12

Pain 5 months after femoral SFX. It can't be a rebreak, right? (Read 141 times)

scappodaqui


rather be sprinting

    Sorry, crossposting this from runnersworld because they don't respond and you guys are awesome.

     

    I incurred a femoral neck stress fraction, compression side, in late June or early July.  I took off running (swam instead) throughout August and September, after a few weeks on crutches.

     

    With permission from my doctor, I began modest running, all at easy pace, in October.  (I also recommenced weight lifting with legs, though quite light relative to my abilities... but may have pushed that lately).  In terms of running, mileage build has been reasonably gradual:

     

    mpw:

    7.5

    13

    16

    17

    18

    18

    23

    18

    28

    20

     

    with a few shorter midweek runs and a long run starting at 6 miles, then 7, then 8, then 9.5 last week, which may have been too much.  I rarely run on back to back days but sometimes have (if I do they are shorter runs, I generally run 3.5-5 miles during the week).

     

    I felt ZERO pain or discomfort until this week, almost 5 months after my stress fracture!  The pain is mild but present even when lying in bed, a kind of throbbing right where my stress fracture was... is????  It's in exactly the same area, anterior pelvis, all through the hip, and slightly down the thigh--seems to move around a bit.  I can hop on the foot without discomfort and I don't really feel it while running, but afterwards and throughout the day for the past 3 days there's been lingering soreness.

     

    I should mention that perhaps it began not with running but when I attempted Bulgarian split squats with 30lb dumbbells in each hand.  That is a moderate load, but may have been overreaching.

     

    Someone please help.  I know it would be very odd to rebreak the area since it should have fully healed by now, according to my doctor (yes, I am calling him tomorrow).  WHAT is going on?

     

    Obviously I did not run today and plan not to run tomorrow either.  But I'd like to know how to proceed and what may be wrong with me, as I am very scared.

    PRs: 5k 19:25, mile 5:38, HM 1:30:56

    Lifting PRs: back squat 176 lb

      Did you ever figure out and address the root cause of your injury?

      Runners run.

      scappodaqui


      rather be sprinting

        Did you ever figure out and address the root cause of your injury?

         

        The only theory is that it was too much intensity on too little mileage base (I had come back from another injury, plantar fasciitis).  And I did 3 days of sprinting/speedwork AND two days of Olympic lifting a week, so it seems that excessive intensity was to blame.  I was only doing 20-30 mpw at the time, too! Too much, for sure.  (I was trying to get a fast 400 on the track).

         

        I haven't sprinted or done explosive lifts or plyos at all since injury.  Only easy running.

         

        In terms of my gait, I just don't know.  I have been assessed by several coaches and most tell me I have a very textbook style of running, midfoot strike (maybe slightly forward because I am so used to sprinting style running, but I settle back when doing easy pace), very upright posture, light tread. So it LOOKS right but might not BE right--I just don't know what to fix.

         

        I wear New Balance 890s, btw, which may be too cushioned?  IDK, they're fairly light but might be wrong?  I've tried other shoes and that's when I got PF, so again, not sure.  I know Camille Herron (http://camilleherron.com/2011/05/11/overcoming-stress-fractures/) talks about minimalist shoes or flats for people who want to avoid sfx, but again, I don't know.  She also talks about not running on soft surfaces (I've been running on packed dirt, which is somewhere between hard and soft).  So again, not sure.

        PRs: 5k 19:25, mile 5:38, HM 1:30:56

        Lifting PRs: back squat 176 lb

        SillyC


          Oh, sorry to hear this.

           

          Could be that you didn't JUST have a stress fracture - you had a stress fracture and a labral tear at the same time.  I hope that's not the case, but it's what happened to a friend of mine with a femoral sfx.

          http://heatherrunstoomuch.blogspot.com/

          scappodaqui


          rather be sprinting

            The MRI would have shown a labral tear, though, right?  (I did get an MRI).  And the pain now is very mild and not localized enough to seem like a labral tear.

            PRs: 5k 19:25, mile 5:38, HM 1:30:56

            Lifting PRs: back squat 176 lb

            bluerun


            Super B****

              The MRI would have shown a labral tear, though, right?  (I did get an MRI).  And the pain now is very mild and not localized enough to seem like a labral tear.

               

              Yes, it would have shown up in an MRI.

               

              FWIW, my last fractures were in June of 2012, and I still get weird sensations.  I also fractured my right pubic rami seven months after I had already fractured it, so it IS possible; just because it feels like exactly the same spot doesn't necessarily mean it is.

               

              If it were me, I'd get it checked out, just because I'm paranoid about such things.  It can't hurt, right?


              LimpingBehind.com

                Labral tears don't show in regular MRIs - you need an MRA (MRI with contrast) to see the tear.

                 Want a discount code for the San Francisco marathon?  Message me :)

                scappodaqui


                rather be sprinting

                  http://shp.missouri.edu/vhct/case3605/running.htm

                   

                  "If the patient reports a dull ache and soreness in the healing area, she still should continue with her running / walking schedule. A red flag and definite indication for not running or performing a repetitive weight-bearing activity is pain prior to exercise. For instance, if a patient feels mild soreness or pain walking around or at rest then running should be omitted or postponed."

