Serious Running/Athletics Injuries: Global Group blog

Pubic bone stress fracture - sigh

2011-10-22T00:05:00.000+01:00

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

2011-10-17T15:24:00.002+01:00

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

2011-06-23T00:04:00.002+01:00

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?

2011-06-22T18:42:00.004+01:00

The neverending story

2011-06-03T17:14:00.003+01:00

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

2011-05-25T19:58:00.003+01:00

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

2011-03-28T00:06:00.002+01:00

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!

CT

2011-03-15T02:54:00.002Z

Today I went to go get my CT scan for my pubic ramus stress fracture. The orthopedic finally told me that after this he will refer me to surgeons who specialize on these types of injuries. Who knows, I might have damaged a ligament in that area. Hopefully I will get the results soon!

Frustrated!

2011-03-09T02:14:00.002Z

Hi! My name is Yamila. I am 16 years old, and currently attend high school in California. I was on the Cross Country team and had been running since the summer, and then I suddenly get this stress fracture down there near the pubic ramus! I am really frustrated and haven't been able to do any fiscal activity since September of 2010!
It really hurts to just walk ( on/off pain). And my orthopedic has not really done much, he just keeps telling me to come back in a month every single time! All he really does is take x-rays saying, "well it looks like it is healing, come back in a month to see me."
I desperately want a 2nd opinion but don't know what type of specialist to ask.
Anyone know what type of specialist I should go see?

healing

2011-01-27T20:17:00.001Z

Hey all,

I've been meaning to post an update for a while now. I initially described my dx in October. I took off running and walking more than necessary until the end of December. I also worked really hard at not carrying my daughter on my right hip- the injured one. In December I went back to the orthopedic doc who recommended p.t. I went to one appointment and got the exercises.

I feel like my greater healing, though, can be attributed to three things.

1. Practicing yoga. It's been helpful in strengthening and body awareness.

2. Reading up and beginning to practice chi running. I'm convinced my running posture and form were, in part, why I got injured. I took a workshop, bought the book and the DVD.

3. I am going to a Rolfer. My very beginner knowledge of rolfing is about getting gravity to work with your body.

I have been running three days a week since early January- making sure not to run two days in a row per many of your recommendations. I have some ache-iness, but no real sharp pain as before. As of right now I'm planning on running the Colorado Half on the first of May.

My hope is that by listening to my body I'll be able to run healthily for years to come!

Take care,
Sarah

Severe Pelvic Injury

2011-01-19T00:31:00.002Z

Hi Bloggers!
I am so happy that I found this blog! I have researched like crazy over the internet and finally came across something I was interested in, and thought it would be very beneficial. I have thoroughly enjoyed reading the posts, and want to send out my sympathy to everyone that has suffered from this type of injury. So I guess I'll post "my story," along with a video blog that I created a couple of months ago.

My Story-

In January of 2010 I was seriously injured in a car accident. I was ejected through the passenger side window at almost 90 mph. My femur was pushed out of socket and severely shattered my pelvis and right hip. Part of my pelvis was detached from my spinal cord and my pubis bone was broken in a half. Luckily, because of god's mercy I had no internal damage. Doctor's said it was a miracle! I also broke my ankle, jaw was broken in half, and had several facial fractures, just to name a few... I had to undergo a 12 hour surgery to put my pelvis back together. My surgeon is one of the top orthopedic trauma surgeons in the nation. He said he had done over 800 pelvic surgeries and mine was one of the worst he had seen. As a result of the surgery, I was left with a lot of nerve damage, and now have "foot drop."

This week will be the one year anniversary of my accident. Everyday has been a struggle, but I have come so far! I am still in a great deal of pain and discomfort, mostly from my sciatic nerve. I have tried pills,herbs, pain patches, creams, oils, you name it! Nothing seems to give me relief except for ice. I have a collection of 8 ice packs that I carry with me at all times in my very convenient cooler! :)

I am still hopeful that my nerve damage will heal, but I know it may take some time. Living in chronic pain is not easy, but I am trying to stay positive, and remain thankful.

Here is a link to my video blog: I hope you enjoy it! http://www.youtube.com/watch?v=V1NJ2D8A21U

-Caitlin

looking for sports specialist

2011-01-12T17:27:00.002Z

Hello everyone,

I am new to the blog and have gathered a lot of great advice in reading posts from many of you. I was diagnosed with my stress fracture last September, took eight weeks to recover and was back to running in late November. Unfortunately, I did too much too soon and had a reinjury beginning of Dec. I am hoping to find a sports MD or other specialist in the SF bay area who can help me put together a plan for getting back to running safely. Any advice in this area would greatly appreciated.

Thank you,

Heather

Recovery Update

2010-11-01T04:15:00.003Z

Hey All-
Just wanted to publish an update. I am doing great! After my last doctor visit at the end of September, my Dr. was really pleased with my recovery and gave me the go-ahead to start running VERY SLOWLY! He didn't want to see me again, just send him an email and let him know how I am doing around the 2nd week of November. I started out doing 30 second runs with 1:30 min rests for about an hour. Today, I completed 7 minutes run with 3 minutes rest for an 1 hr. 15 min and covered 7.5 miles! Pain FREE! I had had a bit of pain when I first started out last month, but had to learn what was pain that I should stop running, as opposed to pain that was just annoying pain that I could run through. I have to admit that the thing I was worried most about was the fear that I would always be thinking about getting injured again, but I find that I don't think about it too much. I'm not being stupid and overtraining anymore, but the fear thing has subsided greatly. I have been doing lots of yoga and I think that helped me a great deal. I may also add that before the doctor gave me the go ahead to run, I had been walking a 4.5 mile loop in my neighborhood and that had also helped me a great deal. I will also not run 2 days in a row anymore for a long, long time, if ever. I also found some great shoes that I love-FINALLY! I had ordered a pair of Brooks that have a lot of cushioning, but felt they were too heavy and use them as my everyday shoes. What really surprised me was the pair of Saucony training flats that I had ordered, at the same time. I put them on and it was a perfect match! I was afraid to wear such light shoes, again, seeing that that's what I was wearing at the time of my injury, but these just felt right. So, 7 months later, here I am. Not perfect, but on the road to recovery! I mostly have to be careful not to overdo it. Sometimes I will get tinges of bone pain and it keeps me grounded. I've already turned down one relay team invitation and am not signing up for any events until my main Ironman in June. For the first time in a very long time, I feel like I will be there on the starting time. I won't be able to try and qualify for Boston or NYC marathons with my friends, but maybe after next year, I'll be able to do that. If I even want to. I think marathon training and racing are much more stressful than training for the Ironman. So, to all who are suffering from this injury, I hope this helps. Stopping everything for the few months that I did, was really beneficial to me. The doctor told me it was a good call. Still haven't been able to lose this extra few pounds though!

new dx

2010-10-19T20:42:00.000+01:00

Hello all,
So glad to have found this blog. I had my third child a year ago and have been getting back into running since the spring. I have been a runner since my jr. high days. Most recently I was training for the Twin Cities 10 mile. In mid-September I went out for a four mile run. About two miles into it I had intense groin pain. The pain started to radiate around my entire hip. I decided to take a week off and try to run again. Not good. Still in pain. Especially when trying to stand just on the injured leg and when walking long distances. My leg would "give out" just standing there. The Thursday before the race I went out for a three mile run and was in quite a bit of pain so the Friday night before the Sun. race I went to a walk in ortho sports clinic in Bloomington, MN. The doc thought it was just a muscle strain as I wasn't having pain while hopping on my right leg. I told him my goal was to run as soon as possible and so he said to wait until after the MRI. A week and a half later I had the MRI and was diagnosed with a interior pubic ramus stress fracture. At this point I haven't been running for four weeks so the dx is a bummer, but the no running part was harder two weeks ago. He told me to use crutches for four weeks which isn't possible with three children five and under. If it takes a little longer to heal, so be it.
This site has been very helpful. As has this site.
I haven't been able to read through all the entries, but I'm wondering if anyone has done anything to change their running pose. Such as chi, evolution or Pose running? Or done more barefoot running or used Newton shoes? I am most certainly a heal striker and wondering if I should make some shifts away from that.
Take care and thanks again for being such a wonderful, hopeful resource.

2010-10-18T04:58:00.003+01:00

delete

Hi All

2010-10-07T15:33:00.002+01:00

Hi Everyone,

Have been reading this blog for a few weeks as I suspected a Pelvic Stress Fracture before I was diagnosed. I have spent a lot of time reading all your stories.

I was diagnosed this week with Superior and Inferior Pubic Ramus Stress Fractures. It happened about six weeks ago: I was doing a long training run one day and felt these odd sort of pinching sensations in my groin area but they didn't hurt so I kept going. Later that evening I experienced some pain in my hip so rested for a few days until it felt normal again and then went out for a short run. About a mile in I was in absolute agony...It felt like some sort of awful muscle pull or tear in my hip/groin/buttock accompanied by shocking sciatic type pains all down the back of my leg. I could barely lift my leg to step up onto the curb and had to hobble home. An hour later, I was hysterical because I was in extreme pain, couldn't walk and my husband was away on business. I have three small children so have to be on my feet most of the the day. That first week was horrible...I hobbled around everywhere, could barely put on pants, get in and out of the car. I realize in hindsight that I should have been on crutches. I finally went in to see my doctor and she sent me to a physiotherapist (we both thought it was a piriformis issue because at this point it didn't feel like "bony" pain it was more like muscle). The physiotherapy didn't help and they couldn't give me any more ideas about what was wrong with it. I tried to run on it a few times during this time but realized that this was impossible...SO painful and would cause me to limp and hobble for the rest of the day. Also, the pain started to feel more like it was a bone-type pain and became more focussed to the pelvic area. Went back to see my doctor who sent me for x-rays (normal), ultrasound (normal) and then finally a bone-scan this week which showed the stress fractures in two places. It has now been six weeks and I am still in low level pain most of the time. Running is impossible, walking is not too bad but causes that throbbing ache later in the day. I'm finding that sitting and driving are really problematic. I am unable to sit comfortably for more than a minute or two. Stretching and yoga-type activities are also too painful to do. Turning suddenly, lifting heavy things or anything that requires me to weight-bear on one side still produce those sharp twinges. Lying on my left side at night is still painful. I have been riding my stationary bike which seems to not bother it, strangely. Have now been referred to an orthopedist but have to wait a month to see him. In the meantime I'm really not sure what I'm supposed to be doing/not doing. My family doctor has never seen this injury before so couldn't really offer much advice.

I'm completely baffled about this whole thing. I'm 33 and have been running and doing aerobics for years When this happened, I felt like I was in the best shape of my life. I used to get up before dawn to run 5 or 6 days a week (averaging about 30 miles a week). It was such a wonderful stress reliever and energizer. Missing it SO much and feeling extremely worried that I might never be able to run again or that it will become a chronic pain issue. Sigh.

Thanks for letting me vent here...as some of you have said, non-runners and family members don't really seem to understand because a lot of the time you look 'normal'.

One thing I wonder about is the diagnostic process for this injury. At my initial appointment with the doctor and physio I was able to do the hop test and range of motion tests with no problem (although they undoubtedly painful). I'm concerned that a lot of people seem to have very long healing times because this ( in most cases) takes so long to diagnose. I worry that I done lasting damage by "testing" the injury in those first few weeks...

I would love any words of advice or wisdom anyone can offer--trying to keep things in perspective; I know it could be much worse.

Stops and starts

2010-08-31T19:05:00.000+01:00

I didn't realize until just a second ago that the last time I wrote in this blog was all the way back in October on my injury anniversary. So much has happened since then and I haven't had the time and/or I've been putting off this update. Warning: This is long.

I guess I'll start way back at the beginning since its been so long. I was injured in late October 2008, a month after my second half marathon. I know how I did it. I had been training on run/walk intervals, but after completely changing my plan during the half, I decided to switch to all running. But I did too much too soon.

Long story short, it took a month to have the stress fracture diagnosed. Like many stories I've read here, initial thoughts were that it was a muscle strain. Just before Thanksgiving I had an MRI and my diagnosis. At first I tried to do light cross training but eventually ended up completely sedentary and using crutches to try and promote healing. I was finally cleared to run again just two days before finding out I was pregnant in February 2009. After the first trimester I ran a little bit but couldn't continue because of my lack of a base.

Fast forward to October 30, 2009, I gave birth to my beautiful now 10-month-old daugher Allie. There are many pictures posted in my other blog. I think it really helped my recovery to not run for that extended time during pregnancy. I started running again in December, but battled shin splints and a crazy schedule. In January, after a year of being unemployed, I started work for the State of Wisconsin Department of Workforce Development in unemployment insurance. It was really tough to figure out a good schedule for working out. I've never really been a morning person, but I finally settled on getting up a half hour earlier three days a week to run. Now I have the dilemma of whether or not to run outside in the morning while its still dark. I'll be stuck on the treadmill all winter, so I'm trying to keep running outside as long as I can.

I had decided on a goal half for Memorial Day weekend and another in August. I also wanted to run a full in the fall. But those goals proved way too high for me this year. Luckily I realized that before I hurt myself or got burned out.

The shin splints have been quite a challenge. I've had them off and on the whole time I've been running. But they really got bad at the end of March. I ended up taking off most of April because of the shin splints and because I was sick a lot (I spent a year basically in my house so I think my immune system was down). I came back to running in May, but had more problems with shin splints after getting new custom orthotics. It got to the point where I thought I had stress fractures. But a month and a half off and doctor's visit reassured me that my legs were fine.

