Forums >Health and Nutrition>Stress Fracture of the Ischium - Advice?
Long story short, I couldn't run last summer because a problem in my hip, got motivated again over the holidays with the Holiday Run Streak and kept it going past New Years. Was feeling great and my mileage was coming up, had a big year planned with a race series and full marathon training after my base was solid again. Was hitting mileage in the upper 40's every week. About March my hamstring started to feel sore so i read up everything from the site about hamstring strains and took some easy weeks, rolled, stretched, even went back to my old PT exercises for my hip. Had two solid races (4 milers with the second just over 28:00 with goals of getting under 28) but my pain was getting worse and worse, not better, and I was taking more and more time off and running easier and easier. It got to where my pain was constant all day long and yesterday after not being able to run one mile without cringing I got in to see a sports medicine doc. Pelvic stress fracture of the Ischium start PT again next week, doc told me three weeks no running but everything I have read online says 6 weeks at least...
anyone else had experience with this? Any advice? how much time did you have to take off? It's super frustrating since I was just starting to feel good again and now I'm back to no running and will have essentially the same summer as I did last year. I was hoping to smash a BQ marathon at the end of this year and now I probably wont' even get to run it. no money for joining a gym so I guess I'm going to look for a stationary bike on craigslist or something. Would love to hear from anyone who has lived through this
I had a pelvic sfx - but not of the ischium AFAIK. (Doctor just said pelvis, not which part.) Best advice is to rest it as much as you can. For my sfx, the doctor said I could use a stationary bike or pool running for exercise. I didn't understand that I shouldn't continue my usual dog walks (since it rarely hurt at first) and so overdid things until the pain got so bad I had no choice but to rest completely. RW had a long thread on pelvic sfx and the healing time varied a lot - anywhere from 2 months to two years. Those who had a delayed diagnoses fared worst, not surprisingly, since they usually continued to run and made the fracture worse. For me, it was about 5 months before I could walk again without pain and 8 months before I could run. I tried to begin running at 6 months (after a month of walking without problems) but ramped it up too quickly and had to wait for another two months. Bottom line - be patient and don't push yourself too quickly. I know how frustrating it is to not be able to run, but the more you do now, the longer it will take to be able to run again.
wow, five months? I know I probably made things worse by just running through the pain, I really thought that since it didn't hurt "that bad" it couldn't be anything that serious. I ran about three months with pain, so yeah...it looks like I am going to have several months ahead of me of resting. I know that runners get injured and I know that lots of people are dealing with things right now, I just feel so frustrated by it all.
Thanks for the reply!
Super B****
I've had multiple pelvic fractures -- inferior and superior pubic rami. Depending on the exact location, I suppose the inferior pubic ramus could be considered the ischium.
The first time it happened (three pelvic fractures + two sacral, yes, at the same time), I took off close to three months because I was erring on the side of caution. Once the initial pain subsided, I was able to bike some, but I stopped when any of the fracture sites started feeling sore. Swimming bothered me for a few weeks, but that was because of the sacral fractures -- it was fine when I was only dealing with a pubic ramus fracture.
When I caught a fracture early, I was back to running within a month, albeit starting out on the AlterG. If you've been running on it for three months, though... three weeks seems beyond overly optimistic. It IS frustrating, but it DOES get better.
chasing the impossible
because i never shut up ... i blog
SMART Approach
Long story short, I couldn't run last summer because a problem in my hip, got motivated again over the holidays with the Holiday Run Streak and kept it going past New Years. Was feeling great and my mileage was coming up, had a big year planned with a race series and full marathon training after my base was solid again. Was hitting mileage in the upper 40's every week. About March my hamstring started to feel sore so i read up everything from the site about hamstring strains and took some easy weeks, rolled, stretched, even went back to my old PT exercises for my hip. Had two solid races (4 milers with the second just over 28:00 with goals of getting under 28) but my pain was getting worse and worse, not better, and I was taking more and more time off and running easier and easier. It got to where my pain was constant all day long and yesterday after not being able to run one mile without cringing I got in to see a sports medicine doc. Pelvic stress fracture of the Ischium start PT again next week, doc told me three weeks no running but everything I have read online says 6 weeks at least... anyone else had experience with this? Any advice? how much time did you have to take off? It's super frustrating since I was just starting to feel good again and now I'm back to no running and will have essentially the same summer as I did last year. I was hoping to smash a BQ marathon at the end of this year and now I probably wont' even get to run it. no money for joining a gym so I guess I'm going to look for a stationary bike on craigslist or something. Would love to hear from anyone who has lived through this
Is the fracture seen on x-rays with some callous formation??? OR, did he do an MRI or CT scan of your pelvis? I assume he sees the fracture. Curious of your age and bone density. Is it sore to touch? A couple suggestions assuming stress fx is definitive.
