I am interested in others’ experiences on how they managed their comeback to running after a stress fracture. By standards here, I have a very straightforward fracture and hopefully have fully recovered to begin running again. I have patiently waited 9 weeks. Doc said 4-6 weeks, diagnosed from x-ray only as a ‘fissure/hairline fx’ about 4 weeks after break. May be helpful to know it wasn’t an overuse fracture, but actually happened when stepping out of bed and leg was asleep (lame I know). More of an acute event than from overuse.
My background was tri for 8 yrs then running only after kids for the last 2 yrs. Been running ultras 50-100k successfully with no injury and manage 40-50 mpw all year with higher as race distance dictates. I am not a natural runner and certainly never confused with a fast one.
What was your comeback approach? I do have the discipline to come back slowly and want to avoid setbacks as I am eyeing some ultras this summer.
My approach thus far feels very conservative and a bit silly. 8 weeks after injury I started walking 45min every other day. A good pace, not a stroll in the park. 9th week I added a 1 mile run in the middle of the walk. Will slowly increase and continue to approach conservatively but looking for other successful approaches.
Had a tibial stress fracture last year… took 12 weeks to heal and after that I came back very slowly.
Week1: 6 X (1min run, 4 walk) - 3 times a week
Week2: 6 X (2min run, 3walk)
etc… until you are running 30min at a time. All just easy. After that increase it by 10% a week until you get to an 45mins. At that point you can start adding some tempo in.
Thanks for pointing that out. My fracture was on the 5th metatarsal. It was like rolling the ankle to the outside, but as my leg was partially asleep I planted all my weight on the outside of my foot. I did a google images search and would say perhaps more of a Avulsion or Jones Fx:
I’ll be watching this thread closely. I have had increasingly bad groin pain over the last few weeks. Went to see the consultant yesterday, who didn’t think it was my adductors. He’s booked me in for am MRI at teh end of the week to see whether there is a stress fracture of the femoral neck. Which I do not like the sound of. Lots of time on crutches if it is.
FWIW, my money is on something caused by an unstable SIJ. We shall see.
That is what I thought. Believe it or not, a relatively common injury! Very different than a stress fx we talk of with endurance runners. Leg/foot falls asleep, phone/doorbell rings, people jump up, “roll” the ankle, and an avulsion fracture at the base of the 5th met. There have been a few threads here regarding this injury. These almost always heal eventually, but slowly because of constant traction (from both ground/weight bearing forces and traction pull of the peroneus brevis tendon insertion).
Started out running on sand, we have some irrigation canals that are empty for much of the year. Once comfortable on sand gradually progress to grass, then trails, then pavement.
Thanks for the insight. I did some searches around ST and indeed found some interesting experiences with an avulsion fracture and has me reconsidering if I really am ready to start running again. The clear difference between my case and the others is my break seems pretty small, in fact I am not sure I see it on the xrays below. I do not have a trained eye to spot these things, but I have to assume it is the slightly darker grey area in the red box? 9-10 weeks now and no pain while fast walking, cycling, and a little running.
For what looks like a very minor avulsion fracture, what is the course of treatment? Thanks again for the links, some interesting stories about screws, etc. I had asked the Doc at the time if a rescan was necessary to confirm healing and she did not feel it was necessary. The radiographs taken below were around 2 weeks after the break, not 4 as I had thought.
Yes, very subtle in your case. Should heal uneventfully. Plenty of threads on progression back to running. It will be tender for a lot longer than you think though (way past when it is “healed” radiographically), so you will likely have to run with some tenderness in the area unless you wait 6 months+ (which isn’t practical, nor desirable for a type-A endurance athlete). If you are 10 weeks past that injury, time to return to running carefully.
Zone11, if you have access to an Alter G, that would be a perfect way to ease back into running. The Alter G allows you to unweight yourself in 1% body weight increments to mitigate impact - thus, a great way to both train through and recover from injury.
If you are in the Bay Area, you might visit - http://www.m2rev.net/wp/m2-studio/alter-g-running/. We have had a number of elite runners who have largely trained through stress fractures, maintaining basic fitness and a seeing a quicker return to form. Progression and rotation was Alter G > treadmill > outdoors.
Thanks for the thread. I no longer have reliable access to a pool, but am quite familiar with aqua running. Back when I lived very close to one I employed aqua running with a belt, mp3 player in a ziploc bag in running hat, etc. Boring as crap, but would do it if I had a pool.
Very interesting, thanks for the link. I’ll certainly keep my eye out for something like that out here. I’m in Belgium, so not too close to the Bay Area.
It sounds like you are not in a hurry to get back and THAT is usually the main problem with endurance athletes…
100% correct. As a runner AND as a coach, I have seen two problems. First, people don’t do anything during their injured periods. No cross-training, no rehab, nothing. They just wait for it to get better and lose fitness. Second, people try to make up for lost time by loading on the miles as soon as they think they can safely do so. As a result, they either end up re-injured, over-trained, or injured in a whole new way.
The tl;dr version is that you need to return slower than you think you should. It’s not just the worry of reinjuring that foot, but also all the new stuff that can pop up if you ramp up too quickly.
18 months ago I was rounding a corner during a real easy early morning run, stepped on a rock the size of a lacrosse ball, rolled my left foot hard to the outside and sustained an avulsion fracture of the 5th metatarsal (not Jones). It was minimally displaced and I was put in a boot for 11 long weeks. I began a walking progression when I got out of the boot starting with 5 minutes per walk and working up to an hour. After 2-3 weeks of walking, when I was up to a solid hour, I started a run/walk of 1 min run 4 mins walk and progressed it gradually from there like the other posters have indicated. I felt soreness and aching in my foot for a year. I was positive in the early going that I had re-fractured it somehow - that wasn’t the case. Although I felt I returned slowly and gradually I developed an awesome case of PF in both feet that lasted a good 6 months. Now, 18 months later I still feel the fractured bone soreness when I kick hard at swimming or when my shoes are too tight. I can press on the fracture site with precision and feel exactly where it was broken. Pretty weird. I completed IMCDA exactly a year later after the fracture. The fitness comes back so fast that you really wonder what you were concerned about to begin with.
If you do anything at all you should listen to what Dr. Roof says. He’s a smart dude.