Since I had stopped running again, I decided to build up to running the way I did after the stress fracture, where I'd increase my running time by a few minutes each run. I had been trying to train on intervals and on the intervals I could do more than I was ready for. Thats my theory at least. I figure thats why the shin splints got so bad. So I used my umpteeth restart as a complete start over and have increased my running time to an hour. I focused on the time instead of distance until I reached 45 minutes. My longest run so far has been 4.5 miles. I was going to run 5 miles last week when I fell half a mile from being done and sprained my ankle! The ankle is much better now and I ran this morning. I was more upset about not finishing 5 than getting hurt, that is, until it really start to hurt.

I posted the link to my family blog earlier, and I have a running blog too. I stopped posting in it while I was injured and pregnant, but now I have revived it. If anyone is interested in reading, here's the link to that one.

Overall I'm confident in my running even though I still haven't accomplished real consistent weekly mileage. I increase one week only to decrease the following week because of shin concerns or, as was the case last week, a sprained ankle. But I've increased my monthly mileage and I even have a racing calendar again! I started it the weekend before last by running the 5K that was actually paired with the half I had planned to run. It was a bad race for many reasons, but the next one will be better. I am running an 8K the weekend after next with my family so that will be fun!

Of course I'm thinking long term goals because I do want to run that full one day. To start on that journey I'm running a leg of the California International Marathon relay in December with some other new moms I met through the runners world forums. I'm looking forward to the vacation and the race. I'm also looking forward to training up to the longer distance. Its intimidating but I'm excited. When I ran my first half two years ago I loved the feeling I got when I realized I really can make my body do anything. I'm feeling that again.

My new goal is to run the half next May that I wanted to run this year. I'm probably also aiming for the half next September but after that I'm training for the full! My dream is to run the New York Marahon some day, even if its as an automatic entry after not being selected in the lottery three years in a row. I had entered the lottery in 2009 but I didn't this year so I'll have to start that process again. It gives me plenty of time!

The stress fracture is always on my mind though. I'm being careful not to increase my mileage too much. When I started running again the spot would really ache afterward. I didn't even realize the ache was gone until it randomly started to ache again after a long run a couple weeks ago. Nearly two years later and I still have that phantom pain. I run three days a week and I never run two days in a row because that worry is always there. But later I might add a fourth run to my training and try two days in a row.

I'm so happy to be running again and in some ways I'm running better than I did before I got hurt. After I had Allie I told anyone who would listen, even the doctors and nurses in the hospital, about my plans to get back to running. It took longer than I anticipated, but I'm finally back.

Latest Update

2010-08-31T04:36:00.002+01:00

Hey Guys:

Just thought I'd post my latest visit to the Dr. I got a very good mark! They took an x-ray to look at the bone, as opposed to an MRI. He wanted to see without the soft tissue around. He said the bone looked really healthy and was healing well. He had told me that I could still bike and swim, but let pain be my guide. I had decided that I just needed to stop it all. That was the best thing I could have ever done for myself! It's been about 5 weeks since my last bike and about 2 weeks ago, I started having a few hours a day where I actually felt normal! No pain. Each day it seems that my pain has lifted more and more and now I am walking about 3-4 miles every other day and I feel great! I know I'm not even close to running yet, but I do feel like I'm healing. I am now going to start deep water running and some light yoga in another week. I have put on about 7 lbs. Ugh. I had also investigated ultrasound treatments and was giving myself some, but the Dr. suggested that I do the treatments after the bone has healed itself. It seems the quality of the bone when healed on it's own is better than the healing with the ultrasound, but I could certainly do it when I'm healed to strengthen the new bone. I've learned alot about all of this because I have really felt alone. All of the books and most of the Drs. will tell you that you can still do light training as long as it doesn't hurt. I'm very happy that I took myself off of everything. I'm still signed up for Ironman in June of 2011, but if I can't make it- oh well. I really feel this total stopping has helped me try and make that goal. Hope any of this helps to all of those with this stress fracture. I have another Drs. appt end of Sept. will check in then. Thanks!

Steve

Introduction

2010-08-28T23:53:00.003+01:00

Hi, everyone. I've been reading your posts since I was diagnosed a month ago, and I thought I'd introduce myself. It sounds like I was lucky, in that I went to a sports medicine doc and got an MRI right away. Basically, I was out for a run one day, stumbled, kept going and then had horrible pain in my hip and groin after I got home and sat for a few minutes. Initially the doc thought it was a muscle pull and told me to rest it until the pain was gone and then resume running. About five days later, it felt fine and I went on a run with my group. I got about 2 miles into a 6-mile run and had to walk, but I thought I could walk it off and start running again. Instead, by mile 3 I was too far out to do anything but limp the 3 miles back to my car. After that, I couldn't put any weight on it at all. Went to the doc that Monday, and had an X-ray and MRI within a couple of days that confirmed a stress fracture.

So here I am after four weeks. He said not to do anything, including pool running, until the pain was gone. Every weekend I think I'm going to be ready, and every weekend I'm not (and thanks to the posts here, I show some sense and don't even try). I'm leaving Thursday for a birthday trip to Disneyland, where I was supposed to run a 5K on Saturday. Good sense may prevail, especially after trying to walk around the parks all day Friday, but I'm still hoping to at least walk the darn thing. Feel free to tell me how stupid this is. :)

I'm also registered for a half marathon on Dec. 5. I'd be OK with a run/walk, if I can just finish the darn thing. I've already accepted that my running group has passed me by and I might never catch up. Do any of you guys run with groups? Did you go back after your injury, or was it pointless to try?
Robin

Update

2010-08-10T15:13:00.003+01:00

Hey everyone its been quite awhile since my last post, my pubic ramus fracture occurred in Sept. '08 and like most of us I felt it was just a groin pull or strain. I quit trying to run due to the discomfort, but I continued to use the elliptical trainer and take my spin class. It wasn't until Nov. '08 that I finally had a MRI to reveal the stress fracture, my first. I was a guy who at one time was logging 50 MPW, ran marathons and 50K trail races, I had the normal problems with IT band and runners knee, but never any stress fractures I was shocked.

Finally starting in Jan. '09 I quit everything except swimming no kicking used a pull buoy, and lifted weights. I did this for 15 weeks and slowly incorporated back using the elliptical trainer. I want to be clear at most I have done the elliptical two times per week, not everyday.
I can go for a week at a time and my groin/thigh feels great no problems, then at other times it still is achy.

Now we are almost at my 2-year anniversary of the injury, I have yet to go for a run yet, I admit mostly out of fear, I still have times of dull aches and "twitches" in my thigh and right groin area. After sitting for long periods I definitely get a dull in my right buttock area.
I have improved my diet, I always ate clean maybe too clean not enough fats, I also have been taking my vitamins including D and calcium. Also has anyone heard of the herbal supplement cissus quadrangularis?
It is a Indian herbal supplement used for years to help heal tendon and bone fractures, I have investgated it and lots of the bodybuilding websites reccommend it for joint problems, it seems to be popular with those guys. On some other plevic stress fracture blogs some runners are using it. I am still curious about the safety of it, any new information would help.

My question is does anyone have any suggestions, should I still be having aches from just one time per week on the elliptical trainer?
I know now I really was dumb to continue to cross-train in the beginning, however I feel as though I have been much smarter and quite good to my body to allow for healing.
I would really appreciate any advice and support!

Thanks,
Jonathan

Great Posts Guys

2010-08-05T06:47:00.002+01:00

Not real savvy with blogging- Just wanted to say 'Thanks' to Scott, Allison & Lizanne for their great comments. I know the ultra sound is probably just to satisfy me that I am doing something. Will let you know what the Dr. says- Still haven't heard back from him. Hmmm. 2 days now. I've thought about the crutches, as well. I'm so glad that I've stopped the cross training. I did make the mistake of getting on the scale this morning. Not good. Have been eating so good, too! Maybe just a bit too much hummus. It's like candy to me. Anyway, I'll check in after my Dr. appt. on the 23rd of August. Thanks, again.

Steve

Dodged a bullet!

2010-08-04T15:02:00.001+01:00

I just wanted to offer some words of wisdom... I am a 25 year old former collegiate runner who has been running competitively since I was 12) Back in 2006 I also thought that I developed a groin strain during a workout, and the doctors agreed. I continued to run on it, despite the fact that I could only handle limping through 3 miles or so, believing it would "work itself out." That went on for well over a month until one day I couldn't put any weight on it at all - the doc finally ordered an MRI, which showed a complete fracture of the left inferior pubic ramus.

I was also told I could do non-impact exercise, and went straight to aquajogging, the elliptical, anything to feed the exercise addiction ;) Long story short, I wasn't truly healthy and able to run again for a solid 10 months. I'd wait out the "prescribed" time, try to run, it'd flare back up, and so on. It took me 8 months to finally just REST and not try to cross train, which seemed to be key in finally healing.

Anyways, I finally got healthy and have been running just fine ever since. This past year I started to train very seriously again, as part of an olympic development team, and have been running 90-120mpw. No injury issues whatsoever until four days before my marathon in June. I first felt that stabbing groin pain when I went to put on a pair of shorts. I knew that pain allllll too well! This time was the right side. At that point it didn't even hurt to run, but I knew better. I went straight to the doctor, told him I needed an mri and got it done right away. I was sort of right - luckily I caught it early enough that it was still a stress reaction, with no fracture line. They said one more run probably would've done it.

So I was upset about the race, but my relief at catching it early took over! I was smart this time (experience is the best teacher, right?) and did absolutely NOTHING for two weeks. The doctor told me I could pool run, bike, but I knew better. I put myself on crutches, enjoyed getting some extra sleep and was patient.
After two weeks I got into the pool and was able to aquajog with no problems. I tried to get on the bike but the spot was "noticeable," so I got right off. At 4.5 weeks I ran 3 miles...NO PAIN. Nothing. I've been slowing building up for 2.5 weeks now and feel great, albeit a bit out of shape. I ran 7 miles this morning and feel confident that I dodged a bullet.

My suggestions: Do it right away! If you missed that window, do it now. You will be fine, you won't get fat, and you will heal much more quickly! Crutches helped me take the rest seriously, and I definitely recommend them even if you *can* walk. Find a physical therapist or strength coach who works with runners, knows something about the body, about biomechanics and can help you identify weaknesses and develop a strength training plan. I didn't do much with this my first go-round, and here I am with the same injury again. This time, I've identified adductor/hamstring weakness, overdeveloped quads and a pretty significant pelvic tilt. I've been diligent about sticking to my strength/stretching plan and working on realigning my body with yoga-type work. You have to figure out why it happened.

Back to the cross training...as much as you want to convince yourself that nonimpact is fine, keep in mind that this particular bone is attached to your adductors, abdominals, etc and is going to be aggravated with any sort of leg or core movement. Give it time to calm down before you stress it again.

Eat well. Don't freak out about not being able to exercise and resort to eating sugar-free fat-free everything. Those chemicals have no place in your body and are not going to speed up healing. Eat whole, real, nutritious foods, give your body what it needs. Your appetite will regulate, I promise

Anyways, hopefully something I've written will help some of you, or at least give you hope as you deal with this loooooooong injury. I've been through it, and had a list of things I'd do differently if it ever happened again. Well, it happened again and I stuck to that list and so far, so good.

No matter what, remember that you WILL get back to running. When you're finally ready, start up slower than slow and be patient. Before you know it, this thing will be a distant memory and you will be fit as ever.

Pelvic Stress Fracture from Overtraining?

2010-08-04T03:56:00.003+01:00

Hello Everybody:

It's nice to know that I am not alone with this 'bizarre' injury! I am a two-time Ironman triathlete and was actually training for a Boston qualifying marathon when all of this ensued. I had switched to training flats earlier in the year and was really running well throughout this past insanely cold and wet winter upping my mileage to around 50-55 miles per week. In April (2010), I had committed to be on an 80 mile relay team in Southern Illinois called River to River. It's only 3 legs, but it is extremely hilly and fast. There are 8 people on the team and I was an early leg, so after I was finished, I decided to run the last leg with the last runner. I don't know if I was fatigued from the 3 previous legs or if it was the intense downhill of this 'extra' leg, but I remember feeling a bit tired and having a hard time running. I didn't really question it- just threw it to being a long and hard day. After the long ride home, I remember feeling like I had a zit or irritation starting on the inside of my left thigh. I took a day off and the following day, I resumed with what was to be my last long run before my marathon. Well, I got to mile 14 and I felt like I had a cannon ball in my shorts! The weirdest sensation ever! It wasn't especially painful- definitely not sharp, but very intense and deep. That was April 19th. Now, I have trained for 2 years straight, before this summer, and I was to take this summer off before returning to Ironman June 2011. I had had a multitude of problems with my left leg; IT Band issues, knee soreness & terrible plantar plantar fasciitis in both feet. I just chalked it up to another leg issue. This, however, was not going away. I chatted up all of my Physical Therapy biking & running buddies and after a month or so, I actually had 'Stress Fracture' come up. Trying to avoid the cost of an MRI (embarrassed by that!), I had a regular x-ray and of course, nothing showed up. I finally, went to a Sports MD and even he didn't think I had a stress fracture, but wanted me to finally have the MRI that day to rule it out. Well, not only do I have a stress fracture on my inferior left pubic ramis, but also a labral tear on each hip! I'm doing some physical therapy on the hips, but am told to just wait out the long haul on the fracture. I've gotten a hold of an Exogen Ultra Sound machine. Just waiting for the Dr.'s OK to use it. It's supposed to reduce healing time of regular breaks and stress fractures. Anybody using ultra sound out there? It's been the strangest few months. Nobody really seems to know a great deal on how or why or how long healing is. I feel a bit alone in this whole thing. I'm still mobile, but I do have discomfort and was told I could bike and swim as long as I don't feel pain. I did and I've stopped that too. Feel like a sloth! I'm hoping that I can be back to start training in January and long shot get to my Ironman in June of next year. Oh well, I guess we'll see. Thanks for letting me post. Maybe this will help somebody. PS. I'm 47, have been gradually working on becoming a vegetarian and generally very healthy. I have never broken a bone in my life! My doctor kept asking me about my diet. I eat really, very well and try to eat many different grains and beans etc., so I don't think it could be that. I'm going to get a physical now and have my blood tested. Haven't gotten a bone density test done. Getting older sucks!

