Pubic bone stress fracture - sigh

Ray here... diagnosed last Friday with a stress fracture of the pubic bone. I'm soon to turn 51.

I have been running since I was 20.  I'm not a maniac with miles, but have been a "runner" all of those 30 years with the exception of a 12 month hiatus 5 years ago.  In my 20s I was a high mileage, somewhat fast road racer (33 minute 10K time).  Now I'm a casual runner, 30 miles a week tops, and would struggle to break 40 minutes in a 10K).  I coach cross country and get miles in with my kids - a joy and blessing.

My stress fracture is most probably due to a groin pull that I suffered 18 months ago.  Oddly, this occurred because I was making a change to my golf swing.  I coach XC, so in July (2010) began working with the team, and by Fall had a full blown groin tear (guessing - wasn't diagnosed, tried to treat it myself with common sense and rest).

Related to all of this is an injury to my right hip that I received when I was 27 and changed directions quickly to get away from a dog.  Because of pain in this hip causing some tightness and spasms in my lower back, I sought treatment and care for the hip.

Dr. Greg Coppola (Erie PA) put me into PT with Impact Physical Therapy for the hip.  The PT folks were amazing and taught me, at the ripe old age of 50, a key lesson I'd somehow overlooked.  Many injuries are caused by a muscle weakness somewhere - something in the biomechanical system not doing its job.  Through strength work, some intense muscle release moves at the hands of Curt Cardman (one of the two owners of Impact), I made significant strides in terms of range of motion and generally feeling good when I ran.

However, there were still some restrictions in the hip and as a result, Dr. Coppola wanted to investigate further what this was.  I was still having some discomfort deep in my pelvis, primarily at the site of ligament and muscle attachment for my right groin muscles.

The MRI was ordered 2 weeks ago, and as I said at the start of this story, the read came back "stress fracture of the pubic bone".  Yesterday, I saw the MRI and we did an sonogram to investigate the specific points of pain.

The bottom line (I don't do short stories, sorry), is that essentially I have not rested for more than a week since the original groin pull.  As someone else on the blog noted, when the integrity of the muscles is compromised, the bone structures receive more stress and load and may ultimately fracture.  That's where I'm at.

I've generally taken ibuprofen with some regularity.  I have to stop that now and am on a minimum of 6 weeks rest.  From what I've read here, my pain is less intense now than many of you describe. However, I have a lot of "stabs" on a daily basis.  Sharp, deep pain that lasts only briefly.  Sometimes a dull ache in the attachment areas and occasionally a "take your breath away" kind of shot of pain.

Until we saw the fracture, I was running and generally feeling good while running - actually better than for a lot of years.

The point of all of this story, I suppose, is that my flaw was not getting a simple groin pull addressed or treated by a competent sports medicine / PT person when I had the chance.

I hope this is helpful to someone.
All the best.

AS

Hey all - I was out for a year with a Sacral Stress Fracture - missed the whole of 2009 with a few start/stops trying to get going. 2010 I got back into shape again and even finished the year off with a PR marathon but there were occasional on and off soreness as I trained back in that same SI Joint area where the stress fracture was in 2009. At the start of 2011 recovering from the marathon soreness I found that soreness to be to great to run again and I feared I'd done it again - another Sacral Stress fracture - I should note the prior one that knocked me out in 2009 seemed to come from the PR marathon I'd run at the end of 2008 so the pattern was repeating. But this time the doctors didn't conclude there was a stress fracture but rather ended up referring me to a Rheumatologist where I eventually ended up with the diagnosis of Ankylosing Spondilitis (AS). A somewhat genetic related autoimmune desease that generally starts in 20s or so. I'm 44 and as I think back I can recall even before my running days periods of what I thought of a Siatica - pain in the butt - going back for decades so apparently it was this AS all along. More than likely the Stress Fracture I got at the end of 2008 was a combination of inflamation from this AS in the SI joint (a common place for the AS to initially start) weakenning the bone somewhat and then combined with the running resulted in the SFX. For the back half of 2009 the SFX was most likely fully healed but the inflamation from AS was still there off and on as is pretty typical with AS and when I tried to run and felt some pain from the AS I feared another SFX and I'd back off running again and this cycle went through the back half of the year.

