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Femoral Neck Stress Fracture

 

   


elastigirl

Jun 1, 13 19:07

Post #1 of 20 (3511 views)
Femoral Neck Stress Fracture Quote | Reply

My left leg suddenly and mysteriously "locked up" halfway through my fourth marathon. I was shocked to find out from the MRI that I have a femoral neck stress fracture. I found a couple old threads on this injury but it appears relatively rare. It is on the compression side. Any athletes out there dealing with/successfully healed a FNSF? Right now all I can do is swim (and the doc only wants me pulling with a buoy).
Ugh.
***************************************
"You're the fastest of the slow people" ~ my son


tigerchik

Jun 1, 13 19:10

Post #2 of 20 (3504 views)
Re: Femoral Neck Stress Fracture [elastigirl] [In reply to] Quote | Reply

Sorry to hear.
Get lots of calcium.
_________________________________________
HOL-LAND! HOL-LAND! HOL-LAND!
PM for blog accesshttp://www.tigerchik2.wordpress.com"]


YTZ

Jun 1, 13 19:17

Post #3 of 20 (3494 views)
Re: Femoral Neck Stress Fracture [elastigirl] [In reply to] Quote | Reply

be very careful, you may want to be non weight bearing on crutches for awhile. this is one injury you do not want to mess with. let it heal and do not run until there is evidence by xray that it is healing...surgery to correct a broken femoral head may end competitive running so be careful! 6-10 weeks of recovery!


venge

Jun 1, 13 19:50

Post #4 of 20 (3476 views)
Re: Femoral Neck Stress Fracture [elastigirl] [In reply to] Quote | Reply

I broke my femur in 2 places last May. Broke it mid way down, and broke the ball off. After some titanium rods and bolts I was back to running in about 6 months. Listen to the docs, but also push yourself a little and listen to your body.


tridana

Jun 1, 13 19:58

Post #5 of 20 (3467 views)
Re: Femoral Neck Stress Fracture [elastigirl] [In reply to] Quote | Reply

So sorry to hear of your diagnosis. It can be a long road and one that you only want to be on once!

In general, if there was a stress fracture to get, the compression side (medial) is 'better' relative to the tension side (lateral). Follow the weight bearing and impact instructions from your physician to the letter. This can be frustrating, but in my experience the people that don't heal, return to impact or load bearing activity too quickly. I have had a patient go from a femoral neck stress fracture to a pubic rami stress fracture needing a bone stimulator (I can hear y'all snickering!) just because she refused to lay off. It was months longer rehab simply because she wanted to push.

Based on your ST name I am assuming you are female. This next part is easy to dismiss, but I would highly recommend additional work-up to ensure there is no evidence of osteoporosis. Stress fractures in female athletes are often a symptoms of larger dietary or metabolic changes. I would encourage you to ensure you know exactly what caused this and not just chalk it up to 'running a lot'. How is your diet? Your cycle? Iron levels? Vit D levels? Calcium? If all of these are truly fine as you are weaning back into activity ensure you have a good rehab team (Ortho, PT, DC, etc) that will appropriately balance your strengthening and analyze your gait during running, jogging and walking.

Good luck. The time to take to heal it NOW will be well worth it. Do it right the first time - pushing now is likely only to delay healing.
________________________________________________
Don't Just Live, Thrive!
Thrive Kinematics Physical Therapy - http://www.facebook.com/...8178667572974?ref=hl


Dnowak

Jun 1, 13 20:12

Post #6 of 20 (3456 views)
Re: Femoral Neck Stress Fracture [elastigirl] [In reply to] Quote | Reply

I am an orthopod sports medicine specialist, but don't take this as official advise as I have not examined you in person and don't know your history.

If you don't let it heal, you WILL need surgery and it may never be the same again.  It sucks, but you have to rest it.  If you rest it properly, it should be the same when healed.  Definitely should be on crutches.   After a few weeks, cycling on a trainer typically is allowed, discuss that with your orthopod..  Swim with buoy for first few weeks is safer than kicking.   Again, this is serious if you don't let it heal right.

