October 30th, 2011
I’m beginning to think this is not a sfx after all or if it is in that family, maybe it’s his friendlier cousin, stress reaction. It’s day 12 of rest and I just went for a walk to the park, about 2 miles, and had no pain or need to limp. Also, the testing stance that has elicited a twinge since this thing began gives nothing.
Most happy-making is that descending stairs, which has been a no-fail way to get a grimace or 12 outta me for weeks now, doesn’t produce a thing. It’s weird to automatically brace myself for that first step only to find nothing bites and I can just walk down the damn things.
So now it’s a waiting game for the MRI appointment (hopefully insurance will let me call for one tomorrow). If, knock on wood, the results are clear and they tell me what’s what over the phone, I might cancel the 5 minute appt. on Friday, since between co-pay and getting a car it’ll be about $65, though I’d still stay off it till the end of the week.
OTOH, I am interested in seeing the MRI if there’s something to see (not just for worst case scenario), so if there’s some crappy stuff to look at, I’ll go.
Speaking of moolah, for interests sake, here’s the lowdown on the cost of this. I have an HMO through Aetna so the specialist copay is $50 and if I’m reading the plan correctly, it’s $50 for x-rays and $250 for an MRI.
Money aside, I’ll never put off calling a doctor again for something like this again. I’m kicking myself for not doing it 6 weeks sooner but my aversion to (what I thought would be) red tape was enough to put me off. Had I known how straightforward the process was…anyway, lesson learned.
But I’m getting ahead of myself since it’s still up in the air. For now, I’m just thrilled to finally be wince-free.
Soft Tissue vs SFX
I’ve read in numerous forum posts over the years and well-meaning folk have said to me that perhaps a sfx is not worse case scenario because at least it’s over in a finite amount of time. I can totally understand this reasoning and have even offered it to friends who’ve had sfx’s as an “upside” because compared to chronic or serious soft tissue injuries like plantar fasciitis, achilles tendonitis, a Grade 3 muscle/tendon tear or an issue that never gets properly diagnosed then yes, a sfx is definitely preferable.
But here’s the dirt on a femoral sfx: providing everything goes smoothly, there’s generally about 4 months from diagnosis till running semi-regular mileage after a slow, drawn out ramp-up in the 3rd month. The road to return is usually accompanied by tons of self-doubt, fear of reinjury and an ongoing sense of fragility.
In contrast, a non-chronic, non Grade3 soft tissue injury, when given time to rest/heal, will usually resolve itself within a period of weeks, not months. I know I don’t have a Grade 3 injury and it’s highly unlikely to be chronic since the ART lady gave me immediate relief and my current state is pain-free. Thus, I’m sticking to my “hope this is soft tissue” druthers.
If it is a stress fracture
I don’t think it’s my shoes, my gait, the surfaces on which I run or even my mileage (caveat below) that caused it. You can tsk, tsk in your mind and I know some will, but I’m convinced that the underlying cause was a muscle strain that grew out of control, the way shin splints can cause a sfx on the lower leg.
I can easily find that set of affected muscles now but I couldn’t then. So the next time I can’t locate the source of a problem, I’m not going to hope for the best, I’ll call a doctor. Period.
As far as mileage, I don’t think the level I reached was to blame and I’m raring to get back to it. However, the mileage I kept after the injury had been planted…that was greediness and I screwed up. I should have been happy with 5 miles a day but I kept pushing the envelope till it tore. I take full responsibility for that.
In my defense (defending myself to myself, lol) I’ve had 2 real injuries besides this one: ITBS and an ankle injury. Both lasted a couple months but I was able to run through them. I thought I could do the same with this and perhaps I could’ve if I’d cut back more sensibly. But I didn’t. Live and learn.
A Question For Those Who’ve Had Stress Fractures
What is your experience with declining symptoms? Did your symptoms disappear soon after you stopped running or did they last a few weeks? I know everybody’s different but I’m looking for masochistic ways to kill time, so this question is a good start.
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With my femoral sfx in 2003, I limped for WEEKS after I stopped running. It even hurt to bike (stationary and MTB) even 6-8 weeks afterwards, although perhaps HURT is too strong a word. At the 3 month mark I still had an “awareness” of the area although I would not describe it as pain or discomfort.
With the femoral stress reaction I had this July (diagnosed on clinical grounds – fulcrum and hop test – plus an MRI that had VERY subtle changes), the discomfort went away almost within 24-48 hrs of stopping running. The tests were negative within a week. I don’t think I ever actually limped, the most I felt was an ache in my anterior thigh during my final run, which was a 3M TM double.