Last Post

2010-08-04T02:14:00.002+01:00

I did not get a response to my post here so I have moved to the Runner's World forum called "Post Pelvic Stress Fracture Recovery and Insanity". To find it, go to the RW website and click on Forums/Injury Prevention/Injuries. It is very active and Badlands does a great job welcoming new people and moderating.

Another newbie - with some questions

2010-08-03T21:15:00.002+01:00

Hi all!

I'm happy to have stumbled across this blog today. I was recently diagnosed with a "displaced fracture to the left inferior pubis ramus." My injury occurred very suddenly - around mile 12.5 of a 14 mile training run. I felt my hamstring tighten up a bit and then WHAM, shooting pain up my inner thigh straight to my pubic bone. I thought I might have pulled my groin muscle at the time. The pain in the first 2 weeks was excruciating. After that, it was a little better but my one attempt to run made it clear that the injury was serious and I'd surely have to miss the half marathon I'd spent the last 4 months training for. At my request, the doctor ordered an x-ray and then an MRI. He was shocked that the scan showed a fracture as he's never seen symptoms like mine. This might be the crux of my uncertainty with listening to his advice...

I'm very slightly encouraged by those of you who have recovered (although the lengths of recovery times is overwhelming). My doctor has said that I can proceed with non-weight bearing activities (swimming, biking, elliptical, etc.) but I am very concerned that even these sorts of activities will impede a full recovery. For the most part, the activities are not painful but I will have a twinge of pain every now and again while doing them. For example, the "jumps" in spinning class have a tendency to irritate the area. I'm finding that my pain is worse some days than others and I haven't been able to pinpoint what might be irritating/aggravating the injury. I'm also not sure what to contribute to the fracture and what to contribute to other issues (maybe muscle soreness?)

I'm most curious about the issue of rest. I'd really like to do some form of workout (I'm going crazy without my regular workouts) but I also don't want to delay the healing process. My doctor says it's okay, but I'm a little reluctant to follow his advice after reading your stories. Has anyone had success healing WHILE still getting in some forms of exercise? What sort of pain might be okay without being an indication of slowing the healing process?

Also, I stopped my yoga workouts because some of the lunge style poses were adding mild discomfort to the groin area but there was some suggestion that this type of strength training is positive. Any thoughts?

Jim--new to this Blog

2010-08-03T18:22:00.002+01:00

Hello Everyone:

I saw that my initial posting did get posted. So please allow me to share...

On June 21st I had a bike accident and fractured by pelvis. I am 65 years of age. I am in pretty good health...always worked out everyday after school. I am a high school counselor. I think my main question is this, which might sound silly: Will I ever heal? I hear that because of my age, the healing of this fracture will take longer. It normally takes 6 weeks for a bone to heal, but in my case, it will probably take anywhere from 8 to 10 weeks. I would like to stop now and hear from anyone who can share there thoughts about the healing process and the time frame.

Thanks

Jim W.

Day #21 Post-Pelvic Stress Fracture

2010-07-16T13:08:00.000+01:00

I feel very fortunate to have found this group blog. Thanks Lizanne for taking the initiative to start this blog and for all of you who have shared your experiences and wisdom. Even though it is depressing to hear how long the recovery will be, having this knowledge will prepare me for the journey ahead.

Here is my story...

I started running 17 years ago at age 27 by joining a learn-to-run group for women - I discovered that I loved running! I continued to run to maintain fitness but only started racing recently. In March 2009, I ran my first half-marathon at age 43 and in October 2009 I ran my first marathon, qualifying for Boston. I continued to train over the winter and ran the Boston marathon in April 2010. By then I was really hooked on long distance running and signed up for the Chicago marathon in October 2010.

I've been training with an on-line coach since January 2010 and have been very careful about increasing my weekly mileage gradually (i.e. no more than 10% per week). I've been monitoring my body closely for signs of overtraining and, up to now, have never missed a workout or race due to injury. I alwlays feel strong and fully recovered between workouts. I keep track of my shoe mileage and throw them out after 700 km. I run on a variety of surfaces: rubberized track for speed work, crushed gravel and asphalt for easy, tempo and long runs. I eat very little processed food and ensure that I get enough protein and carbs. I take calcium and vitamin D supplements. I sleep 8 hours per night. I do my best to manage stress in my fast-paced, demanding job.

On June 19, 2010 I ran a half-marathon and came in first in the women's division. There were only 151 women in the race but it still feels good to win! The following day, I ran a very easy 30-minute recovery run and felt fine. Two days after that, I was 25 minutes into an easy run and felt a slight pain in my left groin. I continued to run but had to stop a few minutes later because I was now limping. I hobbled the rest of the way home.

When I got home, the pain continued to get worse and I could not weight-bear on my left leg. I knew of a sports medicine MD that a running friend had recommended and called him. I was very fortunate that there was a cancellation that morning and I was seen right away.

Dr. E. asked me questions about my running history, diet, and menstruation. I now know about female athlete triad! He did a physical assessment and found that I had no pain when he palpated the muscles in my groin. However, when he pressed on my pelvic bone, I nearly hit the ceiling - the pain was excruciating! His tentative diagnosis was left inferior pubic ramus fracture which was confirmed one week later by my bone scan results. He recommended no exercise for 6 weeks, cross-training for the following 6 weeks, and running after 12 weeks. Before I read the postings on this blog, I actually marked those dates on my calendar!

I am still asking myself "Why did this happen?" Dr. E. also ordered a bone density test and the results were normal. I had my annual physical in March 2010 and my calcium and vitamin D levels were in the normal range. I eat a very healthy non-vegetarian diet.

Dr. E. has a few hypotheses...

I have been running 5-6 days per week which may not allow enough recovery time between workouts. My bones may not be able to tolerate my recent increases in mileage (80-90 km/week). Training for a third marathon within 12 months might be too much for me. I also wonder about muscle weaknesses - especially adductors and hamstrings - since I have not done any exercise except running since I started racing. I used to strength-train and use a variety of cardio equipment at the gym.

I hope that because I stopped exercising immediately after my injury, I will be able to walk without aids within 3 months. I am very lucky to have a husband who has taken responsibility for dog-walking, laundry, housecleaning, and grocery shopping for the past few weeks. I am using two canes in the house and crutches if I need to leave the house. I now have a tolerable, dull ache in my groin if I stay inside and use my canes. However, if I do more - such as lift heavy things, pull/push open heavy doors, walk on inclines/declines, swing my legs apart getting in/out of the car - the pain returns. We rented a cottage last week and I tried swimming but the kick motion for both breast-stroke and freestyle aggravated my pain. Instead, I used a pool noodle to support my abdomen and swam with my arms only!

Monday I have a meeting with an Occupational Health representative and my Manager to discuss a return-to-work plan. Dr. E. recommends that I be assigned to a desk job until I have completed 6 weeks of my recovery. However, after reading this blog, I am wondering how I will cope if I still cannot weight bear after 6 weeks. I work as a hospital Social Worker and must travel to patients' rooms to do my assessments and provide services. I usually have to carry things - forms, brochures, clipboard - so crutches are impractical. I am wondering if I could do my job with a Rollator or wheel-chair. If anyone has had any experiences with returning to a job that does not involve sitting at a desk for most of the day, I would be very interested in hearing about them.

Already, this blog is helping me adjust my expectations for recovery. Initially I was devastated that I could not run in the Chicago marathon this fall. Now, the only thing that matters is that I take care of myself so that I heal and don't prolong this injury. I am in good company with my husband and our Border Collie Abby. Friends, co-workers and neighbours have been very supportive. I feel fortunate. I will recover but it will take time.

Danielle

Updated Info

2010-06-15T18:55:00.002+01:00

Great to see Lizanne and John doing so great! I have a little more information that may help some. This applies to the female runners. If there has been any diet issues prior to the sfx look into your estrogen levels. I found some research from the military that if the estrogen levels drop the incident of sfx goes off the chart. The second thing is that if the runner returns to a normal diet pattern the estrogen level does NOT return to normal. You will need supplements (see MD).

I am suspicious that this "might" be the cause of all the "twinges" This part is just a thought. E-Mail if you have questions and I will try to get back to you as soon as possible.

Life after Sacrum Stress Fracture Recovery

2010-06-14T01:19:00.003+01:00

Hey everyone - I haven't checked in in quite a while but thought I'd drop in real quick with an update on me. After may months off from 11/2008 through 2/2010 - I ran my first mile on the 6th time trying to come back......and I've been taking off ever sense. Back to about 90% of my former speed - still staying mostly with everyother day running but not always - and have gone all the way to the marathon distance. I can't say how nice it is to be running again after so long off.

In hindsight - I really think getting my fitness back through biking before I started running again helped significantly. Here's my comeback quest:

me too!

2010-06-02T01:34:00.002+01:00

Hello. I was diagnosed with a interior pubic rambus stress fracture(left side) on 7/1/09. In hind sight I was doing too much without giving my body adequate rest. I had my third MRI this morning(first in July 09, second Jan. 10, third today) and the stress fracture is not healed. I am a bit disappointed but not entirely shocked as I still have upper hamstring achiness and discomfort when on my feet too much or sitting too long. I have also been going to PT for about the last 6 months. From the beginning of this process I have not had a lot of confidence in my Orthopedist and today he basically told me he doesn't know what to do with me and we just need to wait. I am ok with waiting but I am wondering if anyone has used and/or had success with using a bone stimulator? I am also thinking about getting a second opinion from another orthopedist. I currently live in Albany, NY and am willing to travel to the NYC area to see someone who has a lot of experience in dealing with this kind of fracture. Does anyone live in that area and can give me a recommendation? Thanks in advance!

Running :-)

2010-05-18T23:24:00.000+01:00

Hi guys, there has not been a post in very long and I know there is just a lot of waiting, patience and frustration with most of you and checking into blog every so often to see if any updates. Has anyone else since made a proper recovery? I am going on 19 months post-injury and can run as normal now but only since March of this year a gradual return. There is no during or after effects but I still keep the distance to a minimum of 5 – 8 miles maximum and run every other day – but never two days in a row. I think that was the main thing – running every single day continuously, long distances. I have been very busy with work and studies that the attempt to resume to regular running was not possible. Overeating and not enough exercise has therefore made me quite unfit. But finished up studies for the summer now and hope to try my first race (5k) in few weeks - my first race since Sept 2008 Berlin marathon when the stress fracture hit. My speed is returning (down to 7.2 min/miles) but the fitness etc I once had it will take a lot of time (which is rare these days) to gain again. I think I have to be one of the longest recoveries of this (apparently its max of 18 months) but it felt for so long I would never recover. However, there is still mild sitting discomfort when sitting for too long but I find the weights/pump class I do in gym once/week really helps build leg muscle (squats and lunges) which still helps ensure the whole area… legs, gluteus, etc are kept as strong as possible and can withhold all impact. There is nothing like the freedom and exhilaration of running though. I have a race/road bike I get out on the odd time also and it’s very good/enjoyable but still not comparable. Very hard for non-runners to understand this!! Look forward to hearing from any updates… continuous/full recovery updates… Lizanne

Newly diagnosed pubic ramus stress fracture

2010-03-29T14:59:00.002+01:00

I appreciate tremendously the information that I have received from this blog. I do not fit the profile that I typically read about. I bike regularly during summer vacation, often logging 2000 miles in a few months. I fear that that must come to an end. My stress fracture was caused by a fall on the ice in late January. It was originally diagnosed as a pulled muscle, which I was certain was not correct. After an MRI, it was determined that it was indeed a stress fracture of the pubic ramus. It has been 10 weeks and though I work in a high school, I am able to keep off my weight off my leg. My frustration has been the lack of experience my physicians have had with this. A sports medicine doctor had told me when there was no evidence of the bone healing at an 8 wk Xray, that since I am 60, the bone would take longer than the 6-8 weeks that other bones require. He never mentioned months and months of rest. He said that I could try to walk 1/3 of my normal "fast walking" (1 mile) 3X a week and that I could bike on my stationery bike if I do not feel pain. I know, by reading this blog that he is incorrect on that account too. I continue to take calcium, vitamin D, eat well and stay off my leg. I have not returned to strength training, stretching or exercise of any kind. Though I am in good health, the prognosis from reading the posts on blogs, frightens me. I am not ready to become immobile or helpless. I am a young, active 60 year old who is not ready for the pasture. I want to begin yoga but I cannot trust my physician's recommendation on this one. Any help? Thanks in advance for any advice!

Yoga Helps; Progress towards full recovery;

2010-03-06T23:56:00.002Z

Hey guys, this is just an update about how my progress with recovery is going.