Make sure you are getting enough Vit D and.Calcium.  Depending on your age, you maybe should get a bone density exam.   I'd also recommend getting a Vit D blood test, many are deficient and don't know it.  You need to find out why this happened.  Is it metabolic, dietary deficiency, or simple training errors.

Good luck!

Doug
----------
Doug Nowak, MD
Orthopedic Surgeon, Sports Medicine Specialist
http://www.everettboneandjoint.com/nowak.html


tigerchik

Jun 1, 13 20:17

Post #7 of 20 (3449 views)
Re: Femoral Neck Stress Fracture [IronDoc947] [In reply to] Quote | Reply

not a doctor but an NTX study can measure calcium excretion. Simple urine sample needed.
_________________________________________
HOL-LAND! HOL-LAND! HOL-LAND!
PM for blog accesshttp://www.tigerchik2.wordpress.com"]


maggieru

Jun 2, 13 7:19

Post #8 of 20 (3362 views)
Re: Femoral Neck Stress Fracture [elastigirl] [In reply to] Quote | Reply

So sorry to hear that - good luck in your recovery!

I had two femoral stress fractures (one in each leg) 6 years ago and am now 100% recovered, no lingering issues - BUT I was extremely diligent about listening to my doctor. Crutches for two months (worst two months of my life... in college, without a car, so had to crutch to all my classes) and huge emphasis on getting calcium, right nutrients, etc. Definitely do whatever your doctor says and then some if you're serious about making the recovery stick. I just spent all my workouts swimming and then biking once cleared for that... definitely not worth it to come back a few weeks earlier.

I was also playing college sports at the time so was mandated to go to nutritional counseling - which wasn't anything earth-shattering but helped my recovery and ongoing prevention - I would recommend just checking in with a nutritionist if that's an option.

Haven't had any other follow-up issues even as increasing volume for triathlon but am extremely careful about any potential niggles - e.g. went to the doc for an IT band issue, just to rule out potential stress fracture.

Good luck!!

-----------
@maggieru || Rusch Racing


TriScott

Jun 2, 13 7:30

Post #9 of 20 (3354 views)
Re: Femoral Neck Stress Fracture [elastigirl] [In reply to] Quote | Reply

elastigirl wrote:
My left leg suddenly and mysteriously "locked up" halfway through my fourth marathon. I was shocked to find out from the MRI that I have a femoral neck stress fracture. I found a couple old threads on this injury but it appears relatively rare. It is on the compression side. Any athletes out there dealing with/successfully healed a FNSF? Right now all I can do is swim (and the doc only wants me pulling with a buoy).
Ugh.

Sorry to hear about your injury. I had a femoral neck stress fracture several years ago. In general, do what other folks have said, and follow what the Dr. and PT say. You will be able to come back, but don't push it too hard.

They had me on crutches for 6 weeks and I didn't get in the pool for a month. Then it was with a pull buoy. For a long time after that I was supposed to stay away from breastroke kicking.

In PT they had me start building the lateral strength in my hips. I took it easy when I came back to running and had a gate analysis to make sure there wasn't anything mechanically wrong. I have since upped my calcium and Vitamin D intake as it turns out my bone density was on the low side of normal.

For me I took the rest of the season off (the injury happened at the end of July) and came back the next season.

Good Luck.
-- Scott
CycleOps & PowerTap Grass Roots Team: http://www.CycleOps.com/ http://www.PowerTap.com/
Cobb Mobb Grass Roots Team: http://www.cobbcycling.com/


Pedalhead

Jun 2, 13 12:01

Post #10 of 20 (3308 views)
Re: Femoral Neck Stress Fracture [elastigirl] [In reply to] Quote | Reply

As others have posted, FNSFs are associated with underlying deficient bone mineral metabolism (osteoporosis is the most common, but not the only cause). My guess is that your running-related FNSF is complicated by other risk factors for deficient bone mineral metabolism in your history. Abide your MD's orders.


elastigirl

Jun 2, 13 14:11

Post #11 of 20 (3274 views)
Re: Femoral Neck Stress Fracture [Pedalhead] [In reply to] Quote | Reply

