathon.  I am about 2 months recovered since my last fracture, which was my tibia.  Go see a specialist, my recovery and program this time well exceeded my expectations.  My sports medicine doctor also discovered why I had a pattern of stress fractures, other than overtraining!  ( vitamin D and leg length.)  Good luck on your recovery!

I've just recently started to run regularly after a month-long "break", and have noticed a small, sharp pain in my right ankle. It doesn't hurt while I run, but a few hours later I can barely walk. I took a few days off, and it felt better, but today I just noticed the pain has come back. I don't know how serious it is, but you have definitely given me a wake-up call!

Original Post by pdxsunshine:

 I had a pattern of stress fractures, other than overtraining!  ( vitamin D and leg length.) 

 I have other risk factors than just overtraining as well.  Leg length is one of them.  The others have to do with how small I am and the fact that my body fat tends to get very low when I'm training and in turn I lose my periods...so my bone density isn't horrible, but isn't what a 29 year old's should be.

Thanks for the advice about the sports medicine doctor.  I have a repeat MRI soon to see whats going on so if there's still a lot of healing to be done I'll ask for a referral for one.

Anyone care to explain how leg length increases risk of stress fracture? 

Original Post by chirpp:

Anyone care to explain how leg length increases risk of stress fracture? 

 Having one leg longer throws your body off and puts more impact and pressure on one side of your body.  Over time, with repetitive, high impact exercise it takes its toll on that side and leads to injury.

I hope all of you start a serious diet and weight training program.  You need to gain muscle to help with bone density and increased muscle will decrease the stress on your bones. 

Original Post by agana:

I hope all of you start a serious diet and weight training program.  You need to gain muscle to help with bone density and increased muscle will decrease the stress on your bones. 

 Agana is right about the strength training and I am currently working on that more than cardio.  I need to build up the muscles so that when I do start doing more intense cardio I have strong muscles to keep me safe and injury free. 

I always was pretty good about my diet and always took supplements like a multivitamin & calcium on top of all the calcium rich foods I ate.

Oh.... that makes sense with the uneven legs... I was thinking something along the lines that short-legged people are more/less at risk or stress fractures... your explanation makes much more sense. 

But, agana is spot on with her calcium/strength suggestions!

Hi,

2 years ago I had a tibia stress fracture go to a full fracture! The pain was the worst of my life.  I just kept running initially because it went away after 40 minutes and I figured I just needed to warm up more!

I was out of running for 11 months - because the tibia bone does not get much blood flow so it is one of the slowest healing bones.

I biked and rowed by way to keep my cardio health and worked with a trainer on finding my weak accessory muscles, etc.

Now, I have RULES -

1. try not to run on consecutive days + stretch at end of run (usually about 4X per week with mileage @ 30 miles per week)  and on off days do bike, row, stairmaster, but basically no impact and I do HIIT.

2. run on trails predominantly or asphalt but stay away from concrete

3. strength training 3X per week

If your body hurts - it is telling you something. Listen.  Health is having the proper nutrition, proper rest, proper cardio and proper strength for you to have a happy life.

Ouch. Minie13 is VERY right about listening to our bodies, and very right about how many of us -- especially athletes -- tend to rationalize the pain instead of really looking at it. I'm trying to correct serious issues at the insertion between my back quads and my glutes. Not pretty. But at least they still let me run.

The only thing to add to this thread, since most of it has been said already, is impact over time. I've been strength training, running and running distance since I was 20. When I was younger I could run 4-5 times a week coupled with a nightly strength training session without a problem. At 41 and counting, I realize that my body simply doesn't handle the impact as well anymore. I still run between 25-50 miles a week but don't run more than 3 times max.

One more thing, especially for you younger athletes. Let the injuries heal FULLY. I know it's tough to take 3 weeks or more off, but please trust me when I tell you that the old injuries will come back to haunt you if you're not careful. At best in the form of aches and pains when it is humid or cold. At worst in the form of long-term injuries or issues.

