Stress fractures (1)

Triathlon Forum
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i developed a sharp pain upon putting weight (climbing stairs, running) on the anterior aspect of my left thigh over the last 8 weeks. at first i thought (any my rehab doctor thought) that it was merely a muscle pull/tear so i had some PT done and i stopped running in the meantime (5 weeks now). continued riding and swimming as there was no pain but i noticed things were not getting better and getting even slightly worse. anyways, had a bone scan today and, although it is still not confirmed, it looks like a stress fracture of the proximal femur. my coach has advised that this will probably mean 6-8 weeks of no activity (there goes IMOZ!!!) and i will be seeing the ortho soon to clarify things.

anybody out there whose had a similar injury? how long did you have to lay off? did you totally do nothing or was pain tolerance your barometer of acceptable activity? what did your rehab, if any, consist of?

thanks,

Kim

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If it is a stress fracture you will be off for awhile. No getting away from this. Have to wait to see what the ortho says.

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I am recovering from a stress fracture in my tibia right now. I began having pain at the end of august. Initially I only had pain after I ran , but it got to the point where every step I took gave me sharp shooting pains from my ankle up my leg. I stopped running Sept. 14. The PT told me to try easy running in 4-6 weeks. I waited 6, tried running again, but the pain was still present, although much less severe. I was aware of the area immediately, and the pain started at around .5 mile. It progressively got worse, so I stopped after a mile and walked it in. Went back to the doctor, and they said I needed a lot more rest, and when I started back, start with walking first. If I don’t have any pain from walking say 3 miles, then I’m ready to start running. I waited until Dec. 14 (3 months), then started walking briskly. First time was 30 min, then 35, etc culminating in a 1hr and 45 minute (over 5 miles) hike 2 weeks later. Since I never had any pain from this I went running. I walked 10 min, ran 5 min, walked 5min, ran 5 min, and then walked another 5 min. I felt a little “achiness” in the leg, but nothing very severe. I waited a week and just repeated that on this past Monday. So far so good.

Basically, don’t mess with stress fractures as they need complete rest to get better. From what I gathered, most people can start back in 6-8 weeks, but I wasn’t totally inactive with it. I had initially gone to one doctor who never gave me a bone scan, and the PT didn’t seem to take the diagnosis that seriously, so I didn’t take it that seriously. I didn’t run, but I also was a bit careless with it. I would jog across the street, or jump out of the back of a truck, just stupid things that I think slowed the healing process. So, after I went to a second doctor and I had a bone scan done that showed it hadn’t healed yet after 8 weeks, I decided to be much more careful with it and give it more time. Here is a good article that is enlightening on them:

http://www.pfitzinger.com/labreports/stressfracture.shtml

I am following the seven week plan. The thing I liked about it was that it said you should start the plan when you can walk for an hour briskly (I was walking at about 14 min/mile which takes a good bit of concentration for me to achieve) without pain. I never had any indicators like this the first time I tried running. I waited 6 weeks, and went out to try 2 miles (all based on the advice of my PT). My doctor reviewed the fitzinger plan yesterday and liked what he saw.

The big thing to me is not just healing the fracture, but determining what caused it. That’s still up in the air for me, so my toughest days may not be over. I’ll know in a few weeks.

Good luck- Jack

I should say that I was told it was okay to bike and swim and do other activities as long as none resulted in pain. If there is any pain, you should stop whatever activity you were doing.

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Mine was in the hip (femoral neck) and I had to stop everything for 4 months. I was on crutches for for 8 weeks, then started biking and swimming again, and lots of PT before I could even walk for exercise. It can be a very slow process.

5

Thanks for posting this. The responses were helpful to me.

I had pain in the shins, which I thought were shin splints. This was the day before Thanksgiving. I was in so much pain, went to the ortho the following Monday, he said lay off running for 10 more days and then see. Did that, still hurt, waited 10 more days, went back to the ortho, I’m having a bone scan on the 12th. I don’t have severe pain anymore, I just know it’s there and well I do have some pain if I do too much walking. I’ve been riding and swimming (not as much during the holidays) and using the elliptical trainer. I was disappointed because I was training for the Arizona Rock “N” Roll 1/2 marathon, and now I’ll be a volunteer.

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I am the king of pain in the shins. I was a very avid runner from 12-18 years of age, then took a break for a few years and started back up at 21. I made it for a year, and then started having problems which have been bugging me for the past 5 years, culminating in the stress fracture I described above.

Where is your pain located? There are two areas that are referred to as shin splints. The common one is the muscle tissue on the front of the leg. The less common one that I have, has also been called tibial tendonitis, is on the inside of the leg.

The pain was distinctly different going from the tendonitis to the stress fractures. The stress fracture was a very sharp pain, localized to the ankle, and I had sharp shooting pains while running, and intense pain for days after running causing me to limp much like an ankle sprain. The shin splints were a deep, dull general pain in the inside of the lower legs that would come on while I was running, but go away shortly after I stopped running. I found the area where the stress fracture was by pushing on the tibia. It was right next to where the soft tissue was aggravated from the tendonitis, however, it was definitely bone that hurt, rather than the meeting of the bone and soft tissue that hurt from the tendonitis. Pushing on the area sent pain up the leg. Also the doctor flexed my lower leg, much like you flex a stick with two hands when you try to break it, and this induced pain. This will not happen with shin splints/tibial tendonitis.