For some reason biking seems to deminish the inflamation and when I got back going in 2009 I initially took biking up to a pretty high level before I started running which I think helped me bridge into running again and also I kinda pushed through a little soreness from time to time and found I was OK.

Anyway - now that I actually know what I'm dealing with - AS - I treat it by taking NSAIDs (like Ibueprofin) daily to keep the inflamation away and most of the time I can run unrestricted. I've ventured into other sports and have finished off both an ironman and a 50 miler this year and now I'm training to take another crack at a PR marathon in January. I still get occasional set-backs with the AS but usually just 2-4 day outage kinda things. I spent much of 2009 worrying about what possibly could have cause the SFX in the first place checking leg lengths and having gait analysis done and worrying about little imperfections like Morton's toe or a bunnion maybe creating the imbalance that makes me prone to this SFX - but now I have a more solid DX I can deal with. Having AS sucks - don't get me wrong - mostly with the uncertainty of if it will progress or not over the future decades and also worrying about the effect of taking daily drugs for it - but at least I can work with a known quantity vs wondering.

Anyway - just thought I'd share that in case it's helpful to someone who might possible be in a similar prediciment.

Good luck to the long sufferers in getting better!!!

John.

Acetabular Roof Fracture

Hi!

I'm pAt, and I'm from the Philippines. Glad I stumbled into this website, interesting to read and very helpful to my situation. Here's my story:

I had an accident last May 24, dx Right Acetabular Roof Fx. A tiny winy cracked that pushed up my bones. I couldnt move my hips w/o hurting so much, my doctor put me on traction. 5 days at the hospital, I was not able to get up on my own. When I was discharged, doctor adviced me to go on bed rest w/ my traction and could only get up for bathroom stuff, using a walker. Luckily, found someone to help me get up in bed, help me w/my bathroom needs. The worst part came when I had a terrible fungal infection on my b*tt, becoz I was always flat in bed. I never tried to sleep on my left side. After two weeks, follow up check-up and xray. The result showed that my acetabular fx was stable, bones went back to its original position and its healing BUT the xray showed, Right nondisplaced inferior and superior pubic ramus. Doctor never mentioned about the pubic ramus part, but adviced me to continue w/ the traction and I am able to move but non weight bearing on my right side w/ a walker. Follow-up check-up after a month.

It has been almost a month, and now I'm able to stand on my own, walk a little w/my walker companion, do the bathroom stuff on my own. I tried to walk on my own, I can do it BUT I am limping on my right side, it feels like its stiff but I just want to follow doctors order, I'm having it rested for the meantime. and it's almost a month stuck at home, I missed my work, my officemates. I used to be a workaholic, but now I'm confined to the 4 corners of my house. I'll give you an update after my follow-up check-up.

Thank you for sharing.

Will it heal?

The neverending story

Hi everyone,
I too am suffering from a pubic ramus stress fracture.
My story:
I am 35. I love to run and cycle and had been hoping to get back to competition after a couple years off. I had recently lost 15 lbs, had no extra fat on me and was feeling like i was in the best shape i could be in. I teach fitness and am a massage therapist. I first hurt myself in February but thought it was a muscle strain in my leg. I kept it wrapped, stopped exercising but stayed doing massage all day and setting up exercise classes where I could mostly demonstrate. After 2 weeks, i demonstrated a move that had some impact in an exercise class and the pain was instantly sharp and shooting through the groin, adductor and abdominal area (with sharp pain and LOTS of swelling over the pubic ramus). Naturally everyone i saw about it thought it was a groin strain, as did I. It wasn't until sometime around 2-2.5 months ago that I found out whhat it was. I stopped exercising for the most part, except a few minutes of elliptical with a young man that i was training. I remained on my feet most of the day for massage. The pain diminished to the point that I can still do activities of daily living, but sharp pain returns periodically (with exercise) and twinges are constant. It is now June, and i have taken 3 weeks off of work to completely rest on crutches. I live in canada, where sometimes it can take weeks or months to get an MRI appointment, so I can't get imaging easily, and I do not live close to a major city. I am waiting for an appointment now, so i don't know if the fracture is still there, but the pain certainly is. It is not sharp all the time like it was, and I can stand on one foot. I can feel the injury always and the pain/twinges resume with activity, and last long after. I can walk without limping now. I keep reading posts where people mention that the residual pain continues AFTER the fracture has healed, and my question is: was there a noticeable difference between the pain before the fracture had been declared "healed" and the pain after the fracture had healed? how long did the pain or twinges continue after you had been declared healed? does anyone know why the pain continues on afterwards?
Thanks!
Natasha