Perhaps the quick resolution of your pain means it’s more a stress reaction than a frank fracture, but I would still be cautious, which it sounds like you are. The worst thing I did with the 2003 sfx was try to keep exercising when really I probably should have been on crutches, or at least no exercise whatsoever. What can I say, I’m a stubborn so-and-so, but even so I made it out of that one eventually. Meaning 6 months of no running, but there were other things going on as well that are too boring to mention here.
Your MRI result will be very interesting to hear, good luck with it all, Flo.
Hi Flo,
I had a stress fracture of the femur in 2006. It was no where close to 4 months that I was off. When it was diagnosed, the doctor told me it was already healing pretty well and told me no running for 6 to 8 weeks. I rode bike, but pretty much used the time to rest. I resumed running six-weeks later and never looked back. Mine was due to ramping up mileage too quicky (going from 40 to 70 in a few weeks time!) and trying to do it in too little shoe.
Good luck!
Rick
Rachel, good stuff, thank you. No wonder you’re so watchful about them, that one in 2003 sounds like a long and worrisome recovery. I should go back and read your reaction posts in the 3:10 thread, glad you were able to take care of it so quickly.
Rick, I didn’t say 4 months off, 4 months to be back to your old self (gleaned from the sfx threads in the injury forum). Seems to be commonly 8 weeks off then run/walk ramp up begins. Nice to know it can be 6 weeks before you get to run again. So you were running on it up until the diagnosis? Or had you already taken time off?
I was running with a nagging pain in my hip for a week or so. Took a week off and it was worse, so thats when I decided to see the doctor. I had a bone scan done, which showed a hairline crack in my upper femur. The pain was never centralized and always felt more like hip pain. Never had trouble walking, just running. I guess from the start of the pain to running “normarlly” was about 9 to 10 weeks.
Thanks, that’s definitely not too terrible at all. I mean, it sucks and is worse than 3 weeks for a tissue thing but not as heinous.
Man, I WISH it had only cost me $250 for the MRI. Envy envy envy. (I have a high-deductible plan, since I telecommute to an employer 350 miles away, and the HMO, which is the best deal, is also 350 miles away.)
My sfx was in a different place (metatarsal), but for me, time off did not help one whit. Well, let me rephrase that; the pain while walking went away after a week, but as soon as I tried running again, BAM. I did not improve until I did the 3 weeks on crutches.
Sorry to hear you have a high deductible thing, those certainly are more painful to pay for when something happens, unless you’re constantly at the doctor anyway. And yikes on your story. That is my fear, that it’s fine now and running will make it hurt again, though I feel better now than I was non-running, so I’m hopeful it’ll carry over.
Flo,
I most definitely had pain at the sfx site for weeks following the injury. Overzealous cross-training may have had something to do with that, but I am certain the pain would not have cleared up within a week, even if I did nothing but sit. So I think that is a very positive sign for you!
Also, I completely agree with your theory re: reason for the injury. Mine occurred due to an inner ankle injury I kept running on – I compensated for the pain by running on the outside of my foot and fractured the 4th metatarsal.
Keep on posting updates. My fingers, formerly broken toe, and everything else I can cross is being done in your honor! xoxoxo
Cool on you sharing the same theory of why. You are so cute, I’ll take those broken and non-broken crossed thing wishes and wish upon you no more broken anything, ever.
When I had my stress reaction (right leg, medial, mid-shaft), not running or exercising on it the first few weeks DID alleviate the pain for me. It felt a little “wonky” at first, but I never had sharp localized pain that maybe a metatarsal, or tibial sfx gets. I think it’s because that femur is surrounded by a lot of muscle,etc. Anyway, it was hard for me to believe I was injured because just walking around, up/down stairs, doing normal daily things I felt nothing. But I had the bone scan and MRI to prove it. Idk.
Also, I remember when my doctor gave me the official diagnosis and told me “16 weeks of no running” I nearly fainted. Cried all the way home. Maybe he is just super cautious, but he is also a very reputable Ortho. around here…has treated all kinds of athletes from recreational runners to professional basketball players. So Idk about the proper recovery time.
As for cause, I totally agree with your assessment. In my case, I am pretty certain the cause was my faulty gait. I didn’t know I had this weird gait issue until I went to have a gait analysis done at Nebraska Orthopedic Hospital last Fall with a discount coupon..LOL. They videotaped me and were all, “Ooohhh, do you see that?? ::murmur murmur::” My right foot does not plant correctly..It’s very different from the left and causes my tibia and femur to twist in too much. I should email the video to you that I just had taken a couple of days ago..it is better, but still there. I’ve been working with an amazing PT here who specializes in what they call “Postural Restoration” and she is really helping me correct this.