I did my stress fracture (pubic ramus) in January 2009, and have spent the time since then more or less resting it, with very careful rest from June 2009 through December. The last time I posted an update I think was in October and I thought I would need two more months and then hopefully would be healed.

Well that was not to be, as when I started to do a bit of jogging again at the beginning of the year it seemed as though nothing had improved at all. In fact, it seemed like the injury had not improved any since the previous June, which was very frustrating. It made me wonder if the pain that I was experiencing was from something other than the stress fracture.

I still was getting sore just from walking a mile or two, and I started to wonder if some of the problem was that I had gotten out of the habit of supporting my hip the way I normally would because of the stress fracture. I started to concentrate on tightening up all those support muscles in my thigh and hip whenever I was standing or walking and this immediately seemed to help a little bit.

This gave me the idea that I needed to rehabilitate all this support structure around the hip after letting it lay dormant for the past year, and I tried a little bit of yoga with this in mind. The yoga is really nice becase it is no impact, no jerks or jarring, it's all about building stable postures and flexibility, which is perfect. Anyway, I always was a bit scornful of yoga in the past, but as soon as I tried a pose or two I could immediately tell how much it was helping, the poses just felt really good like they were something my body needed to be doing, and I could tell how weak and unflexible my body had become especially around the hip on the side where I did the stress fracture.

Anyway, I've just been doing these yoga poses at home using a wii fit (lol), and started out real slow, and have been doing that for the past two months. I would really reccomend the yoga to everyone in the recovery stage from this pelvix sfx injury, it really helps to build up good habits of posture and good support musculature again, and it is very gentle with no impact or jarring as I said. The yoga really helped me a lot and after about a month I could go for a walk of two or three miles with no pain, and generally was not experiencing any pain at all anymore.

So that was around the beginning of February and I started to do a bit of jogging and kicking around a soccer ball a little bit, because playing soccer again is my main goal right now with regard to this injury. I started out real slow, just doing some jogs a couple laps around the field with a soccer ball. During the past month I have been gradually increasing and now have done some semi-intense runs of a couple miles or gone and done some soccer stuff kicking the ball for thirty or forty-five minutes. Unfortunately, I am starting to get some twinges and pain again and that sense of weakness around my hip like when the injury started. Argh.

So I don't know, I still have a hope that I can play soccer again this spring, maybe if I just play once a week or something it will be ok. But if the pain keeps getting worse I will of course have to stop and do more resting again.

BUT one thing I probably won't have to stop is the yoga, because it really makes everything feel a lot better for me with regard to the sfx, and I would reccomend it to everyone as a tool in your recuperation from this injury. Start out slow with it, don't push too hard, and I think you will feel the benefits right away like I did.

-Cam

Update

2010-02-18T09:48:00.005Z

Hi guys,

It’s great to see many people still checking in updating progress through comments on the blog. I know (from emails) many of you also checking in to read blog often but you’re not posting as you still have no updates... That of course is the biggest frustration with stress fractures around the pelvis – they take so long to heal with very little noticeable improvements when you do start to improve... often the original pain returns again due to the new-found confidence from slight improvement, you start to increase exercise... then are pushed back again. The other frustrating part of the confusion in how the pain changes feeling and location / depth.

My update I think will always be the same but here it goes: Now 1 year, 5 months after getting injury: the trials and tribulations I have been through with it.... I still have limits and can still trigger the twinges to return but I am much more in control and knowledgeable.... I can run... but I know the limit is max 6 miles. But not every day – every few days with bike / cross trainer other in-between days. Some times 6 mile run will have me sore that can’t do anything for another few days. I will always totally rest at least 2 days/week and not do anything. Other times it feels like I have never had this injury at all. It’s very unpredictable. The routine that works now with minimal ‘damage’ is gym 3 – 4 days/week (cross trainer / weights class /swimming) Run attempt (only chance is weekend) 5 – 6.5 miles (max) on grass or forest softer terrain. Or a 1 hour+ road cycle if feeling any way ‘twingy’.

The main things I learned though is that over-striding seriously triggers it (also contributing factor to causing this). The key is shorter strides. Another thing is not to be keeping your upper body so stiff (chi running style) and loosen out, swing your pelvis more, let your body move more free and not rigid.
Again I cannot emphasise enough strength training: Not just core work but leg work too: particularly squatting and lunging with weights. I only do these class once or twice a week at best but the benefits of this leg muscle strengthening cannot be said enough.
Extensive sitting (Work/study etc) is unfortunately not good. I am just back from a week long vacation therefore I was not sitting constantly like I am now again with office work and college... since I returned from vacation I feel 100%. Not just due to ‘rest’ but I’m certain it’s by not sitting constantly in the one spot hours-on-end. From reading other forums on our SFX this is true for everybody – get up and move about as often as possible when sitting for long periods.

Again I know my limits. I can make the pain return full force by just going out for a 7+ mile run... or a very long road cycling always sitting.... but by mixing things up (cross trainer, > 6 mile run, biking etc and not same thing every day) I feel 98% most of the time. I do feel that one day I will be 100% and I know extreme cases like me can easily take up to 2 yrs sometimes more... but have hope. Mine is one of the longer ones. Stress doesn’t help and thinking/obsessing about it constantly (I let this consume me over 1 year!) but just letting it go, returning my focus to work, studies, relationships friends... I am returning to normality and realise life isn’t all about ‘running’! I love it though like most of you - it will always be a passion. But not an absolute necessity like I once treated it. Good luck and keep sharing! My old Blog: Lizanne Blog

11 Month Post Stress Fracture Update

2010-02-04T22:34:00.002Z

Hi everyone,

Just thought I'd give an update. It has been 11 months since the stress fractures:
http://www.over40runner.com/info/injuries/StressFractures.html

I ran a half marathon on January 24th and my long runs are up to 17 miles. My doctors gave me the okay to start running again on October 1st. But the pain is still there. Every run produces varying degrees of pain, usually after 5 miles or so. Consequently, I don't recommend what I'm doing because I have a feeling I might end up with a hip replacement. Although I'm beginning to think that would take less time to heal than this injury!

My Boston Qualification is good for 2 years and this is the last year. So I am babying this injury to get me through Boston, and then I might actually go see yet another doctor to determine why the pain is still there.

I only run 3 days a week with 2 days of cycling. One of the days is a tempo run, the other is a interval run or easy run (depending on how I feel), and the long run is on a soft surface trail.

I hurt after every run with some pain after the 5 mile point of most runs. However, it usually goes away after 24 to 38 hours. If it hurts longer than that, I'll only run 2 days a week or I'll switch a speedwork run with a slow soft surface trail run.

In addition to physical therapy, muscle strengthening and balancing, an ultrasound bone stimulator, and a bone building diet, I don't know what else I can do. I originally thought the pain now might be due to microscopic muscle tears or referred pain. I tried it all - multiple doctors, cross friction massage on my thigh muscle, trigger point therapy, diet, rest, non-rest.

I even changed my running form to minimize impact when landing (http://www.newtonrunning.com/run-better/land-lever-lift and http://www.chirunning.com/).
The short strides and higher cadence with ChiRunning did seem to really help with the pain.

There was also a recent article in Runner's World about how bad it is to run on cambered roads and I put in a lot of miles on cambered roads where my right leg was landing higher than my left prior to the injury.

If the pain continues after Boston, there are 3 specialists in the US considered the best hip specialists that I might consider seeing. One of them is on my insurance plan but out of state.

Anyway, I keep researching this thing hoping to find answers and so far I haven't found any. And my doctors did every test imaginable (blood tests including hormone levels and Vitamin D levels, MRI, bone scans).

The only thing I didn't try was total rest for a year. But I did take 6 months off from running (http://www.over40runner.com/training/2009Mileage.html) . There were a few 1-2 mile attempts in there, but I was mainly non-weight bearing for 6 months.

I had a great run last Sunday with minimal pain so I thought it might finally be getting better. But then the pain came back with a vengeance on Tuesday.

So please let me know if anyone comes across any new info on this injury.

Thanks!
Vanessa

update

2010-01-12T03:03:00.002Z

Hey guys,

It has been a while since I reported, but I thought I would drop a comment on how I have been doing. It has been 9 months since I have had this sacral ala stress fracture. It has been healing and does feel a lot better than it use to. In October I started seeing a physical therapist that does manual therapy for an entire hour on you. It isn't like a normal physical therapy session. She literally works for one full hour on loosening up your body. I have found it very beneficial. I have started running a little more I have met two friends who has the same stress fracture as me. One of them is working with a running coach who has given her guidance along the way. She does a run/walk routine where she will start walking for 4 minutes with 30 second runs inbetween. She increases the amount of running she does by 30 seconds each week. It has seemed to work okay for me. I have really found that I like the manual therapy that has been involved too. I am beginning to see glimplses of my life back and it has really helped. I will admit though, it is the most frustrating thing I have ever had to deal with!!! I was helpful to know that Meb K. The winner of the New York City marathon had a pelvic stress fracture and it took him nearly 18 months before he started feeling normal again. Two years after the stress fracture he ended up winning the marathon!!! I am confident we will all get through this. It may just take more time.

Lizanne, I am interested to know that if it is nerve damage, is there anything they can do for that?

Please everyone...keep posting your progress.

Update

2010-01-03T00:15:00.003Z

Hi guys, Happy New Year. I hope 2010 brings happiness, and most importantly, health for us all. I know most of us are still lurking here every so often for updates so I thought I would post. The reason for the inactivity of our posting I think is mostly due to how slow, confusing and ever-changing this healing process is for us - irrespective of which pelvic area we got the stress fracture. I often think that one day – boom – it will all be 100% total history and I’ll be running as normal again. Alas unfortunately not. It is now nearly 15-months after I got this injury (pubic ramus stress fracture) and despite being able to now exercise, limits still clearly exist. Yes – I can now run. Wow… something I couldn’t do for a year; yet alone walk properly without too much pain. But I can only try running once or twice a week at weekends maximum. I will often feel the usual twinges the longer I go but its tolerable. I can only do soft terrain…. grass or forest. Sometimes after such a run (about 6 miles max)… I will feel fine with just the ghost-twinges during and after, when sitting and sudden leg lifts… but other times after a running attempt I can feel back to square-one again: as bad as before… but after few a days rest, OK again.
Most of my exercise now is just mainly in the gym doing weights: focusing on leg muscle strengthening (very beneficial)… and for cardio the cross-trainer (elliptical) machine (about 40-50 mins). All this is without limits but due to time/life restraints, I’m not exercising as much as I should or would like to these days. I don’t see the point in going back for any medical advice from any more coaches, PT’s, physiotherapists or seeking other solutions as I think the response will be exactly what I don’t need to hear: “More rest, time and patience…”. Sorry but I have given it more than enough time and patience…. 15 months post-injury, still sore and unable to run properly just can’t be right… can it!? Do share any updates you have or tips you have found with us too. I will update again when I find any progress or tips!
My Blog

Myofascial Release therapy

2009-11-12T17:29:00.002Z

Just wanted to post a quick update on my new-found hope. As stated much earlier in "my story" I have suffered since 1995 with compounded effects after a sx fx pelvis.

Two months ago my DO doc suggested I try her new medical massage therapist for chronic pain problems. I almost rolled my eyes because it seems that everyone is telling me to try this or that and nothing really works. I figured to try it at least once.

The guy was quite a chatterbox in explaining everything he did, starting with adjusting my feet, then hitting ALL the pain spots in my body to 'turn off the pain signals'. The first session made a tiny improvement, but since it was only an hour session I decided to go to his other clinic where he can do a full body release (2.5 hours or so). He really dug into the problem areas that originated in my pelvis/tailbone/thighs that were caused because of the boot camp exercises which cracked my bone.

WOW! My pain went from a chronic level of 9 to a 5. I am able to walk without a cane now and my daily headaches are nearly non-existent! I am very happy to have gone thru this therapy! I actually have hope now that I can do things and live again. My kids are excited to have me go on walks again.

I can feel the tightness coming back 2 months later and know that I will have to schedule another appt soon. It all makes sense...

Our feet get misaligned ever so slightly, causing the muscles to fire out of order, which makes them 'tighten' up to protect themselves from further injury. If rest & proper therapy is not administered, things will get worse. The body will compensate to keep the eyes level and after years of being in compensation, the pain gets worse as the muscles/tendons/myofascia get 'stuck' in their stressed position, which cause the skeletal system to become mis-aligned as well. My body never stayed after a chiro or osteopathic adjustment. This caused my hips to move improperly in my joints, causing early osteoarthritis damage. Since the soft tissue in my pelvic area were so stressed, they were slowly curving me forward, throwing pain into my abdomen, ribs, sternum and neck. The result would eventually be Kyphosis and then fusion. I am glad to be able to stop that progression and stand tall again!

I'm not saying this therapy is a must for everyone, I just wanted to share what has finally worked for me. After years of searching. I am overjoyed!

Wanted to pass on some hope

2009-10-30T02:32:00.002Z

Hi everyone! Although this is my first post, I am no stranger to the pelvic stress fracture blog. I think there were days that it maintained my sanity. Just to know there were others out there that understood and shared my pain was a comforting thing. I want to share my story so you will know there is hope for recovery and a future filled with running again.

I got my pelvic stress fracture during a 5 mile run in April 2009, but didn't get a bone scan until the end of June. Looking back on things, I probably made the injury worse by trying to walk and run when I should have been resting. Once I found out what was wrong, I did NOTHING for 8 weeks. I was actually relieved to just know what was wrong with me. I was so tired of guessing and researching on the internet for hours every night.