:) Thanks Minnie13 for the post. And best of luck to you.

i stress fractured my femur and tibia from the long distance running and it was very painful.  i was able to do spin and the elliptical (on the pain meds) shortly after though.  i did body pump class without weights on the legs.

anyway after it healed i was able to distance run again...  hang in there!

i took fosamax (sp) and did strength training and my bone density improved somewhat.

I have just stumbled across this thread, and have read the posts with great interest.

Scaroppo, I am nearly 40 and was particularly interested in your post, with us being similar ages.   I guess I run on average 4 times a week, two long runs of about 8-10 miles and two shorter runs of about 5-7 miles or thereabouts.  I am a treadmill runner by the way, not an out door runner.

In between my runs I cross train using the elliptical and I do hill power-walking, and also do strength/resistance work 2 or 3 times a week, using both fixed weights and machines.  I like to mix things up alot with my resistance training instead of just using the same old machines.

Would you (or anyone else who cares to read my post!) say that my routine was acceptable at my age?

Just to add, I workout 6 days a week for 1.25 - 1.5 hours each time, am 5 ft 4" tall and weight 8 stones (about 51kg).

Thanks for any advice!

I am 38 and waycat i think you have a great workout going.  i did my cardio 5-6x a week only bc i loved running.  and bodypump 3x a week. my gym closed and i am only doing cardio currently.

the stregth training and spin i did helped my fitness though!!

sounds to me like your in great stregth.  i think i developed stress fractures bc i never drank milk!!  or took vit d in combo with 50+ mile weeks.

good luck to you.

Thanks for  the reply, sfredbull.  I can see that lack of calcium would certainly be an issue where bone strength is concerned. 

I am lactose intolerant, but get my calcium from other sources - plus, soya milk and yoghurts all have added calcium, so that's OK. 

50 miles a week!  Phew!  That's alot!  I take it you have cut down now to something more manageable?

Thanks again!

I don't know what 50 miles is in kilometers - I'm from Australia we go by kilometers.

But good post. I started running this year but got serious about it for the races. For me the long distance gave a huge adrenaline rush but the racing even more.  I was already doing fitness/exercise stuff at the gym classes like Body Attack, Body Pump, RPM, cycle but just running on the treadmill prior to starting any classes that probably was 8-10 kilometers each week. Then when I got more focused on running a suddenly jumped my weekly milage to almost 35 kilometers. So that on top of 3 body attack classes a week - the cycle and RPM ok but the amount of running + those attack classes was too much of an increase. 

First I quickly started getting major calf cramping which I continued to run through, then pain/cramping/tightness up the side of my legs that was worse than the calf cramps. I started taping/banaged which sort of helped then stopped so I quit taping up my legs and just like that was running pain free again except my R foot going numb. I got the cramping again all through my left leg and kept running through at by 5km I HAD to stop I couldn't put weight on it for a while and felt pain when I pressed on the bone not even less than a week later I did the same thing with the right leg and started getting pain if I pressed on the bone (tibia). At that point I had almost no muscular pain just feeling pain through the bone (tibia) when running + took pain killers.

Saw a sports dr at first thought compartment sydrome but had bone scan and have EARLY stress fractures left and right tibia + said the whole bone (L & R) is under a lot of stress. Sucks, I really really wanted to get fit and strong enough to do a half marathon October this year but since my sport dr says no running till July and then need to have him rehab me ... Some good has come from it though, like a getting a road bike for my birthday soon, probably joining triathlon club (already made contact)

What I've learnt is and when I get back to running cross train is V. important and agree with the not running on consecutive days. Also started taking calcium and vitamin D tablets. I eat well (carbs, protein, good fats) but kind of neglect the calcium part. Also been told it's important to complement fitness with strength, obviously not bulking up ... this coming from  PT's (one who has and still does a lot of long distance running)

runner_au, you have been through it haven't you?