ANYWAY, sorry about the novel, but I know that when I was hurt and looking for answers, no amount of info or personal stories was too much. : )
I’m hoping for positive news for you this week!! Stay cautious until you know!
xoxo
No apologies at all!! I want your novels, they’re fascinating. Very cool about the gait analysis, I hope that makes running better for you in all ways, not just healthier but even a speed infusion since working on that stuff seems to help with that even when it’s not the intended target. I’m excited for you to be on the upswing, you have a lot of unfinished business to do on the roads, my dear.
Another thing I found out that was interesting during all this gait analysis is that apparently I am a natural mid-foot striker. Not heel. So, yeah, I got that going for me…..now just to lose about 20lbs….
Lol, you’d be bored as hell if you couldn’t bitch about your weight.
Speaking of, I’ve been so angelic because I’m not able to run and I don’t want to have to deal with weight on top of lost speed but today I said fuck it. I ate a whole can of Pringles and about 1/2 a big bag of Reeses Pieces. Lunch and dinner. My tummy hurts.
I’m LOVING your posts, thank you so much everyone. Obviously, there is no common answer here but it’s still fun to read your experiences. Thank you and keep ‘em coming!
I’m glad that you don’t feel any pain. I will tell you that I had times of pain-free living, too, when it was really a sfx. I hope yours isn’t and you’ll follow through with the MRI just to be sure. I think a bone scan is generally cheaper, but wouldn’t show a soft tissue injury.
Sfx 1, 2007 (really a stress reaction): no running for 6 weeks, then could run. Still occasionally feel a twinge at the site (back of the tibia).
Sfx 2, 2008: no running for 6 weeks, then was only allowed to run supervised by the PT for 8 minutes 3 times a week for 3 weeks, then could gradually increase. Felt twinges from time to time for several months. Every now and then when I’m swimming I feel a small twinge there.
Sfx 3: After being in a cast and on crutches for 6.5 weeks then a boot for 2.5 weeks, all told no running for 3 months. It took 2 months to get up to 5 miles. No real pain or twinges in the foot that was casted, but occasional twinges in the other foot that he didn’t diagnose but was also most likely a fx.
Sfx 4: So far, in a boot for 4 weeks. I’m guessing it will be a while before I can run again.
OMG, your list is too damn long and has too many sad ones! Having to have a PT watch you run for 3 weeks and even then, for only for 8 minutes at a time is just Ugh. And then the next one with 5 months before you could run…that’s just plain depressing.
I’m realist enough to know it doesn’t mean anything if I’m pain-free right now, especially now that I have your history to draw from. I’m definitely doing the MRI, I really want a definitive answer to tell me, even if it’s not a sfx, the root muscles or tendons causing this.
Anyway, may this be a fast healing one for you and may you get to the bottom of why you get these!
I had a tibial SFx 4 years ago (diagnosed by bone scan).
It lasted EXACTLY 3 months – I couldn’t run a few steps without sharp pain. Then it abruptly dispappeared. I was able to ramp up my mileage (~50mpw) within a month.
SFxs of the femoral neck or pelvis would be worse than what I had, however.
I’m guessing (and hoping) you don’t have a SFx. Also, I agree with your comments on SFx healing more reliably than bad soft tissue injuries.
Take a Valium before you get in the MRI!!!
Best,
- rovatti
Wow, that’s a heartening story, not about the 3 months but the fast ramp up – really good to know. I think if I have a sfx it’s in the shaft since that’s where most of the discomfort was. But what do I know? This shit’s a mystery.
Lol, thanks for the valium tip. Wish I had some.
I have no experience or advice for ANY of this, but I would encourage you to get with Adrienne about questions. She had her run-in with SFX and has come back 110% stronger. She did a LOT of work to recover from the injuries, and in her words, “taught herself how to run again.” She also has her theories on what caused the problem, and can tell you what she did (is doing) to prevent it. She’s amazing…
I totally hope she pipes up but if I remember correctly, Adrienne’s “achilles heel” has typically been based around mileage builds leaving her injured, so that would point to form changes. As mentioned in the post, I’m confident that mine is not a mechanical issue but a one-off from letting a muscular issue blossom, so no form changes or prevention to worry about other than limiting mileage more sensibly when injured and calling a doctor sooner rather than later.
I’ve requested her presence here.