The thing with my tibial tendonitis is that it would come back even after taking months off. I would rest, then start running, and the pain would be right there again. At first after I rested it would take a few weeks before the pain came back, but just this past summer it would come on as soon as I started running after a layoff.

Definitely get the bone scan, but thought you might like to hear my experiences with both shin splints and stress fractures to maybe give you some things to consider.

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I have twice stress-fractured my tibia (but not the femur - yet), and the lost running time can vary. The first time it happened, in Jan. '00, it was initially misdiagnosed as shin splints, and I periodically attempted runs for the next 4-5 weeks. X-rays showed nothing, but a bone scan finally proved that I had a stress fracture. Because I had continued to compromise it for about a month, I had to go run-less for 12 weeks. Last February I clobbered the shin against an immovable object, and suffered a hairline fracture at the same site (so I guess it could count as a second stress fracture). The first time I felt the pain from the fracture, after a run, I immediately didn’t run again until I had seen my doctor. Because I was wise and conservative, my penance was only 8 weeks, and I was back running by early April. It the meantime, practically anything is fair game - last year I kept extra-busy on rollers, a trainer, swimming followed by deep-water running, and cross-country skiing. These will all work for a tibial stress fracture; as for the femur, I can’t say. Be smart, be conservative, and DON’T RUSH BACK! It is truly a shame about IMOZ, but the last thing you want to do now is sacrifice your entire season. Good luck with this - I’ll be thinking about you!

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I had to take about 7 weeks off of running then 1 week of a quarter milerun every thrid day, one week of a quarter mile run every other day then a week of half mile one day, a mile 2 days later. Better safe then having it fracture worse or having it reoccur mid season.
Plan on peaking for he late season races. Swim and bike like crazy and view it as a long focus on elevating the rest of your triathlon game.

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Jack,

My pain is on the inside. In fact in the days following, I limped terribly, which prompted my ortho visit. I have only run about 5 yards, felt pain and won’t even think about it now. I can point it out to you right now and I did no training today as of yet. I was hoping it was some type of tendonitis that would go away with rest. My doctor used a tuning fork (he says it’s the poor man’s xray!) and place it over the spot and there was pain.

I read another poster said he did deep water running, I’m thinking about giving it a shot after my scan and a definite diagnosis, although it sounds as exciting as watching paint dry. This is my first year, I 've done 5 sprints and a 10k (it was the lack of rest after the 10k that did it). I’ve signed up for my first oly in May, I figure it I can get this thing healed, I’ll have enough time to be ready.

Thanks for your post. It gives me things to ponder

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That sounds very similar to my stress fracture experience.

I really like that website and guide on returning from a stress fracture. The walking guage is a good one I believe. I was actually suprised at how much I liked it. If you go fast enough it gets your endorphins pumping and allows conversation with someone who may not be as fit (if you can find someone to drag along) or more fit. I felt awesome afterward. It’s a good way to test the leg without really setting yourself back.

Hope things go well,

Jack

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you may want to ask your doc about a bone density scan. Don’t forget men can also can lose bone density, it’s just not quite as common. It’s easy to stop (but not reverse I don’t think) density loss and a good idea to rule this out as to the cause (along with lots of training) as to why you are getting them.

As for the healing time, I think I read somewhere that the closer to the core of the body the fracture is, the longer it takes to heal.

Sorry to hear about OZ.

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thanks guys for all the advice and words of encouragement! had repeat x-rays done today and it turns out that it’s more serious than a stress fracture. with what little experience i have looking at x-rays, it seems like a benign tumor. won’t really know for sure until it is biopsied.

i’m keeping my fingers crossed! thanks again!

Kim

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Talk about the epitome of irony…I logged on today for the express reason of getting some input re my just diagnosed stress fracture(s)! Too weird. The info here has been very insightful. However, my factures are in my feet, so I’m going to start a different thread to ask for additional information.

Good luck with your recovery. I have a friend who is a top age grouper who had a stress fracture of the femur three years ago. He was out of the game for nearly two years because he failed to allow proper healing. My wife has had three in her tibia, but healed fairly quickly. Her doc said that once she could pass the “hop test” i.e., hopping on the bad leg without pain, she could slowly begin running again. Worked for her. Cheers.

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i too ended up with a tibial stress fracture at the end of august. ive been through such an ordeal with it and only now am i actually starting to heal. best advice is to take it slow! if you feel it might be too soon to start running again (even if you want to) then it probably is. i re-injured my leg 3 weeks ago after my physical therapist convinced me i should run – bad idea. i knew it was too soon but i trusted the “professional” advice even after i voiced my concern. so i have now set myself back about a month in my recovery (soooo frustrating) and only now am i starting to bike/swim again. also found out from all the tests my doctor ordered that i have osteopenia (sp?) in my spine and low protein levels. so ive gotten on calcium supplements and higher protein diet along with custom orthotics made, so i hope i will be able to prevent any future stress fractures since i fully intend to continue to race triathlons. my doctor places a lot of importance on finding the source(s) of the problem and working on prevention, which i really value.