After resting for 8 weeks, I was still not ready to run, but started physical therapy. Some days I felt ok, while other days I was filled with aches and pains. Lifting things and sitting for too long really seemed to bother me. This was the period that got very frustrating because I had done everything I should have, but was still not healing. Around mid-september, I still had pain from sitting, but I was feeling stronger. At the end of September I had an MRI which showed I was healed!!! There was no sign of the fracture or any inflammation at all. It was a very good day :) I also had an MRI of my spine at the same time which showed a small tear in my lowest disc. My doctor thinks that this could be the cause of the pain while sitting.

Once I got the clean MRI, I decided to attempt a very slow walk/run. I was so scared that I would feel that pain again. If you are reading this blog, you know the exact pain I am referring to. It's almost as if you're waiting for it to happen. I started with a 5 min. walk/2 min. run and continued this for 2 miles. I decided that I would only go out every other day. The next time, I increased my mileage a bit more and felt even stronger. It has been a month now and I'm finally up to 2 miles and feeling GREAT! I can't describe the wonderful feeling of being back out on the road.

Although I do still have pain from sitting for too long, I'm not sure if it's related to the stress fracture or the tear in my disc. I've been told it's normal to have muscle tightness and soreness from the injury and I've been trying to stretch and do core strengthening to combat this. I will continue to slowly increase my mileage and hope for the best. Looking at the complexity of the injury, I feel fortunate that it only took 6 months to heal. There were days I was convinced I'd never run again. The most important thing that I did was rest. I have read so many stories where people keep pushing the limit and testing the injury. I am guilty of it too. You get to a point where you trick yourself into thinking you are better. Deep down inside though, I knew I was fooling myself. Time was the only thing that made it better. Be patient and give your body time to heal and get strong again.

I wish you all a speedy recovery and hope that this entry will provide you with encouragement during the frustrating healing process.

My injury anniversary

2009-10-27T02:38:00.002Z

It was one year ago today I injured my inferior pubis ramus. My husband and I had taken a long weekend to Detroit to see his team, the Washington Redskins, play the Lions. While there I got in a few runs on the hotel treadmill. It was Sunday night after the game. I ran on the treadmill and we later went to dinner and then hung out for a little bit at the hotel bar. I first felt the pain in my pelvic area when I was leaning toward the table to pick up my drink.

It wasn't a terrible pain. In fact, I thought I had felt the same thing before. I had just pulled something. We were driving home the next day, Monday, and I didn't plan a run after the seven-hour trip in the car. It still hurt a bit, just felt like a muscular pain. The next morning, Tuesday, I went to my regular spinning class and it felt fine. So on Wednesday afternoon I went out for a six-mile run. It was probably my best run, up to that point. At the time I worked nights, so I got done running and went home, got ready for work and went into work. By the time I left for work, I could barely walk.

I should back up here. I started running in January 2008 when I joined Team in Training to run a half marathon in San Diego. I started out on run/walk intervals. I enjoyed the half in June and decided to sign up for another in September. I continued on my run/walk intervals, but lengthened the run portion. During the half I felt so good that I decided to ditch the intervals and just run as much as I could. I didn't take too many walk breaks and lasted almost up until the last half mile when I ran out of steam. I was still pleased with my results though and decided to start training without the walking intervals. But I now realize I did too much, too fast. I should have mixed it up a bit and not been running so much right away.

My last run was six miles without stopping. I felt the groin pain during, but everytime I was about to stop, the pain eased or kind of went away. So I thought I was fine. But it became obvious I was not fine. That night at work everytime I had to stand up and walk it was terrible. I even went in the bathroom and cried at one point!

I didn't know what was going on. I went to the immediate care clinic the next day because it hurt so bad and the didn't really tell me anything other than what I thought I already knew. So I took a few days off. My running store had a physical therapist come in for free consultations and I went to one, and she didn't really tell me anything either. It was about a week and a half after not being able to walk that I was feeling better and went to a kickboxing aerobics class. Early in the class the pain came back.

So I scheduled an appointment with a sports medicine doctor. I was so afraid they were going to tell me this pain was all in my head, there was nothing wrong. Because the pain was so funny, it seemed to move around! I couldn't really define it. The doctor wasn't really sure of the diagnosis, x-ray didn't find anything. So she ordered an MRI because she was concerned about a stress fracture either in my pubis ramus or in my hip. I had the MRI two days later and she called within two hours with the news it was the stress fracture of the inferior pubis ramus. At the time I couldn't find a darn thing about it! I couldn't even find a picture of the bone!

She said it would be a minimum of 8 weeks to heal. Those 8 weeks came and went. I got my diagnosis in mid-November and it was early February before I was cleared to run again, about three and a half months after my injury. Over that time I went back and forth between trying to exercise, to none at all, to swimming or non-impact. I even tried crutches because the injury wouldn't heal. In using the crutches, I sprained my arm because I had the crutches adjusted incorrectly! It was a rough time.

I was finally cleared to run again about two days before I found out I was pregnant. I did still try to run on the gradual plan my doctor gave me, starting with only 10 minutes running and working up to a half an hour. I did run pretty well for a bit. I quickly went back to my run/walk intervals though. I was able to run my comeback race in April, a popular local 8K, and I did pretty well. But that was my only race and I didn't run very long. With my pregnancy and since I didn't have enough of a running base, I had to stop running pretty early. I also had some knee issues stemming from physical therapy and pregnancy hormones. I haven't run since about mid-July. I still have groin issues, but I'm not sure if they're from the stress fracture or pregnancy. I'll find out soon though, as I'm due in 10 days.

I have some big goals for my return to running! I'm hoping to start running again in December, with perhaps a race on New Years Day. But my goal is to really start training in January for a May half marathon and then a September full marathon. That was actually my goal for this year, but it was derailed by the injury and then pregnancy. I WILL run that full marathon!

This injury is a long road, but it does get better. I lost a year of running, but the great thing is you can start over again at any time!

Runner with pelvic stress fractures

2009-10-23T23:16:00.002+01:00

I'm new posting here. I am a 40 year old distance runner who has just recently been diagnosed with stress fractures to the pubic ramus and ischial tuberosity. I've been running high mileage (75-95 miles/week) for years, primarily on trails without any serious injuries. Then, this fall, I started developing little nagging problems. First, I had pain where the hamstring attaches to my butt. Then, I started in with pain in my hip joint. I did not pay too much attention to the pain, as it was not overwhelming. I iced and took anti-inflammatories and kept running. I had a marathon planned for labor day, and I just figured that I would run it and worry about my little nagging pains after the fact.

My race went fantastic. But, I went home and had crushing pain develop through my lower back and in through my groin and thigh. I could not stand up straight for a week afterwards. I went to PT for three weeks, and he was able to get me standing upright, but we didn't make too much more progress. Finally, my primary care doc ordered an MRI, and that is when the diagnosis was made. I have the two stress fractures, a torn gluteal muscle, a herniated disc, etc. I saw an orthopedics doctor after I got the MRI. I am supposed to be on crutches, but I am finding it very difficult to stay on them while taking care of my children, my home, etc., especially now that I have a sick child at home (the flu). I have a lot of groin pain, swelling in the upper thigh. pain in the hip. I have excruciating pain at night. Sleeping is just a disaster. The only position I can lay in is on my side with a pillow between my legs, and still, every night, I wake up as soon as the pain meds wear off, with just burning pain. It is horrible. Sitting is very painful.

From what it sounds like, this will take a long time to overcome. I've never had a running injury that side-lined me for more than a couple of days, so this will be a challenge. The only cross-training that I can do right now is swimming and upper body weights.

My doctors say this was caused by overtraining, but I don't know...I have not had any problems before this year despite years of doing the same thing. The difference this year was I did some training on the roads, and maybe too much hill training, which I think stressed the ischial tuberosity. And maybe my bone density is not what it should be? I think there are a lot of factors at work. Certainly I think I should cross train more once I am able to start running again.

Advice for a pubic bone stress fracture

2009-10-23T16:03:00.003+01:00

hello -

i am a long distance runner who was recently (2 weeks ago) diagnosed with a left pubic bone stress fracture. i had been running on the injury for months (thinking it was a groin pull) until the pain got so bad whether running, walking or sitting that i sought a diagnosis from an ortho surgeon.

the ortho said no form of exercise at all for four weeks and recommended alleve (one pill twice a day). i must admit the groin pain and tailbone pain has gotten better, but the pressure and swelling in my abdominal cavity is horrible. i sit at a desk for 9 hours a day (ugh!) and that is even getting uncomfortable.

i have not exercised and try to avoid stairs, but with two little toddlers it can be challenging.

was wondering if anyone else had that bloated pressure feeling in their abdominal/pelvic cavity. the mri did show inflammation so wondering if that is the problem. have left two messages for the ortho but no response. i have also scheduled an appt. with a new ortho.

was also wondering if others went through physical therapy? am thinking this might be needed?

looking forward to hearing from folks. thank you:)

The long road to recovery, updates and ideas.

2009-10-12T23:43:00.003+01:00

Hey Folks,

Just thought I would drop in here again and post an update. Long story short: my pubic ramus sfx is still not healed. I did the injury back in January, so it has been a pretty frustrating ten months so far, with lots of discouragement, which seems to be the usual case with this injury, heh. Probably what is so frustrating is you keep thinking, "Oh, a few more months, then I will DEFINITELY be healed!" But, of course, you aren't........

So anyway, since the last time I posted about my status, I had decided I was going to rest more seriously for four months since it didn't seem I was making good healing progress, so I cut out almost all exercise form my life from like April 1 - July 30. I did feel a lot better by the end of this period, not much twinges and stuff, but when I slowly started doing some light soccer workouts again, going very slow, it quickly became clear that I was still injured and I had to stop.

So I rested good for two more months and then tried again at the beginning of October, just recently. I went really slow as I started trying stuff again, but was feeling twinges pretty quickly, but I tried to tell myself that it was just stiffness and muscle pain from such a long layoff.... But it wasn't, I started to get aching and that weak, tender twinge-y feeling in my hip and groin, and so I've stopped again. But the good news is that it feels like it is really healing now, I am hopeful that with a couple of more months of resting and healing this injury will finally be put to bed.

It is very frustrating when you are working so hard to get well, as I know so many people here have found. I have changed my diet completely to load up on calcium and vitamins, eating really very healthy which is a lot of work, no processed foods, and religiously going out and getting tons of sun every day to load up on vitamin D in the most natural way, and also boosting with supplements of vitamin D and calcium, and even incorporating prunes into my diet, which I always hated, and I posted about that before. I'm glad I'm doing all these things, though, because it is better to be healthier in general, anyway, and it seems like because of various factors in my life my bones aren't as robust as they could be, and I am going about fixing that now, so hopefully no more sfx in the future.

Prunes, btw, are one of the keys, one of the few things that has been medically demonstrated to actually increase bone mass even in post-menopausal women with osteopenia and osteoporosis. This is pretty new research, too, so if you haven't heard of it before that would be why, but a lot of doctors are starting to reccomend prunes. I made a more detailed post about prunes before, but here are some tips after I have become an "experienced" prune connoiseur [lol], having eaten five prunes every morning for the past six months or so. [You need to eat them religiously, this is a long term process! Bone mass takes forever to regrow, as we all know, so you might get like .5% bone mass every six months [a result fairly typical in one study I read of postmenopausal women with osteopenia] while you are eating your prunes, ok, not that much, but after five years that could be 10% increase in bone mass, a VERY signifigant increase in bone strength and health!]

1) start out with just two or three prunes a day, then gradually build to the level you want, this makes it easier on your stomach, as obviously prunes are a famous laxative

2) Eat prunes with some other food that is easy on your stomach, such as bread. I eat mine with some healthy oatmeal and walnut cookies that I eat for breakfast every morning, I basically eat one cookie, then one prune. If you break it up like this it makes the prunes sit much better on your stomache.

3) Chew thoroughly. This is probably the most important part.

That is probably more 'precaution' than is necessary, but in any case this is what I do and my stomache has not been affected by the prunes in any way. You will get used to them, and they won't be so nasty anymore, nor will they bother your stomach. I don't mind eating the prunes at all now; you get used to them pretty fast.

OH, AND ANOTHER THING,

For those of you who live in cooler climes, where you can't get the sunshine [without sunscreen!] that is healthy for your body, there is new medical evidence to indicate the benefits of tanning. Basically, in the first medical study of it's kind they found that use of a tanning bed during the winter correlates strongly with healthy vitamin D levels and higher bone mass. So you CAN get your vitamin D from a tanning bed, and it is good for your bone health. Also, tanning beds have a beneficial effect on eczema and psoriasis [because UV radiation acts as a beneficial immune suppressant in the skin], AND using the tanning booth makes you feel good and often helps people with seasonal affective disorder. I reccomend using a strong sunscreen on your face, though, to prevent wrinkles and eventual leather face that will happen after years of tanning. But the UV fear-mongering of the sunscreendermatology [sic] industry is so ridiculous, UV radiation on your skin is so important for the body's health, human beings evolved to be exposed to the sun, i.e. UV, and the tanning booth is the same thing, just UV radiation which your skin is naturally designed to be exposed to and benefit from. If your bones are weak and you live in a place where you can't get enough sunshine, then using a tanning booth is really worth thinking about!

