What Would You Do? (Read 975 times)

I don't know how to keep this short so if you don't want to read a novel don't continue. I've been running since 2006 and for the past year I have been plagued with stress fractured femurs. Once in the left leg and the most recent in the right. The first one was diagnosed in April 2008. I was one week from running another half marathon and finally gave in and went to a sports doctor who ordered an MRI. Femoral stress fracture on the left leg. I was banned from running until I was healed and used the bike at the gym to keep somewhat fit. Talk about wanting to poke your eyes out...BORING! I had every intention of making 2008 my year to run a marathon. I was even registered for Chicago and had to eat the $110 registration fee due to this injury. By August 2007 I felt well enough to start running again. Everything was going great...ran a 5k, 4 mile and 10k race in November and was looking foward to training for a Spring Marathon. Mid-December 2008. Started feeling that familar pain again only this time in my right femur. Since I was heading on vacation for the Christmas holiday I could not see the sports doc until December 31st. And because I was heading someplace warm I could not not run so I did run a few runs even though I had a feeling it was another stress fracture. Saw the doctor and had another MRI the second week of January. Yes, I kept running on the treadmill for two weeks after I saw the doctor but only 5 miles every other day. Call me thick headed but I knew I was heading back to the bench. This time, because I knew the symptoms, it was not as bad as the first fracture and once again was banned from running until I was painfree. This time I spent the majority of my exercising on a seated elliptical which is better than the bike but still boring. I also went to physical therapy which, quite honestly, was more like having a glorified trainer as she just showed me some exercises to do for my core. I also had a dexa scan and my bone density is fine. March 2008. Got the okay to run...again. Every other day, slow, short distance...same as before. Felt great the first 2 runs but by the 3rd that old familar pain was back. Gave myself a week off and tried again last week. Same thing. First 2 runs good but by the 3rd I'm aching in the femur. I have another recheck with the sports doc tomorrow and I'm at my wits end as to what my next step is. I feel like we have exhausted all my options to keep me away from these fractures. I have no noticable leg length difference, I am not extremely heavy but could stand to lose around 15 lbs(5'4 and 138 currently), my bones are strong(I even take calcium, Vitamin D and magnesium) and I even switched from a stability/motion controlled shoe (NB 1223 and 1224) to a neutral, highly cushioned model (Brooks Glycerin 7) with hopes that a change in shoe would keep the fractures away. Would you push the doc to order a clinical gait analysis? I've had my gait tested at the running store but I'm thinking there must be a big difference in analysis at a clinic compared to a shoe testing one. Oh, and if you check my log you will see that I am far from a speed demon. I am a 43 YO wife/mother who loves to run because it keeps me sane, fit and makes me happy. Also, my log is incomplete, a lot of my runs from last winter and this December might not have made it to my log as they were done on a treadmill. Thanks to any and all insight.

I'm not very excellent at giving medical advice, but I want to reply to you before your questions drop off the front board. I think you need to try something different. Since you asked "What would you do," here are some things I would consider: Barefoot running, which could take off some of the stride impact More pre-injury cross training - swimming, biking, yardwork, carpentry, ditch digging Taking a couple days off as soon as the pain starts, rather than trying to get in that last hurrah, which might be the leg breaker I'm sure that others here will have good, and hopefully better, ideas.

Thanks for the speedy response Carl. I agree that I need to incorporate more cross training. Not sure about that ditch digging though. Barefoot running is not something I ever thought about before...Hmmmm.

I would recommend a gait analysis. Some how you are putting more stress on your quad/femur and it could be related to your running form. You may also have not healed the stress fractures. I saw an athlete this morning that has had a tibial stress fracture for 7 months. At 4 months it was feeling good and doc gave her clearance to jog. She went for 2 runs and the pain was immediately back. I set her up with my company's ultrasonic bone healing system 2 weeks ago at the sports doc's request. Even at 7 months and being non weightbearing the last 8 weeks, I could hardly touch her tibia without her jumping. She has used the ultrasonic bone stimulator now for 15 days and in her words has noticed "an 80% improvement" and hopefully on her way to healing. The doc is now allowing her to weight bear as long as there is no pain. You simply may need to heal or have a biological deficiency preventing you from healing which again is where ultrasonic bone healing system might be of benefit but your physician has to be on board and prescribe it.

I would recommend a gait analysis. Some how you are putting more stress on your quad/femur and it could be related to your running form. You may also have not healed the stress fractures. I saw an athlete this morning that has had a tibial stress fracture for 7 months. At 4 months it was feeling good and doc gave her clearance to jog. She went for 2 runs and the pain was immediately back. I set her up with my company's ultrasonic bone healing system 2 weeks ago at the sports doc's request. Even at 7 months and being non weightbearing the last 8 weeks, I could hardly touch her tibia without her jumping. She has used the ultrasonic bone stimulator now for 15 days and in her words has noticed "an 80% improvement" and hopefully on her way to healing. The doc is now allowing her to weight bear as long as there is no pain. You simply may need to heal or have a biological deficiency preventing you from healing which again is where ultrasonic bone healing system might be of benefit but your physician has to be on board and prescribe it.

It is funny you bring the bone stimulator up. With my first stress fracture I asked about that and he said that because the femur bone is so deep the stimulator would not work that well. But at my last recheck he brought it up again. He also stated it was very expensive and hard to get insurance to okay the charge. Your client's results are amazing! I'm going to push for that gait analysis. Thanks again for all the tips. I'm taking notes for my appointment tomorrow.

Exogen has very strong heal rates in the femur (thigh). The depth of penetration for the Exogen ultrasound bone stim is 10.5 inches. Ultrasound travels very easily through muscle and fat. Unless you have more than 10.5 inches of fat or muscle on your thigh, the mechanical pressure waves will get to your fracture site no problem. You can email me direct if you have more questions.

WOW! Great info Tchuck! Are you a sports doc or a ATC? I may take you up on your offer to email if I have more questions after I google. And I don't have that much fat on my legs...it is is mostly in my belly! LOL!

I think there are 2 issues: how to fix this current injury as fast as possible and why are you getting all these stress fx's. You say your bones are strong and you take Calcium + Vit D. Have you ever had a dexa scan? How much calcium and D are you taking? (Things to ask your doc, not me!) Are you doing "too much too soon?" Starting at 3 mile runs after a couple months off due to an injury sounds high to me. Though I know if you were training for a marathon it feels like nothing!

Thanks!!!! Did ya notice that I used the "route" you mapped out a while ago to find my next turn? http://www.websitetoolbox.com/tool/post/timrock/vpost?id=1773047