I wasn’t talking about the achilles thing…
Lol, I meant “achilles heel” figuratively, thus the quotation marks. I can see how a runner might interpret that literally.
She sent me a great message, loved hearing her experiences. She’s a real sweetie, that Adrienne.
Aw, gee thanks Flo! Always happy to help.
In my experience, the relief of symptoms has been very site-dependent. Tibia and mid-metatarsals, walking was fine within a week or two, it just became obvious if I tried to run. Pelvis/sacrum I would have twinges of pain while just turning over in bed for almost a month.
Also, if you google “william and mary return to running plan,” click on the first PDF, and scroll to the bottom of the last page, that’s what I typically do after a 6+ week layoff (usually the first 2 weeks are timed walk-jog mixes just because I’m really out of shape). Four months to full mileage is certainly not unheard of, but from my experience is aggressive, so don’t get your heart set on being perfectly in shape on that date! BUT, good that things are improving!
Thanks for the plan! Daniels also has a return to running plan I was eyeing. I hope I don’t need either but it’s good to be prepared. About that 4 months, I didn’t think full fitness would be back by then, just “semi-regular mileage” (note the semi), so no miracles expected.
Wow. Possible good news, so that’s great. Glad you’re wince-free. Perhaps it is a stress reaction rather than a fracture.
Sorry, but I’m as useless as Rebecca with personal experience, although I know athletes who’ve had stress fractures, have recovered, and are running better than ever. Anyway, good luck for the rest of the week. By the way, this page will be a great resource for sfx sufferers!
This is good news! I hope you are well on the way to recovery.
To answer your question to those with stress fractures, my walking symptoms went away once I stopped running for about 12 days. However, I did have that bone stim machine that I purchased very quickly. And mine were in the shins so it could be different. I hope you get your answers soon!
Ewen, thanks you big sweetie. It is turning into a very rich page, ’tis true!
Greenlee, thanks for the contribution. Aha on the bone stim machine. My, but I hope it doesn’t come down to that.
No experience here, but I’m a fascinated spectator who would like to avoid all this. The apparent improvement sounds like good news though. I am prompted to wonder if women get sfxs more than men. Are there any stats on that?
Yup, got this off the Orthopedic Association site:
“Medical studies have shown that female athletes seem to experience more stress fractures than their male counterparts. Many orthopaedic surgeons attribute this to a condition referred to as “the female athlete triad”: eating disorders (bulimia or anorexia), amenorrhea (infrequent menstrual cycle), and osteoporosis. As a female’s bone mass decreases, her chances of getting a stress fracture increase.”
Sucks to be female.
I guess it does.
LOL
Flo, you should check out Lauren Fleshman’s (was just on RW cover) website http://www.asklaurefleshman.com She’s a young pup but has been through some injuries including a pesky navicular sfx awhile back. She is a 5k champ, but is running her first marathon at NY this weekend. I just read on her journal on her website that she has suddenly had an issue with her knee about a week ago and is trying to deal with that scare. I love her site, she is very honest and forthcoming with her followers. I think you would really enjoy her. So yeah.
I subscribe to her blog. Agreed, she’s great. Yeah, it was quite a bummer to see the knee issue popping up now.
I had a femoral sfx (mid-shaft) 3 yrs ago. It started as what felt like a deep quad soreness, progressed to sharp pain when running/trying to run. By the time it was officially diagnosed (about 4 weeks later) it was a dull ache even when walking. I was on crutches for 6 weeks total: 2 weeks non-weight bearing, 2 weeks partal weight bearing, then 2 weeks just with 1 crutch. During this time I rode my bike trainer 1 hr/day 6 days/week (very low resistance) and did core work. After the 6 weeks it took my about 4 weeks to ramp up to running. Did just walking for 1 week, then walk/running. I ran (and BQ’d) a marathon 6 months later. I think my problem was lack of calcium in my diet because I hadn’t been doing anything radically different with my running. So for 2-3 months post sfx, I took 3000mg calcium per day. I am still extremely faithful with the calcium, taking 1500 mg daily and sometimes more if I am marathon training.
Good luck, Flo!
Also meant to say that my pain did not stop until I was on the crutches and keeping weight off the leg completely.
Thanks for the contribution, Beth! You and Beth above, with 6 and 6.5 weeks of crutches…oy, you poor things. I was talking with a friend who’d had a stint with crutches about how you don’t even realize the simplest things you can’t do anymore, like carry a cup of coffee. I think I’d cry for a week. Thank goodness for happy endings and your resulting BQ.