Here's the link to the article:
http://www.uvadvantage.org/portals/0/pdf/Tangpricha%20Tanning%2012-04.pdf

And a link to the pro-UV website of Dr. Michael Hollick of the Boston University School of Medecine:

http://www.uvadvantage.org/Home/tabid/36/Default.aspx

ANOTHER THOUGHT,

Since a lot of you guys are runners, I thought I would throw up some links about barefoot running and the athletic shoe industry, as this seems to be an important factor in injury. Basically the idea is that injury rates among runners have just gone up, up, up since the introduction of modern running shoes [trainers] and as the supposed technology put into these shoes has increased. Now there is this huge business around buying the perfect running shoe to prevent injury, but in the past people wore simple shoes or even no shoes at all and the injury rates among runners were FAR lower. Something to think about for you injured runners; I know for me even though I run more as a cross-training, I have always found simple, flat soled shoes are the best, and expensive running shoes have always caused problems to my joints.

Here are the links, great read for all runners, food for thought:

http://www.latimes.com/features/health/la-he-barefoot5-2009oct05,0,4122017.column

http://www.dailymail.co.uk/home/moslive/article-1170253/The-painful-truth-trainers-Are-expensive-running-shoes-waste-money.html

http://www.heraldsun.com.au/news/breaking-news/no-evidence-on-running-shoe-safety/story-e6frf7jx-1225715383899

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Good luck everyone!!!! Let's all get well soon and be back to our best for the new year, right? Right? I'm sending out good vibrations to you. Yes you! :)

And I hope the 'post-injury' recuperation is going well, Lizanne. I know by the start of 2010 you will be running again like you never had to stop!

Thank You Lizanne

2009-09-29T02:52:00.002+01:00

First of all I want to thank Lizanne for creating this blog for all of us pelvis fractured people. It is such a mystery and very true that many doctors don't have a clue to how to treat them or advice to give people. I have had some amazing friends that have suffered from the same injury help me through this. It has also helped to find this blog, knowing that there are people out there dealing with it and there is hope for recover.

SO here is how it happened for me. I have ran for about16 years and have never been injured. I would always tell people that and was so proud of myself. Well, last September I had a little girl(love her). Anway, two weeks after I had her I started running pretty hard. I was determined to get a P.R. in the Salt Lake Half marathon and then continue on to get a P.R. in the Top of Utah full marathon. I was sprinting and running my long runs at around 7:15. Which, for me is fastt..I know not too fast for most but for just having a baby it was pushing it. My last en mile run felt a little weird I couldn't figure out what was wrong. I went out a few days later and tried to run three miles but coudn't kick the pain in my hip. I tried to ignore it and loaded up on ibuprofen and went and played a soccer game(biggest mistake ever). After the game I couldn't even walk. All the docs diagnosed it as a glut tear, then maybe my S.I. joint and then after two months they said pirformis syndrome. I had had it because it wasn't getting better. So, in May I did something really stupid. I went out and tried to run three miles and shake of f the pain. As we all know that doesn't work. The injury hurt all over again. So, I finally decided to get an MRI which detected what I never would have even guessed. A sacral ala stress fracture. I was told to wait three months before doing anything. Well, it has now been six months since injury and four months since diagnosis and I still feel it but not near as bad. Last week i had an MRI and it said that all was healed!! I was excited but very confused as to why I still have pain especially when I am sitting. I have come to accept the fact that it will take time. I have had some great advice from a few others with the same problem and they have helped me with stretches and stenght training and walking techniques for this injury. I have no idea where I would be if I was all alone in this. THanks to everyone for all your help and support.

I really know that this thing will be healed one day, but will take time, patience, and faith.

Thanks to everyone for their posts.

Lizanne, I am so glad things are healing up for you!!

Kelli

new here

2009-09-28T16:09:00.001+01:00

Hi everyone and thanks so much for contributing to this blog. After
reading another blog thread on the same topic where it seemed no one
had recovered from this injury, I was despairing that I would never
run again. But I am really encouraged to hear some other people's
encouraging stories.

I got a pubic ramus fracture the beginning of April while training for
my third marathon (which I had to bail on obviously). I only recently
got diagnosed because I didn't have an MRI right away, just expected
it to be some muscular thing that would go away a lot more quickly.

I was not able to do much exercise at first, but within a couple of
weeks was able to walk without pain and never had pain sitting as I
noticed many have. I can hike forever, even carrying a heavy
backpacking pack and although I couldn't for the first few months, I
can now do spinning without problems. Running is pretty much the only
thing I can't do. When I was diagnosed a few weeks ago the doctors
recommended I try to get back into running by aqua jogging and trying
slow 30-second running intervals on a level dirt trail. I have pain in
less than 30 seconds though, and based on what I'm reading from you
guys it sounds like that means I should stop. I also have no idea how
to aqua jog and it sounds frustrating. ?

My MRI showed my bone was definitely healing - you could see a bunch
of bone layers over the fracture, with the whole area looking thicker
than on the opposite, unbroken side. I'm kind of confused as to why
this takes so long when bones heal in about 3 months usually I
thought. And also why if all the layers of bone have built up, I still
can't run.

I'm sure many people here can identify with being totally addicted to
running. Without it, I've been depressed and have gained 30 pounds.
(Has this happened to anyone else or am I just a pig?)

Sacrum Stress Fracture

2009-09-28T15:19:00.005+01:00

Hi everyone – new to this blog but not new to being injured. I’ve had a short but incredible running life. Started at the end of 2005 after 20+ years off from High School Track/Cross Country to knock out a bucket-list item to finish a marathon. After an incredible couple months from couch potato to marathoner I succeeded in finishing that thing in 4:30 hours. Teetering on One-n-Done or trying another I somehow got the bug to not just finish but finish well. Next race was a BQ, then on the Boston, then Sub3, then within a couple years I was winning stuff – it was an incredible rush. I knocked down a Master’s win at the Houston Marathon in 2008 which was nearly the first thing I’d ever won. I’d worked hard to get fast and I wanted to run most everything and by the end of 2008 I’d run 5 marathons winning my age group in every one (except Boston) and even scoring a 2nd and 4th overall in a couple of them. The last race was the San Antonio Marathon after a hot Houston Summer of training I got real lucky with the best possible weather – mid-30s to start and low 50s to finish with no wind on a relatively flat course. Ran my heart out scored the Masters win and finally got under a goal that had evaded me all year of sub240 – and scored a VIP beer at the end which was sweet.

I never felt the need in that few years of running to focus on much more than the actual running. I did get on a foam roller pretty regularly to knock down some soft tissue injuries I got occasionally. I had PF mostly on the right but also some on the left foot for a stretch of 6 months which I ran through, Achillies pain on the right that didn't seem to go away with rest so I just ran on that too, some right hip pain from time to time. I rarely stretched, no yoga, no strength training and pretty much never changed my eating patterns (lots of fastfood) from being a non-runner except I ate more to keep the engines burning. Shoes have always been the same - Brooks Adrenaline - about 1 size bigger than my walking around shoes. Morters toenails lost regularly despite the extra shoe length (I noticed SF/John mentioning the mortors toe link between us so I just thought I'd mention I have that too). In 2008 I started wearing light racers for racing only and wore the Brooks Speedsters in the last race too.

That was my last real run last November 16th 2008 – 10 months ago. By the next weekend something was wrong – I was fine initially on runs but within a couple miles some pain in the glut would develop and I’d stop. I went for the rest of the year with vain attempts of short rests- a few days, a week, a couple weeks, massages, chiropractor visits stretches but things were not going away. It was the strangest injury – non-existent except when I got a few miles into a run but otherwise only the smallest pain threshold in other activities. Finally I start rounds with the orthopedic.

MRI#1 Jan,2009 says I’ve got 1) Sacrum Stress Fractures (Right Sacral Ala) and 2) Sports Hernia (Athletic pubalgia - basically a muscle tear off the pubic bone). Both diagnosis seem to be rare distance running injuries hardly ever seen by any doctors – most definitely not by the doctor in front of me who really gave me no help but to say rest a couple/few month. After my own googling and reading stuff on Running Forum’s I was much more worried about #2 actually as it appears it can only be repaired by surgery by 2 doctors in the whole country. But I decided I wasn’t going under any knife until #1 healed up and I could do some test running and see if #2 was indeed a problem. Stuff I found on #1 had varying things from 4-6 weeks off to months and months.

After about a month deciding to learn how to swim and no running I really wanted to slow-job a little neighborhood 5k that had my whole running crowd involved. I did test runs ramping up from .5 miles up to 2 miles the prior week and all seemed fine – [the low pain threshold on this injury has been the most frustrating as it makes me think I can do more than I can] and I slow jogged the 5k. By 2.5 miles I knew I should stop or at least walk but I slow jogged it in and probably made it 10 times worse and stopped running again. Pain wasn’t really that bad but a building pain while running is never good and I knew better than to push but I did anyway with all my peers around.

After about a 1.5 months from that (I was counting 2.5 months from the MRI but really I should have figured I was re-injured at the 5k) with some more swimming and I’d also taken up cycling and was the weekend warrior many weekends 50-70 mile rides each weekend day [with no pain that I recall - probably there was slight soreness I was ignoring – I don’t know] I start ramping up running yet again – by my 10th day of running I was up to 5 miles – some discomfort but not much and I’d heard many times to expect soreness [and honestly I just didn’t want to believe after 5 months I wasn’t ready to run]. On the 5 miler on the last day I pushed the last mile more than I should have – my thinking was I wanted to be sure this wasn’t some kinda pain that would just go away after a couple miles – I got home and was convinced it wasn’t going away and hung up the running shoes – little did I know what I’d done. I quit the biking and swimming and running thinking maybe something was delaying healing. Over the next couple weeks the pain I felt at the end of the run got a little worse each day until I could barely walk – I even bought crunches just to get around the house and worked from home for a week.

MRI#2 – April, 2009 – decided on trying another orthopedic – the first one was worthless in providing any guidance at all so anything would be better. MRI showed the same Sacrum Stress Fracture as the first along with the word “crack” – I’d heard stories from my new doctor before I got the results of cracks that never heal – how a stress fracture is much worse than a clean break because there is a larger area to heal and a crack within the stressed area/bruised area of the bone can be especially hard. At the time of getting worse and worse for 2 weeks I actually was thinking I could have done some sort of permanent crippling. But once we talked thru the MRI the Doctor told me it would be slow healing (2-6 months kinda slow) but should eventually heal up completely. [The one silver lining was there was no mention of the Sports Hernia on this MRI so maybe that was a bogus first diagnosis]. Told me to do no repetitive impact sports and even no biking for a while – guided by pain and take another MRI in 3 months before starting to run. Also checked blood to find good Ca and Vit D levels - no issues there.

Spent the next 15 weeks doing nothing for exercise at all. Pain diminished to be gone within the first several weeks after the MRI – I was just grateful to be walking normal again with hope to run someday whenever – after thinking permanent crippling – I was OK with waiting – running wasn’t that important.

MRI#3 – July, 2009 – “Mild marrow edema is seen in the right side of the sacral ala. This is significantly less pronounced when compared to the patient's previous MRI." Also checked leg lengths with a bone scan xray - came out spot on the same (I'd convinced myself they were different and was wearing a heal insert the last month in my shoes :) ). With the Dr’s permission I did a couple test runs (1k) and next day I felt the slightest soreness so I waited a few more weeks and started ramping up again in August.

I think I may have ramped August up too fast now that I’ve compared notes with others that actually have the help of medical advisors. I stared with 1 mile, wait a couple days, tried again, wait a couple days, 1.5, off, 2,2,3,5,off,5 – a little sore so off, off, 2,3,off,3,off, 1.5,3.8,3,3,3,3,7,3,4 – at this point I thought I was home free – there was little bits of soreness occasionally – kinda lower than the sfx site - but it actually seemed to be diminishing day by day, but then after a day off I did another 4.4 that started feeling uncomfortable at the end, walked that night a few miles which also felt off, tried to jog next morning and stopped within ½ mile feeling more off. Decided to stop it all and give it a rest – rode a couple long bikerides but felt a little sore after that, tried pool running for 4-5 days and by the last pool run (25 minutes) the familiar pain started again in the wrong place. A couple days of doing nothing and the pain reached a peak which had me limping slightly so I stopped all cold turkey. Within 1 week all the pain went away – I think now I just ramped up the August running too fast.

Right now I’ve switched to Kayaking to get good aerobic workouts in – need to do something as I’ve been slacking on aerobic fitness for too long and it seems a pretty good workout without involving the hips. Just yesterday I thought I’d start ramping up again but this time in ultra-slow motion. Kinda copying what Kate566 has been doing (she’s about 4 weeks ramping up) with mostly walking and brief 30 second jogs every 4 minutes – stay at that level a few weeks and ramp it up slightly. I’m hoping a slower progression will get me all the way there this time.

Planning to get a couple Dr visits in to see what I can do to prevent re-occurance as I don't really have a good understanding yet of how I got this injury in the first place. After reading the book "Born to Run" I've really been thinking a lot lately my problem is too much shoes and that I should go minimalist....when I was running in August I did a lot of it barefoot or with Vibrum 5 finger. I'm thinking toward continuing that strategy but I also want to get some pediatrist input.

Sorry so long winded…….it’s been a long story very ripe for an ending….

If you want the even longer tail you can scroll thru blog posts, the blog has attracted a couple other longsufferers with sacrum SFX and we've also been sharing our struggles on the road to recovery kinda like this bolg - mostly on facebook and direct emails. I see two of them over here on the author list (Kelli and Kate566) so at least I'm not alone crashing a pelvis sfx party with a sacrum sfx :-)...