So sick of this Sacra lStress Fracture

Hi! I am new to posting on the blog but have been reading and re-reading all your posts the past 4 months as I deal with a sacral stress fracture. First, let me say thank you for all your posts - they have been a lifeline when I felt like there was no one (including 3 different doctors) who understood or could give me any guidance.
I am 36, and was out walking my dog of all ridiculous things when I had horrible buttock pain and shooting pain through my low back. Being a hard core exercise girl I blew it off as a muscle cramp and went to a spin class ( dumb, dumb, dumb). I went to an orthopedic surgeon a week later . He x-rayed my back and told me it looked like I had a pinched nerve and sent me to a chiropractor and physical therapist. After being manipulated for another 3 weeks and not having improvement I got an MRI. Sacral stress fracture!
I was devastated when the doctor put me on crutches and told me we'd take things one month at a time. At the time I was horrified by the idea of being out of commision for one month. Silly me. 2 months later I was able to get off the crutches. I have a 2 year old and those were without doubt the hardest, saddest and most painful months of my life.
Now it is almost 5 months post-injury and I can walk around domestically (not for exercise) and swim with a pull-buoy. I also lift light weights for upper body and do stationary bike with no resistance. In all honesty I don't think the bike or weights do my fracture any good. But some days I can't control myself and the bike and weights happen.
So frustrating bc the doctor told me "it is time to get moving" and that I should start taking short walks. Well, short walks result in shooting pain - a few while I am walking and a lot afterward. I am not sure if that is just part of healing? I am not sure whether I am supposed to have NO PAIN while exercising or if that is just unrealistic? At this point I have night terrors about the fracture getting worse or never healing completely. I still have really bad "soreness" and liek I said, sharp pain off and on. But no where near where I was when it all began. I could not sit down or roll over in bed or sneeze without a major problem.
If anyone has experience with a sacral fracture would you please let me know how you "came back?" I am feeling really alone with this, and it takes so long that all the people who were once sympathetic now seem to think I am crazy???
Thanks for any information!

Pelvic Stress Fracture

Hi everyone! My story is similar to many of the ones that I have read on here. I was a collegiate cross country and track runner, and over a year ago, I started having pain in my hip after track practice. I didn't think it was a big deal, and I thought it would go away. After several weeks, I started having pain in my piriformis along with sciatica, and my left groin area felt frozen. I went to the doctor, and he put me on steroids because he thought I had a herniated disk. He also said that the best thing for me to do was to keep running as much as possible. Each morning I could barely walk at breakfast, and I remember counting steps to get places. But, I was stubborn and kept trying to run for about three weeks or a month. Eventually, I had a very hard time getting up from stretching; so, my coach told me that he couldn't let me practice anymore. One of the hardest parts of this process was that I had no idea what was going on. Despite the fact that I had had MRIs, xrays, CAT scans, I did not get a diagnosis until June, and my symptoms had started in the beginning of March. Multiple doctors insisted that it was coming from my back, and another doctor said that it was a groin strain. So, the pictures were of my back, and they did not show anything. Finally, they found two fractures in my pelvis. One in my inferior and superior pubic rambi. I wasn't allowed to do any physical activity for a month, and then I was only allowed to bike and swim and aqua job until mid-October.When I started running again, I was still hurting, but I figured I was just having "phantom" pain. I stopped for several weeks and then tried again, then stopped again, then tried to run again. I haven't run since mid-January, and I had an MRI on February 24 which showed that the fracture in my inferior pubic rambus is still broken. During this whole time, I have done a lot of cross training, but last week I decided to not exercise at all for a month (except for core) to see if it will heal. Not exercising is very, very difficult for me. I might let myself take short walks this next week just so that I can keep my sanity! Before this injury, I was very steady emotionally, but now it is so easy to get down and discouraged. Any tips on coping? recovering and general? And starting back to running safely once I am cleared to start? Thanks!