All these replies are so helpful and I am grateful for everyone taking the time to reply. Yes, 49 year old female. I'm on crutches for the next 2 weeks doctor's orders. Yes likely risk factors mainly dietary, because although no eating disorders, I just really don't like to eat. I could live on smoothies, juices and cookies. History of anemia/low iron and even when normal is always on the low side. During this recovery I'm going to focus diligently on calcium and vitamin D appropriate nutrition.
I don't think I'll ever to be able to run more than 20-25 miles per week. I've struggled with tibial stress fractures on the last 3 marathon buildups. Every time I've gone up to 40+ mpw, even with gradual mileage buildup I've gotten a stress frx. Even with proper nutrition I don't think my bones can take it. Guess a BQ needs to be crossed off my bucket list.
***************************************
"You're the fastest of the slow people" ~ my son


maxsam68

Jun 2, 13 18:42

Post #12 of 20 (3244 views)
Re: Femoral Neck Stress Fracture [elastigirl] [In reply to] Quote | Reply

I am 10 weeks out from a Medial Femoral Neck Stress fracture. 6 weeks on crutches, then slowly to weight bearing. Between 6 and 7 week mark I would hobble around the house, but use crutches to go anywhere outside. First week back to walking was kinda strange.... Took the first week almost totally off after DX. Then started swimming, only with a pull buoy. I think the second week I added in some water running, along with the swimming, and maybe some light trainer riding. Had a bone density scan that was normal. I already took a calcium supp., but he said to up it to 1800-2400mg/day. I take a multivitamin and iron supplements as well. I have never had a fracture of any kind before. I just turned 45 yesterday. My only eating disorder is that I like it too much....I slowly started progressing with trainer rides and water running. Kept watts low on rides, and got really strong in swimming. At 8 weeks I started walk/run. Started the first week with just brisk walking on an incline, first time 4%, second and third at 6%. This week, I did 3 walk/run sessions. started with 1 minute run/5 minute walk. Yesterday I did 3 minute run/4 minute walk. I still am using buoy for swimming about 50% of the time. It was really hard at first to "follow doctors orders", but I figured if I did not I was just going to cause myself more harm that good. I have missed my first couple of races, and will need to do a relay this coming weekend in Kansas, but in the long run the races will always be there and I am not looking for a hip replacement. My goal is Madison in Sept. Talk some deep breathes, try to relax and accept it. There are other things to work on.....I had good and bad days. Some I would feel great and then I would get really sad because I could not be out doing what I wanted to. But, you will be better for it....good luck.


Karaya1

Jun 2, 13 22:08

Post #13 of 20 (3216 views)
Re: Femoral Neck Stress Fracture [IronDoc947] [In reply to] Quote | Reply

IronDoc947 wrote:
I am an orthopod sports medicine specialist, but don't take this as official advise as I have not examined you in person and don't know your history.

If you don't let it heal, you WILL need surgery and it may never be the same again. It sucks, but you have to rest it. If you rest it properly, it should be the same when healed. Definitely should be on crutches. After a few weeks, cycling on a trainer typically is allowed, discuss that with your orthopod.. Swim with buoy for first few weeks is safer than kicking. Again, this is serious if you don't let it heal right.

Make sure you are getting enough Vit D and.Calcium. Depending on your age, you maybe should get a bone density exam. I'd also recommend getting a Vit D blood test, many are deficient and don't know it. You need to find out why this happened. Is it metabolic, dietary deficiency, or simple training errors.

Good luck!

Doug
----------
Doug Nowak, MD
Orthopedic Surgeon, Sports Medicine Specialist
http://www.everettboneandjoint.com/nowak.html

I developed a fracture in my femoral neck when i had a mild parachute malfunction. Normal xrays did not show it and i continued working until i finally had a bone scan when the pain kept persisting, which showed the crack. I immediately went on crutches and in 6 weeks i was biking, 8 weeks it looked good and in 10 weeks i started running again. Its like new now.

Heard a story of another recon Marine who didn't detect it, it snapped and he needed a artificial hip, at age 20.

Take it seriously.


Greg66

Jun 3, 13 2:17

Post #14 of 20 (3190 views)
Re: Femoral Neck Stress Fracture [elastigirl] [In reply to] Quote | Reply

Pretty interesting to see the differences in treatment between the US and the UK.