Good luck everyone getting better!!

Feeling amazing....

2009-09-24T21:55:00.002+01:00

Just wanted to let you know that I am finally feeling like the runner I used to be...I sought treatment about a year ago and finally took time off running from Jan. to May....started walking and when I was ready to run it was really hard. It gave me a new appreciation for all those new runners out there. I kept at it and finally in the last few weeks..my speed is somewhat back...no pain (before, during or AFTER) and I feel like I can physically do all that I did before...I jump, gallop, skip during the day with my Pre-K friends and it feels amazing that I am finally through this injury...I continue to wonder what I learned from it (and even why it happened)but just wanted you all to know that someday it will all be in the past! Best of luck healing and dealing! Tracy

Update

2009-09-01T10:25:00.001+01:00

Hey guys. It’s great to see more new members although of course it’s sad that so many of us really are suffering with this horrible injury. Welcome guys & thanks for sharing your stories. I have just posted my very final post on my personal blog today but I will summarise here again as I plan to continue updates here. Today is 1st September 2009. The reason I decide to post today is because I got this pelvic stress fracture injury in September 2008 and have therefore completed almost 1 year. This injury had literally consumed and drained me this past year as you can see from the previous posts!

I got another MRI scan at the end of July (10-months post injury). The results: pubic ramus bone is no longer fractured and is now consolidated. This was wonderful news but still confusing as to why the pain/discomfort clearly remains, particularly increasing the longer I am sitting. As a result I still cannot cycle or take any impact (e.g.: jogging etc). The most frustrating thing is the long sitting periods in work and college. I need to shift and move about often to relieve the pressure. I can go for long walks since June without any time limits but the muscle burn in the groin intensifies the longer I go. It starts as a mild sensation on the surface, only feeling muscular, but as time progresses it moves deeper towards the pubic bone the longer I’m moving. The radiologist, physio and doctor cannot explain. All they can see is the new MRI scan results which show a fully healed bone and no more extensive muscular oedema or avulsion tears. Therefore the severely stress-fractured pelvic bone has finally healed!

Despite improvement, being much more agile and able to finally walk pain-free and wear heels again after so many months, the groin burn continues and especially noticeable with certain sudden movements and as mentioned - sitting is the worse. So I dug into further investigation and had recently got in contact with a female radiologist in Ireland who suffered this same injury related to long distance running. She explained to me that despite the MRI showing stress fracture bone to be finally healed & consolidated, Micro-fractures on the bone will remain for some time after which take longer to heal and still require much rest in order to heal. Therefore I am at a very vulnerable stage and cannot increase exercise attempts beyond walking as this would cause the muscle in the area to pull on the pelvic bones thus straining it. Despite the fractured bone healed, it’s not 100% there yet and as the pelvis is attached to many ligaments and tendons these are constantly pulling on and moving pelvis. Therefore these micro-fractures will take more time.

Until then I have more than enough to keep me busy and don’t miss running etc. Being without any real exercise or gym for so long now I have gotten use to it and really enjoy and appreciate long walks with friends, more time and less pressure. However since mid-August my priorities have changed since starting Master course in Uni. I no longer have much time for exercise or spare time these days anyway while juggling full-time job and college Masters Course!

Overall I’m happy with this progress update 1 year later but I do feel that running and pre-injury state is still a long way off yet. I have made a few attempts of jogging on grass interspersed between my walks maybe 2-3 times week max. I can get away with this fine for a few 5 minutes jogging here and there… but what’s the point, it should feel right with no limits so I’m really only teasing myself with these random few minutes of feeling running pleasure! I will continue to share updates on our group blog here anyway. I look forward to hearing your updates too :-)
My Blog

3 months in to the healing process....

2009-08-27T20:05:00.007+01:00

Hi Everyone! I was so happy to stumble across this group blog; Lizanne, thanks again!

I haven't gotten through all of the posts from everyone, so please accept my apologies in advance for the length of this post, and also if I'm repeating much of what folks already know/have heard before from others. I know it's helpful for me to hear individual stories, and I hope even one of you is able to glean something useful from mine.

First some background: I'm a 29 year old female distance runner (with a very demanding full time job, unfortunately! ;) I wont bore you with my running resume, but just by way of background, I ran D1 cross-country and track, took some time off while in law school, and then rediscovered my love for running hard/competing/the camaraderie of the sport, and in the process, also discovered my ability in the marathon. I finally got serious about running again late in 2008/early 2009. I ran a marathon in May of 2009, and was hitting about 80-90 miles per week at the peak of my training cycle. I was training HARD for about 4.5 months straight, barely ever taking a day off. Then, I only took about a week off post-race before I started pounding out the miles again. This is all a valuable learning lesson: our bodies need rest! anyway...here is the story of what happened as a result, I'm convinced:

On June 19th, I was on my way home from a 10 mile run in central park and had to stop at a light before I could cross over Fifth Avenue. I had hammered it pretty hard, so I wasn't totally alarmed when I could barely lift my right leg in to the up-swing to start up again. The amount of pain was scary, but I think I am used to running through a certain amount of pain on a daily basis. This time was different, though, and when I got home I was pretty sure it would be idiotic to try to run again before I got checked out. After some very inexperienced web-research on my symptoms, i had convinced myself it was "just a groin muscle strain" and i probably just needed some rest and then id be back at it in no time. however, over that weekend, i also noticed that it was virtually impossible for me to stand on my right leg; it just couldnt support my weight without putting me in excruciating pain. and when i pressed around the hip flexor muscles, it felt like electricity was running down the inside of my thigh. i was pretty scared, to say the least.

Convinced that this was something i just couldnt figure out on my own, I made an appointment for the following week with a fantastic sports med ortho. He listened very carefully to my running history, diet, symptoms and then did a series of resistance exercises to gauge my strength. He said right away that my right hamstring was abnormally weak for an athlete, and ordered an xray on the spot. The x-ray came back negative, of course, and he was optimistic about the look of everything otherwise. However, he was still very concerned about my symptoms, and sent me in for an MRI the following week. During this time, I was ordered to do nothing but rest. The pain was still there; that ache in the butt/upper hamstring area, the sharp pain in the groin area if i moved too quickly or applied too much weight to that leg. Thankfully, I listened to the doctor, though. It wasnt easy, but I resisted the temptation to run or swim or bike. I even wore my running shoes everywhere I could (in NYC, you do a LOT of walking!).

As you all guessed by now, the MRI results came back a few days later (July 6th) with the bad news: non-displaced stress fracture to the right inferior pubic ramus. I don't need to explain to any of you what kind of crushing blow is felt upon hearing those words. The ortho ordered 4 more weeks of strict rest: no gym, no walking around in flip flop, no high heels...you get the idea. He said that after 6 weeks of total rest, I could start physical therapy.

Speaking of physical therapy...sometimes life has a funny way of pulling you in the right direction. The weekend of the New York City triathlon, my boyfriend and I were cheering on friends and hanging out at the finisher area. We ran into acquaintances of ours who are twin sisters and are both professional triathletes who live in NYC. We'd seen them a few weeks back at the Philly tri and i had told one of the sisters about my possible injury. When she asked if i had a diagnosis, i told her the bad news. Turns out, she had the same injury 4 years ago while at the Olympic training center in CO Springs. Even there, they had a terrible time diagnosing her. This seems to be the case with many of you; I consider myself extremely lucky to have found the ortho that i saw. Anyway, she recommended a wonderful physical therapist here in the city and I have been working with him ever since the end of July. (i am happy to share contacts with any of you that may be in the NYC area!).

Here I am at the end of August, and I am basically pain-free. No groin pain at all, and I can completely stand on one leg for a few weeks now with no pain. I have been working hard with my PT to strengthen my hamstrings and core muscles, and we've been gradually working me in to walking backwards/sideways on the treadmill, and very low resistance on the elliptical trainer. most people are surprised to hear elliptical over bike, but sitting in the saddle puts a lot of pressure on the pelvis. i work on the recumbent bike a few days a week when i'm not doing my PT circuit or water jogging (i was able to start water jogging with a support belt about 2 weeks ago).

Still no word on when I'll be able to start running again. It is getting easier to manage the emotional aspect, especially when I realize how lucky I've been to have such great doctors, as well as such a great support system. I know now that i will always have to do drills to correct the muscle imbalance, I need to work on my hamstring strength, and most importantly, I need to find a way to stay healthy when I start cranking back up to 90+ mile weeks again. This probably means a day off every once in a while, more frequent deep tissue massage, and attention to drills and strength (i cant say it enough!). I've also since gotten a coach, which I think will help me to stay focused and more controlled about my training. Always good to have someone else listen to how your body feels and hold you back when you need it.

there are days when i get a twinge in the sfx area (groin is where it hurts when it's the sfx)...other days, i can tell that my hammie is just weak or tired from the gym. im trying hard to stay positive, and reading all of the posts so far has really been a silver lining on what was otherwise a dismal day of worrying/feeling sad about my injury. I cant wait to keep reading! Thank you all for listening to me ramble on, and thanks so much for sharing here! Happy healing, everyone!

Basic Training Injury

2009-08-25T15:56:00.003+01:00

Hi all! I found your group and decided to tell my story. Although it is not an encouraging one.

During Basic training in 1995, during the 'beating for white belts' I developed severe groin pain. After several visits and x-rays I was finally diagnosed with a stress fx superior pubic ramus via nuclear bone scan. Their therapy was Vitamin M (motrin), naproxyn, ice and limited duty. No jumping jacks, running in place, push ups. I did not 'obey' and very rarely pulled my light duty chit because those recruits that did that got 'abused' even more by doing more difficult things, like holding your 10 lb boots out in front of you for 10 minutes (yikes!). I figured to keep doing things like everyone else and I would be ok. Actually, I earned the respect of my superiors because of it! To graduate, I had to get off light duty and perform the PT (run 2 miles, 50 pushups and 50 sit ups). The docs wouldn't accomodate me and put me on crutches instead. I 'graduated' with my class, but then was put on hold until I passed the PT, which I did a week later after 'telling' the docs I was feeling fine. I went over to Hospital Corps school and was put back on crutches.

I found out I was the 11th female to be discharged from the Navy in 6-8 months for pelvic &/or hip fractures. I was 'lucky' that it was only my pelvis. Within a few weeks, a bone scan showed all was 'healed'. The pain was still there and my hips started a peculiar clicking sound when I rotated my legs. I was on crutches for 17 weeks walking with a 'weight-bearing' gait. Sitting on hard surfaces really hurt on the 'sit bones'.

After my medical board was started, my Ortho doc took blood tests & CT scan and suspicioned Ankylosing Spondylitis with SI joint changes because of my continual pain that was starting to move to my SI area.
Soon I was confirmed dx of inflammatory spondyloarthropy, not AS 'yet' because of no fusion.

Fast fwd to now, 14 yrs later:

My groin pain is STILL there and so sensitive I have developed a protective reflex to keep my kids or anybody from touching my pelvic bone when they bump into me or jump onto my lap. I lived through 5 pregnancies with pain increasing in the pubic symphysis during those times. Thankfully, the pregnancies put the spondylitis into 'remission' and slowed the disease by 10 years. Some theories are the disease is started by an injury, infection, chemicals, bacteria, etc.

Now my hips are showing osteoarthritis changes and the doc is seeing 'odd things' with my pubic symphysis. I'm only 35 and I use a cane on a regular basis. Often I use crutches because the pain in my pelvic/SI/hips is so severe I cannot put weight on them.

I always wondered how much collateral damage that pelvic stress fx has caused.

Recently I was talking with my sister-in-law and she had heard from her mother's ortho doc that pelvic bones are like hips and are the most difficult to heal properly.

I wonder if the damage happened in the ligaments/tendons which tightened and cracked the bone. This would make sense because damaged ligaments and tendons do not ever heal properly. Also, those that have SI joint issues can fracture their pelvis easier.

My advice to others: REST and do NOT push thru activity too early. And study up on spondylitis and watch your symptoms. It is an un-diagnosed disease in many, esp women.

I apologize if this post doesn't make sense. The weather changes throw me into more pain that keeps me from sleeping well. No position is comfortable because I cannot ever take the weight off my pelvis.

Maybe things aren't so bad after all

2009-08-02T11:31:00.002+01:00

Hey all, I just wanted to post a quick update. I wrote here last week about how I am having some pregnancy and/or stress fracture-related pain in the area of my stress fracture. I thought for awhile it may be SPD, a pregnancy condition where the pelvis basically separates. I am sure now thats not what this is. Also, I'm sure its not my stress fracture becoming re-injured. It can't be! I am not active enough and I have moved on to less-impact workouts. I think its just the joint relaxing hormones (relaxin prepares the joints for delivery) that have affected my left hip/groin area. I'm sure my left side was predisposed to this more than my right just because of the stress fracture.

Last weekend the joint hurt a lot after walking on the treadmill. I have found this weekend, however, that the elliptical doesn't make it hurt at all. I think its just the impact of the harder steps on the treadmill (from faster walking as opposed to just walking around). I am so happy to have figured this out.

What is still a mystery to me, however, is a soreness I feel in the muscle/tissue area right at the stess fracture spot. I'm not sure how this is related. I feel a soreness when I stand up after sitting awhile on days like today (well, yesterday, since its 5:30 a.m. Sunday, stupid insomnia) when I was on my feet for a long time. It lasts a few steps and then goes away. I can tell its not in the bone. It feels almost like a bruise.