Thanks for taking the time to reply to my post and for the insight into your problems and injuries. 

Occassionally I worry about the amount of running I do, but then I remind myself that I do cross-train aswell, which I have come to realise is a good thing, even if I don't quite get the same "high" on the elliptical or power-walking as I get from a good run.

I guess it's a case of being sensible and thinking of the long term future.  What may seem a good idea now could possibly put me off my feet completely years down the line.  And with two teenage boys and a house and job to hold down, I can't afford to be laid up with a serious injury.

minie13,

I was so glad to see your post. I have searched for the last few weeks for some information regarding the recovery process for a hip stress fracture. It just seems so strange to me, because I am only 36. All the imformation I find for recovery is so vague.

My stress fracture was a build up, like yours, I ignored it thinking it was muscles. I continued to run through it until I couldn't, which was about mile 9 of a half marathon. I walked the remaining 4 miles. I finished, but couldn't walk at all after I crossed the finish line.  I have been on crutches for almost 6 weeks now. I went for a check up at about week 5, and he has me continuing to rest. Still on crutches with toe touch only. I guess the bone is not healing as quickly as he would have liked. I was suppose to be able to swim and stationary bike by now, but he said i still need to wait. It has been so frustrating. To hear that it took you 10 weeks to walk without a visable limp, is also encouraging. I would like to think that I could walk in the next few weeks, even with a limp. I am just so tired of these crutches. I go back at week 9 in hopes that he will say I can apply weight to that leg.

I completely understand what you mean about loving to run. It kills me to see people running. Especially since had to give up my spot on a running team for a 176 mile relay across a Colorado mountain range. All I hear from my friends is about the training. I love to encourage them and hear about the training runs, but it kills me just the same. I remind them now to listen to their body, strength train, swim, bike, take quality vitamins, eat right and rest.

I see it has been ablout 6 months since your last post. I am wondering how you are doing now. I can't wait to get back to my workouts, and right now I'll take workout I can get, I am just waiting for the doctor to give me the word.  

Hi pegi sounds like you sf is worse than mine - (I was told early sf for me). Today is exactly 5 weeks since I last attempted to run --- I say attempted b/c it took my at least 4-5km before I was able to suck up the pain and finish the run.

It's good to see how other do with their sf. Just comparing helps b/c I feel like I could start rebhab process sooner than expected d/t no pain with all acitivities that previously caused pain, just still tender to touch the bone which makes me think my fracture has healed. Hope your sf starts to heal soon!

Hi everyone - I'm back with an update.  I was cleared to exercise (low impact only) in the beginning of March.  I gradually went from the bike to the stairmaster & elliptical, and finally to the treadmill by the end of March/beginning of April.  Its been extremely hard to get back in running condition, having gained weight and not exercised for so long.  I had built myself slowly up to 5 miles 2-3 times per week (I used to think that amount was so pathetic and a waste of time to run so little). I started having problems again after about a month - really severe lower back pain that started to radiate in a circular type pattern that wrapped around the front to my knee- YIKES! Thats how the pain started last time.  So I stopped and went to the doctor.  They told me it was probably just my body adjusting and give myself 4-5 days between runs and to be extra viligant in paying attention to my pains.  So I did that and the pain subsided, so I started building again (with permission). 

That brings me to the beginning of this week.  I still could only run 3-4 miles 3-4 days a week or the pain was pretty bad.  Then wednesday something happened... I'm not sure what, but definitely something.  I got x-rays on thursday and am scheduled for the MRI next week.  The theory is that the crack is worsening again...  I'm not sure why this fracture was so different that others and is not healing properly, and neither are the doctors for that matter.  I'm mostly just able to do strength stuff at this point and then only arms and abs/back - no legs.  I can't even walk slowly on the treadmill without moderate pain. 

So anyway thats my update.  One of these days I'm going to come on here and be able to post a positive update, I promise.