I was initially diagnosed with a FNSF - compression side, estimated to be almost half way though - at the beginning of Dec last year, after an MRI (I had had a niggling hip pain which got progressively worse after each run, until one run in particular that left me non weight bearing for 36 hours). I then had a CAT scan that revealed no fracture, so the MRI result was reassessed as a stress reaction: an inflammation or oedema that precedes a fracture.

My running preceding this was classic "too much too soon" - I restarted it after a reasonable summer of cycling (so fair aerobic base but no technique) and went straight in at 30k/week with sprint sets, all on hard pavements.

I wasn't put on crutches and had been told that I wouldn't have been put on them even with a fracture. My consultant told me not to walk long distances on it, take it easy, rest, etc. I was allowed to swim, cycle and (crucially) use cross trainers. Basically minimise impacts and eliminate "added load" impacts (eg from running or jumping). FWIW my consultant is a sport doc who works on some of the GB Oly team, so I doubt this was "rogue" advice. Instead of the treadmill I had intended to buy I bought an old style Nordic Track Achiever from a guy in Oregon who restores them, and had it shipped to England. Life saver.

The restorative phase was a bit odd. After two and a bit months I was (according to the consultant) about 30% better, and after five months I had zero inflammation on the bone. Definitely non-linear.

During that restorative phase I used the Nordic Track as much as I could, and also x-trainers and something I think is called an adaptive motion machine in the gym (looks like a x-trainer but with a more circular foot movement.

Once cleared to run, I was told to keep to a max of 30 mins with a min of 48 hours between each run, and to stay on soft ground. I followed that protocol. After two weeks I was told I could increase my volumes, and that I could add all the increased volume to one run - so I went to 30/30/45, 30/30/60 and so on. As of this weekend just gone, I'm either 5 or 6 weeks back into running (forget which) and I'm at 30/30/90. No adverse symptoms.

I think the most frustrating thing I found was the disconnect between diagnosis of the problem (very good) and identification of the cause (virtually none). During the restorative phase I saw a physio who was very keen to get my glute meds firing properly to stabilise my hips. I've no doubt that the exercises she gave me have made a difference on that score, but I'm left feeling that I had been doing something in my running which was damaging me, and now, for whatever reason, that's switched itself off.

So I'd suggest that you put your doc on the spot and find out what non-impact aerobic work you can still do; if you can something, do it to maintain your aerobic fitness. When you are cleared to run, listen to your body - I was told it takes 2-3 weeks for a stress problem to manifest itself, so keep things fairly gentle in that initial period.

Good luck!


dac07011

Dec 17, 13 21:12

Post #15 of 20 (1354 views)
Re: Femoral Neck Stress Fracture [Dnowak] [In reply to] Quote | Reply

I developed a femoral neck stress fracture after training and running a half marathon at the end of October. An MRI showed a FNSF on the compression side, about 1/3 way through. I was on crutches completely non-weight bearing for 6 weeks. I had an appointment yesterday and got an X-Ray which showed new bone growth (positive). My doctor said I can ditch the crutches but should ease back into exercise. Yesterday my hip felt good- a little weird, but when I woke up this morning and all of today it's definitely aches and is similar to the pain I had before. I'm worried I got off crutches too soon or should have weened myself off crutches. Any advice for this? Is this pain normal?


MI Unsalted

Dec 18, 13 5:45

Post #16 of 20 (1293 views)
Re: Femoral Neck Stress Fracture [dac07011] [In reply to] Quote | Reply

I experienced the same thing last year. After 4 weeks of crutches and 2 weeks of easing back into walking I only felt mild improvement. Did you have an MRI? Did it show anything else other than the stress fracture? My MRI also showed a labral tear and no matter how much rest you get, that will not fix itself and pain will linger. I ended up having surgery for a labral tear and FAI.

Good luck. Don't push through the pain.


Let the crazy out.


Bancarel

Dec 18, 13 6:50

Post #17 of 20 (1266 views)
Re: Femoral Neck Stress Fracture [dac07011] [In reply to] Quote | Reply

+1 on not pushing through the pain.
I had femoral head necrosis + labral tear and cam impingement. Do not push trhough ;)
I had surgery in October, crutches, rehab, swimming, rowing, biking (no resistance) no running (treadmill was even worse for me), patience, patience, patience...