1. Increase Vit D - low blood levels correlate to increased incidence of stress fx. You want your blood levels above 40. I think above 50 is ideal. I would also increase Magnesium intake in chelated form.
2. More rest. These take a while sometime a long while
3. Eat more protein and be nutritionally sound.
4. If persistent discomfort, ask doc to prescribe Exogen ultrasound bone healing system. This device can crank up your biological healing response. It works quite well.
Good luck!
Run Coach. Recovery Coach. Founder of SMART Approach Training, Coaching & Recovery
Structured Marathon Adaptive Recovery Training
Safe Muscle Activation Recovery Technique
www.smartapproachtraining.com
I had this injury when I was a new runner back in 1979 and I was told not to run at all (and limit walking) for 6 weeks. I swam during that time. Even the bike seemed to hurt it. It still hurt some when I started back, but Xray showed it was healed.
I would give it a good 6 weeks. The good news is that it WILL heal! Make sure you aren't taking Boniva or any of that type of osteoporosis medication (I don't know how old you are) because it will hinder healing.
Out there running since dinosaurs roamed the earth
Thanks all, I actually did not go through with the xray because the doc told me only 25% show up AND i am pretty alternative medicine and really didn't want one. I agreed that if the pain isn't better in three weeks that I would have one and possibly MRI if needed. However, all symptoms point to this and I only say that it is this specific area of the pelvis b/c that is what the doc said, it could be in a slightly different spot. I don't think it is hamstring because there was never a pop or pull and there is no tender spot. In fact, the doc told me that the biggest sign to him was that I have pretty constant pain throughout the day, although it is severe (lately anyway) when I try to run. I am also nervous about the bike since it isn't particularly comfortable to sit, BUT I just don't have a lot of options. My husband leaves for work early and travels frequently, I balance two special needs kiddos so my hours and availability are limited.
We eat a pretty clean diet although I probably eat the worst of my family since I tend to give the best food in the house to my daughters but what mother doesn't? only in mid-thirties so I hope it's not a bone density issue already! But my daughters do take a Vit D supplement already, so easy enough to put that into my daily routine too
Hi Christirei. I'm in the same boat. Four weeks ago in an easy recovery run from races in back to back weekends (HM and 4 miler), something alarming happened. No pop, not pull, just deep groin pain. After getting nowhere with my family doctor, some sort from an Urgent Care doc who ordered X rays, I finally got to see an Orthopedic doctor who diagnosed the same Ischium stress fracture. I go tomorrow for an MRI to confirm.
Over and over I said, "Thank you" for confirming what I knew what was wrong. My family doc blew it off and I couldn't get an MRI approved through her - her exam didn't warrant one said the insurance company. After everything I read from fellow suffering runners I wanted a clear diagnosis and recovery plan as soon as possible. Still waiting for an official plan. Meanwhile, I'm following the advice of folks like Ginny, who I trust. I'm keeping my weight off my leg as much as passable with the aid of a cane.
Pretty bummed about this injury. I was having a great year, being smart about my mileage and shooting for a lofty goal of 1000 miles this year. Probably not going to happen, and worried about weight gain. Ugh...So stupid, I know.
Anyway, just wanted to bring my chair over and sit in your camp for a while.
