What does this look like to you?
I’ll tell you what it looks like to me – a healthy, happy, solid right tibia. Which sounds about right… I had a pain-free, speedy 5K on Tuesday the 24th (May), and any tibial pain I was feeling a while ago seems to be gone. (**NOTE** That’s not my leg. The CD from my radiologist doesn’t work on a MAC?! Grrr….)
So then at my doctors appointment last Thursday the 26th, why did my doctor order no running or elliptical for three weeks?
STRESS REACTION.
While I wouldn’t wish a stress fracture on anyone, I’m sure there are quite a few of you out there reading and shaking your head with sadness because you too are familiar with this diagnosis. Stress fractures are in the top 5 most common injuries reported by runners, and have been said to account for up to half of the skeletal injuries reported by military recruits. Contributing factors to stress fractures commonly cited include: age, sex, lean body mass, low bone mineral density, low body weight, late onset of menarche, history of stress fractures, disordered eating, and low dietary calcium intake. However, conclusive evidence regarding the pathophisiology and epidemiology of stress fractures is “lacking” considering many studies are short term and use a small population sample. Nonetheless, the one common thread seems to be participation in repetitive, weight-bearing activity. (1) Oh, hey running!
(Nov. 2008 – femoral neck fracture) So what exactly is a stress fracture? A tiny crack in the bone, resulting from repetitive stress or loading. Often caused by doing “too much, too soon” (coughcough 10% rule!), weakened bones (osteoporosis, osteopenia), sex (women, especially with a history of amenorrhea or oligomenorrhea), and faulty biomechanics (leg length discrepancies, heavy heal strikes, etc.). Presents with pain, swelling, tenderness in a specific spot (the “hot spot”), increases in these symptoms with activity and decreases with rest, and earlier onset of these symptoms with each successive exercise bout or workout. Typical treatment is every athlete’s most dreaded prescription – rest. And possibly crutches or the boot of doom. (2)
A stress reaction then, in short, is the precursor to all of this. You are toeing the dangerous line of developing a stress fracture, but haven’t gotten there quite yet. Which apparently, is the case with my left tibia.
Three weeks of no running was [IMO] certainly a conservative measure, but truthfully my running had become so sporadic at that point that I didn’t really care. Some days it was great, some days it hurt. The mandate of “no elliptical” was an attempt to remove any unnecessary loading on the bone and speed up the process of recovery, and the prescription to bike and swim my butt off was to any ounce of sanity left, not to mention not be disowned from my family (or fired from work) for grouchiness!
Following this three-week-reset I’m going in for a running analysis (Wednesday the 15th) and hopefully will develop a plan with my sports-med team to come back to running (and racing!) safely, and solidly. I’ve been doing all of my treatment for quite a while now at the Institute of Athletic Medicine, and I can say with 100% honesty (and zero persuasion) that I LOVE them. They are honest, direct, proactive, and do what needs to be done!
With a little insight from a couple close freinds/family, I’ve realized lately that ever since my hip surgery in December of 2008 I haven’t been quite the same person. Aside from the cascade of injuries since that date, my “psychology has been off”. My highs aren’t as high, and my lows… well, they’re definitely more apparent. Everything I think of in my history is separated into a “then” (pre-surgery) and ”now” (post). So I finally asked my doctor lastlast Thursday,
Do you think I’ll ever go back to being a “real” runner again? Like the girl who just wakes up and runs out the door, and doesn’t think anything of it? Do you think I’ll ever be able to run another marathon?
And her response?
Yes. Absolutely. But will you be able to exclusively be a runner, and not do anything else? No.
Seeing as how I’m slightly invested in this triathlon thing, I guess I can roll with that. I’m not sure if her “yes” included being able to run marathons again or not, but for now I’ll just take things one step at a time.
(Manitou Tri – June 2010) Regarding racing: my three-week hiatus unfortunately extends past June 12th, which is the date of the Manitou Triathlon. This is hands down one of my top three favorite Minnesota races, and “bummed” doesn’t exactly exemplify how I feel about missing it. My plan until my legs are race ready is to volunteer (and relay!!) my butt off. I’m definitely not ready to leave the Minnesota Tri community yet.
READER Qs:
Have you ever had a stress fracture, or a stress reaction? Any local readers racing Manitou?Anybody interested in a TRI RELAY!?
What is your next race coming up? What is your favorite form of cross training when “on the mend”?
Take luck mis amigos (+1,000 if you know the reference!!!!),
-E
(1) Kelsey, J. L., Bachrach, L. K., Procter-Gray, E., Nieves, J., Greendale, G. A., Sowers, M., & … Cobb, K. L. (2007). Risk Factors for Stress Fracture among Young Female Cross-Country Runners. Medicine & Science in Sports & Exercise, 39(9), 1457-1463. doi: 10.1249/mss.0b013e318074e54b
(2) Mayo Clinic. (2010, December 7). Stress fractures. Retrieved from http://www.mayoclinic.com/health/stress-fractures/DS00556
