MRA (with the dye for better contrast) might even be more precise to determine the extent of the actual damage.

Consulting and orthopaedic surgeon might be a good idea to get options.

Good luck and stay positive. But please be careful and you might want to stop running altogether for a little while.


Only fools never change their minds and I'll never change my mind about that.


Greg66

Dec 18, 13 8:53

Post #18 of 20 (1247 views)
Re: Femoral Neck Stress Fracture [dac07011] [In reply to] Quote | Reply

6w sounds pretty short to come back from a FNSF, to be honest. IIRC the femoral neck doesn't have great supply, which doesn't help healing. You will no doubt have been told that there is bone growth at 6w, but from what I've read of bone healing in relation to my metatarsal, 3weeks gets you a cartilage bridge and the 3-6weeks after that is the mineralisation process. The replacement of that mineralised substance with compact bone takes years.

FWIW, I knew when mine was OK (and mine was a reaction rather than a full fracture), and I knew when my femoral shaft on the other side was ok. Pain free - no twinges, pings, nothing. And I could run happily. So I'd say you're pushing it too soon.


TriScott

Dec 18, 13 10:49

Post #19 of 20 (1225 views)
Re: Femoral Neck Stress Fracture [MI Unsalted] [In reply to] Quote | Reply

MI Unsalted wrote:
I experienced the same thing last year. After 4 weeks of crutches and 2 weeks of easing back into walking I only felt mild improvement. Did you have an MRI? Did it show anything else other than the stress fracture? My MRI also showed a labral tear and no matter how much rest you get, that will not fix itself and pain will linger. I ended up having surgery for a labral tear and FAI.

Good luck. Don't push through the pain.

That sounds very similar to mine. Both stress fracture of the femoral neck and a labral tear. I was 2 months out prior to starting to swim with a pull buoy and pushing off the wall with one leg. I also did some water running. It was 3 months or better before I tried some treadmill running.

I'll echo the "Don't push it" meme. It's been 8 years since my fracture, so it isn't a career ender.
-- Scott
CycleOps & PowerTap Grass Roots Team: http://www.CycleOps.com/ http://www.PowerTap.com/
Cobb Mobb Grass Roots Team: http://www.cobbcycling.com/


type 1 cyclist

Jun 9, 14 11:43

Post #20 of 20 (360 views)
Re: Femoral Neck Stress Fracture [Karaya1] [In reply to] Quote | Reply

This forum has been a real encouragement for me. Please forgive me this forum intended for triathletes when I am a road cyclist. I hope you won't hold that against me. I have a severe scoliosis so running is not an option for me. I do have a question that fits right in with this forum and would be much indebted to you if you can give me an idea of what level of recovery I can expect. I am a type 1 diabetic. Have been from the age of 2 years old. I am now 51 years old and until April 28th 2014, I was still going strong. On that date, I struck a dog at 28 mph. I had just looked at my speedo. prior to the dog cutting me off. I went airborne and hit the pavement hard. 4 hoers later I was in surgery for a fractured femoral neck. The ball of the hip had been snapped off and was slightly displaced. I had 3 cannulated screws installed. I was concerned when I read that athletes having suffered displaced femoral neck fractures can almost never return to athletic level activity. I am still worried about this. I know that in this case, there is a 20% or so chance of bone mortality if blood flow can't be restored. Normally, the bone mortality rate is higher than that, but my surgeon feels that given my physical conditioning and "young age", hahaha, that I may have a slightly better chance. I do understand that only time will tell.

I'm now 6 weeks post op. and hope to make a full recovery. I'd love to come back even stronger like some do after injuries. Has anyone on this forum suffered a displaced femoral neck fracture and returned to full athletic activity? If not, does anyone on this forum know of any cases where athletes suffering a displaced femoral neck fracture were able to return to full athletic activity? Road cycling is my sport of choice. I sure hope to be able to return to a sport I am passionate about. As you might have guessed, I appreciate your sport very much as well.

Thanks in advance.

   
 
 
 



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