Kathleen
2015 Goals:
Sub 30 5K
Sub 60 10K
runsonsyrup
Oh, how I feel your pain. I've had three stress fractures of my inferior ischial/pubic ramus. Twice at one time, and then once another time. My advice is to stay COMPLETELY away from running until you have ZERO pain while doing so. PT helped me, along with boring hours on the elliptical when it didn't hurt to do so. I'm not a swimmer, but also got in the water with a kickboard to help stay in shape.
Be patient with yourself. It sucks, believe me! That particular stress fracture is incredibly painful and very hard to get over (I'm sorry!). Both times, it took me six weeks. The first time, I went back to running after a month, re-injured it, and then had to take six weeks off.
Once you get back to running, do plenty of hip/adductor/abductor exercises and stretching. Also, check your diet. Make sure the fracture isn't due to low caloric intake, or low vitamin D or calcium.
Until you're better, try to have a sense of humor about it or find something to make you smile. I got a kick out of all the different ways my friends could say, "Stacey broke her crotch bone" You will get over it, just let your body guide you until it's time.
Good luck!!
www.runsonsyrup.com
If by ischium, you mean the ischium tuberosity, I can definitely relate to you. I had a stress fracture in mine a couple years ago (MRI confirmed), and frankly, I still have some pain. It often hurts to sit.
I made the mistake of thinking riding a bike would be a nice alternative to running. I think it made the pain in my rear worse as the seat is always stressing that area.
Eccentric exercises are good as well as less impacting aerobic (such as the elliptial), or even the Jacob's Ladder if you have a health club that one.
Good luck... this truly is a pain in the rear.
I found this article on line for a 9-week deep-water recovery plan. I've sent it to my PT and will bring it with me when I see my Orthopedic doctor next Monday. I'm hoping I get the go ahead for this. It's been over 4 weeks since my injury with no running, no exercising, just stress baking. UGH!
I suggest you also check into some eccentric hamstring exercises.
Here are some good ones to do:
Brady Exercise
Single Leg Deadlift (w/ out weights to start) - just do the eccentric portion to start.
Nordic Hamstring Curl
Glute Bridges (single and double leg)
Glute Bridge w/ march
Thanks all for the sympathy and advice!! I have been staying away from RA b/c I have just been a complete grump!! After a positive PT apt last week where the PT thought perhaps it was only a strained hamstring I faithfully did the exercises at home and every time they made my leg hurt, sometimes badly. I think most of them are the hamstring exercises you listed BoilerTom
not sure what to think about that but emailed the PT and he told me to stop until he saw me again. Also go in for a follow up with the sports medicine doc I saw previously...not sure what to think right now, but I am SO GRUMPY. I ended a 165 day running streak and now have done nothing for two weeks...it's making me nuts. I tried riding a stationary bike but that increased the pain. I hadn't thought of it like this, but BoilerTom put it perfectly, "it's a pain in the rear"
Sorry, just reread my post, when I say that my leg pain increases I am experiencing pain in my upper hamstring with some leg movements, but mostly it is pain in my rear and hip when I sit and stand, for some reason driving is especially painful :/ Also have noticed that pain is the worst first thing in the morning and then towards the end of the day, might be that I don't notice it as much during the day since I am pretty busy with my kiddos
I went through this same thing - so frustrating. For me, it was a tendonitis/bursitis with inflammation righy where hamstring tendon attaches to the ischium. It caused pain and burning big time when sitting big time and even sore to walk. It was so chronic. Cortisone was only thing that knocked it down and made me feel better. I had a relapse a year later and ultimately, my tendons became diseases from scar tissue, chronic use etc. I had chronic pain without inflammation but not so acute like the initial where it burned and really hurt to sit. Purchase seat cushion like Wonder Gel. This definitely helps. I have purchased about a dozen cushion for car, office, home etc. Please, try to get it to heal this time or you may be in for years of issues. Be smart and don't rush it. Take your time to get it right. Focus on a lot of core, hip, glute exercises as you want your butt muscles doing more work when running rather than your hammys. Also, a lot of hip flexor, iliiopsoas stretching - is so key to prevent a pelvic tilt which cause more stress at that attachment point.