                   

                   

                  Well, now I'm just confused.  I highly doubt it is a labral tear, though, as the pain has now mostly gone away.  (It was present for 3 days).  WTF.  I guess I may be fine and it's normal?  Still going to discuss with doctor.

                  PRs: 5k 19:25, mile 5:38, HM 1:30:56

                  Lifting PRs: back squat 176 lb

                  cookiemonster


                  Connoisseur of Cookies

                    Labral tears don't show in regular MRIs - you need an MRA (MRI with contrast) to see the tear.

                     

                    Quoted for emphasis.  An MRA will show a tear.

                    ***************************************************************************************

                     

                    "C" is for cookie.  That's good enough for me.

                      Nnnooooo...

                       

                      ...is really all that went through my mind when I read your post. How frustrating!

                       

                      Have nothing more constructive to say but really hope you figure it out (and that it isn't broken again!) Maybe your brain is just playing tricks on you and going all psychosomatic-phantom-pain for some reason. I swear to god I can induce achilles pain just by lying in bed thinking about how much I don't want to get achilles tendonitis again.

                         I know Camille Herron (http://camilleherron.com/2011/05/11/overcoming-stress-fractures/) talks about minimalist shoes or flats for people who want to avoid sfx, but again, I don't know.  She also talks about not running on soft surfaces (I've been running on packed dirt, which is somewhere between hard and soft).  So again, not sure.

                         

                        Good link, and among a lot more stuff, she emphasizes:

                         

                        It takes a very long time for a bone to fully remodel itself (8-12 months, depending on severity and size of bone) and be normal again. Thus, that bone will develop a bone callus as the bone heals, and this will not only cause you to slightly change your gait (~placing stress elsewhere), but that bone callus may also irritate the surrounding soft tissue and nerves, causing residual pain when you start running again. You never need to worry about this residual pain or re-injuring the bone in the same spot, as this spot is stronger than ever. My experience is this residual pain should go away within 2 weeks of returning to consistent running. - See more at: http://camilleherron.com/2011/05/11/overcoming-stress-fractures/#sthash.NT8K7Yx1.dpuf

                         

                        Hope that's the case for you, but let's not make assumptions without your doctor's confirmation.

                         

                        Good luck!

                        Well at least someone here is making relevance to the subject.

                        scappodaqui


                        rather be sprinting

                          Thank you all for your perspective and wellwishes.  I spoke with my doctor today, who said to try a short, slow run and see if that hurt.  I did 3 miles very easy and paid particular attention to my gait.  All feels fine, apart from some tightness in my glute.  Since there's no lingering pain, I'm optimistic but will be more careful from here on out.

                           

                          Um... how should I be more careful?  Shorter runs?  Less frequent runs?  <--that doesn't seem wise to me, as how will I adapt to the pounding?  I will also continue to use the 4-way hip machine at the gym to strengthen my hips.

                           

                          Oh, and I have a doctor's appointment next Thursday, so hopefully I can clear things up then.

                           

                          The worst part of this is that I thought the injury would be a memory by now.  I got through weeks and weeks of running with zero issues... it's very overwhelming to feel so frightened to do something I love so much.  I don't even dislike easy running anymore.  I just can't live with it being dangled in front of me and then yanked away over and over and over.

                          PRs: 5k 19:25, mile 5:38, HM 1:30:56

                          Lifting PRs: back squat 176 lb


                          LimpingBehind.com

                            Scap - I know exactly how you feel.  I hope the doc can put your mind at ease so you can continue to run without too much worry Smile

                             Want a discount code for the San Francisco marathon?  Message me :)

                               

                               

                              The worst part of this is that I thought the injury would be a memory by now.  I got through weeks and weeks of running with zero issues... it's very overwhelming to feel so frightened to do something I love so much.  I don't even dislike easy running anymore.  I just can't live with it being dangled in front of me and then yanked away over and over and over.

                               

                              I would feel the same way!!

                               

                              So it doesn't hurt any more? That's good news, right? Until the doctor appointment I would probably stick with what was working for you before this happened, i.e. easy running, not pushing the mileage, and (if I understood the story correctly) not that much weight on your Bulgarian split squats or other former-Soviet-bloc lifts. I might even leave those out for the time being. And lots of deep breaths. Say om. Try not to panic Smile

                               

                              Did you do or are you still doing PT as part of your recovery? If not, do you think it would help to work closely with a PT on your weightlifting and plyo stuff?

                              scappodaqui


                              rather be sprinting

                                Yeah, I think I'm also going to go back to running only every other day, not consecutively.  I think the problems started when I tried to run three days in a row.

                                 

                                I am still having on and off sensations in the hip, which is strange and frustrating to me--sometimes there's something, sometimes there's nothing, sometimes I don't even know.  That seems to indicate it's those phantom healing pains, but the proper response to that appears to be decreased frequency of running and thus more time to repair and recover in between.

                                 

                                If all else fails I'll get an MRI again for reassurance.  In fact I may call now and request one even before having met with the doctor.

                                 

                                Oh, and I am NOT doing any plyos or jumping! I DID see a PT but she told me i didn"t need to continue to see her, and would be fine on my own.

                                 

                                In addition, my doctor said that lifting has no impact on the sfx.  Which makes no sense to me at all.  I feel more pressure on it when I lift than when I run!

                                PRs: 5k 19:25, mile 5:38, HM 1:30:56

                                Lifting PRs: back squat 176 lb

                                12