I think my best method is just to stick with lower impact stuff, which stinks because I'd really love to get back into things like kickboxing, which I enjoyed before the stress fracture. I'm making a very conscious effort to take it easy if I'm sore after a particularly active day. I am getting toward the home stretch of pregnancy, but also the uncomfortable part. However, I think if I'm careful I can still stay active up until delivery.

I'm glad to have so many new posters here. It really feels good to know we are not alone in our injury, doesn't it? Especially in the long recovery.

Thanks!!

2009-08-02T03:10:00.001+01:00

Thanks for all your support and ideas on exercises that might help. I also want to say I'M So Happy For Lizanne! That's great news and it gives me hope that the pain I'm having now may be nothing more than just the muscles and not another fracture. I'm hurting a lot today and have been worrying that it's another break. I've decided to give in and call my Doc on Monday. I was trying to hold out and see if the pain improved but, unfortunatly it has only gotten worse. My doctor said I should use the pain as my guide to let me know when I was over doing it but, if I were to do that, I'd never get anything done cause it ALWAYS hurts! I don't know if the stuff I'm doing is making it worse or better. Can anyone tell me the difference between the pain from the fracture and pain from the muscles? Day by day my pain keeps getting worse and starting to feel more and more like it did when I first broke it. Plus another bad sign is the numbness in my groin area is coming back. I'm really working myself up about it. I was just starting to feel like myself again and I can't imagine having to go through that healing process again. So I'm going to call on Monday..Wish me luck! :( I also wanted to say to anyone that has to take prednisone. PLEASE make sure you bring up the issue of weakened bones with you doctor. I think it's mostly if you have to take it long term but, better safe than sorry...right? I think one of you asked if I had ever had any other fractures? No, this is the first bone I have ever broken and I think I would have rather broken an arm or leg. At least you can put a cast on that and there isn't all the organs and nerves in that area to worry about. This has been an AWFUL experience to say the least. I will post when I find out what's going on and again if anyone can kinda give me an idea on how the pain from the muscle feels in comparison to the pain from a break...I'd so appreciate it. I'm driving myself crazy worrying about it.
Kelly

Fracture to Inferior Pubic Rami

2009-07-30T10:47:00.004+01:00

Hi there, my name is Kerry and I have spent the last 2 years in severe pain in my groin, thigh and knee. To fill you in, I had a shallow hip socket and had an operation called a Ganz Osteotomy where they broke my pelvis, moved it over and pinned it together. This deepend my hip socket but left me with a different kind of pain. Almost immediately I had pain in my knee followed by pain in my groin and thigh. It took my surgeon a long time to figure out what was going on. My xray has always shown that my inferior pubic rami had a fracture after my initial surgery but my surgeon never believed that was what was causing my pain - even though this is a very common fracture after the type of surgery I had. Pretty much every week I have been having physiotherapy treatment and acupuncture - these have never cured me but kept me going! Five months ago I had a cortisone injection into my hip bone - that didnt work. Two months a go I had a hip arthroscopy to look at my hip bone and all came back clear. My surgeon finally decided to concentrate on my inferior pubic rami fracture so yesterday I received an injection of local anesthetic directly into the fracture - wow! Finally he has figured out what is causing my pain. The effects of the injection is only temporary but I am so glad to finally know exactly what is causing the pain. Right now I have been sat in the same position for more than an hour - something I was NEVER able to do before the injection. I always had to sit on my left buttock to ease the pain. My work also invested in a brilliant chair which tilts my pelvis forward enabling me to work at my desk for longer. Unfortunately, my surgeon is not good at communicating and I do not know what is going to happen next. I believe him to be a brilliant surgeon he just doesnt explain things very well! I have always said that if this injection didnt work I would go for a second opinion, but looks like it has! I have to go back to see him in 6 weeks time but right now I do not know what can be done to fix this. I thought it would naturally heal however it has been more than 2 years that it has been like this. I've tried researching treatment for this but to no avail. Things feel really good right now but I know the pain relief wont last forever. I just wonder if anyone else is in similar position and what treatment you have had. Thanks

Spinach is a poor source of calcium....

2009-07-29T21:11:00.003+01:00

Hey Folks,

I have been trying to get a healthy amount of calcium in my diet, and I don't eat any dairy products. Spinach seemed to be the best vegetable for calcium content, but I was surprised to discover that it turns out spinach is a poor source of calcium, because even though it is high in calcium the calcium is not bioavailable and not absorbed due to other chemicals that spinach contains.

It is confusing, as many different references seem to have different data about calcium content, and then the bioavailability is another issue as different foods have a different amount of bioavailable calcium which is different from the amount of calcium total that they provide. Most charts only worry about the total calcium in the vegetable, not how much of it your body can absorb, hence why spinach is often listed as one of the best vegetable sources for calcium even though it is a poor one.

There is always supplementation, but it seems healthier to have a naturally calcium rich diet than to rely on pills.

From what I have been reading, some key foods for a calcium rich diet are blackstrap molasses (!), collard greens, kale, and bok choy. These are what I am tanking up on. [ I'm not that impressed with the soy sources of calcium, which seem to me as basically the same thing as taking a calcium supplement, since the calcium content is added to the food through processing. ]

Anyways, here are a couple great articles on calcium sources for those of us who avoid dairy:

http://www.vrg.org/nutrition/calcium.htm

http://www.nytimes.com/1986/07/30/garden/food-fitness-sources-of-calcium.html

Vitamin D and Calcium Absorption

2009-07-29T13:44:00.002+01:00

Just wanted to pass along a link to this article in the current issue of Running Times about Vitamin D and its role in calcium absorption and the link to stress fractures:
http://runningtimes.com/Article.aspx?ArticleID=16940

My 2nd doctor had recommended a series of blood tests, but I put them off because they weren't recommended by the 1st doctor (and because the 2nd doctor wasn't in my health insurance network so the medical expenses were really adding up).

However, since my pelvic stress fractures (http://www.over40runner.com/info/injuries/StressFractures.html) are still not healed at 15 weeks and I saw the article in Running Times, I went yesterday for the blood tests, including the 25-hydroxyvitamin D test, also called a 25(OH)D. This measures the effective form of the vitamin that can interact with calcium to help bone health. They also ordered tests measuring thyroid, a complete CBC, and tests at 2 different times measuring hormone levels.

I'm scared of hormone replacement therapy because that was the first thing they told my Mom to discontinue when she was diagnosed with breast cancer. However, the doctor seems to think that the bio-identical hormones are safer. The latest article in Newsweek tended to disagree, so I'll get the results first and then make a decision later on whether to do hormone therapy.

At the very least, I'll know if my vitamin D levels are okay. The Running Times article mentioned Deena Kastor taking much more Vitamin D than was recommended by my 1st doctor (pre-test). So I'll be very curious about the test results (e.g. if my 4 months of supplementing with 1000 IU of Vitamin D was enough).

Anyway, just thought I'd pass this info along.

Its just not fair

2009-07-27T02:09:00.002+01:00

At the beginning of my pregnancy I was told by multiple providers (OB, sports med, PT, primary doc) that the stress fracture shouldn't affect pregnancy. Yet right now, for about the last week or so, there's something obviously going on in my pelvis. I can't tell if its the stress fracture or something completely unrelated. There's a condition in pregnancy called symphysis pubis disfunction where the joints of the pelvis essentially separate. I'm not sure if I have this, a stress fracture aggravation, of just the lovely relaxin has invaded that area of my groin.

Last weekend I went to my family reunion and spent some time playing with my nieces and nephews on the playground. After pushing them on the merry-go-round, later that evening my entire groin got really sore. It was so uncomfortable moving in bed that night. And walking wasn't terribly comfortable. It subsided to just a dull ache and stayed that way for most of the week.

This past week my new gym opened and I worked out three days. After walking on the treadmill yesterday, my husband and I spent close to five hours out and about shopping for baby furniture and other stuff for her room. I felt the spot in the groin all day starting with the workout. Later in the night walking got tough again and moving in bed was again difficult last night. And again, as today has gone on, its feeling better.

From what I've read and heard about SPD, I don't think thats what this is, which I am glad about. That condition can be severe and long-lasting. So either I've reinjured the stress fracture or the hormone that relaxes the joints in pregnancy (called relaxin, it stretches the joints to prepare for delivery) has relaxed at least my left hip joint. I'm leaning toward that just because I really don't think my activity level recently has been enough to reinjure a stress fracture, unless my calcuim intake isn't good and the bone is just weak. But doesn't a stress fractured bone heal stronger than it was before injury?

I'm not sure if its worth seeing a doctor about, and if so, who. I don't know if its a question for my OB because it could be pregnancy, or my sports med doc because it could be stress fracture related. But maybe there's no reason to see anyone about it.

Right now I'm just going to try and take it easy. On days when I have to be on my feet a lot, I will rest and not work out. I'm finding that I am getting to the uncomfortable part of pregnancy and it really is starting to affect my body if I do too much. Maybe I'm just being punished for telling people last weekend that I was feeling great.

Sorry if this post doesn't make much sense, but I do figure that if anyone can understand what I'm going through, its this group. I hurt myself nine months ago, thought I was healed, yet I'm finding this injury could still be affecting my body. Its just not fair.

Some good news

2009-07-26T22:47:00.003+01:00

Welcome Jim and Kelly, thanks for sharing your story guys.
I hope everybody is progressing with your pelvic fractures regardless of what frustrating stage of the recovery each of you is at now. I have truly felt that I have had this injury with its many limitations and frustration for years now (despite it only being 10 months). Throughout this entire time I felt like I was never improving or healing. To make it all that more confusing and frustrating is how the doctors and medical “experts” are none the wiser. If anything the real knowledge, understanding, advice and support is from (1) listening to your own body in how it feels – only you can do that (2) advice and support from those who actually have this and are experiencing the same. As we have all learned the very hard-way, this injury is like no other.

I now fully understand that in terms of medical assistance, the only medical interaction required is an MRI scan to diagnose the injury (100% fact) then MRI again months later to check how far we are in terms of being healed. Physical Therapy (core pelvic strengthening) exercise and plain simple rest are the only other 2 things that we can do – this intervention is not necessary from a medic / professional. They can’t say or do any more that read an MRI scan & provide the medical fact of injury diagnosis at that time. After this its almost impossible for them to provide an answer to when we heal because we now understand that this injury is unique. Every body is totally unique and this injury incorporates many factors (age, sex, diet, hormones, deficiencies, biomechanics & medical history) - therefore everyone will heal quicker / slower than others.

And it’s for this reason that there is little knowledge, answers or medical assistance in speeding things up. It is an extremely isolating and frustration recovery – especially in how the pain is very vague and difficult to pin-point. As a result it’s very difficult to see any light at the end of the tunnel and feels as though it will never come to an end. For me I have had far more ‘down and negative’ days than up-days. Almost sometimes believing I will never heal; yet alone run again! SO I want to give you some news that I hope will make some of you believe and feel that there IS light at the end of the tunnel: here is my update:

Since returning from a much needed vacation 4-weeks ago, I still experience the same groin aches, rare pubic twinge and most significantly – the discomfort of sitting pressure right on the bone. BUT it does feel more ‘muscular’ these days where my walking time has increased from +1 hour most days with only minimal increase in groin ache. So getting to the point - I had an MRI scan last weekend. The last scan before this was January. Therefore I felt there just MUST be some improvement in this whole 6 months between scans. I got the phone call from doctor this week: The pubic fractured bone is fully healed now. I almost cried. But still unbelieving, I remembered everything I read in online articles and what some of you say here (Eg: Jim’s post below about muscle tissue edema): So I am assuming that despite my pubic bone being fully healed, the muscle tissue edema surrounding the bone is still a little torn and fatigued, I am thinking. On that phone call I said…..: but doctor, what about the surrounding muscle, there must be edema there because the ‘pain’ is still very clearly there in the groin. He said no, there is nothing in the MRI results from the radiologist to indicate any abnormalities. All is OK he said. Then I said… “So doctor, what is the cause of this continual pain”? But he doesn’t know! So after speaking with some friends, I have learned about this thing called ‘referred memory pain’ which can last in the muscle / nerve endings after a severe trauma injury that has been long-term (months/years) that the body clings onto in memory of experiencing it for so long.
Another suggestion (which I think makes more sense) is that the bone is fully healed (primary) but muscle surrounding a bone is secondary and always takes longer to repair itself. The doctor didn’t mention this but I have been since thinking that the only explanation is: perhaps the muscle is 80% healed, for example, and the MRI scan shows all is OK. However that final 20% for example is still torn and needs longer and more time to repair and strengthen. I don’t know which but all that matters is that the MRI scan shows 100% healed bone!! :-)

However, because the groin pain is still there and will increase slightly with activity (walking time/speed after work in evenings) and if I do push it sometimes I can get the usual deeper twinges, which feels like its still pubic bone. That’s why I’m still shocked at the MRI scan result and almost in disbelief. The results were told over the phone but now that doctor is on vacation for 2 weeks so I can’t see him until then to discuss the ‘next steps’ and establish real reason for the persisting pain. Therefore I will not try push/test limits further and only continue same walking times. I have gone through 10 months so far and have been injected with huge fear of doing anything that could re-injure.

I hope that my results have not only given you some help and knowledge but show you that there is light at the end and you will eventually get better. I know it feels like a lifetime. I will update you in a few weeks when see the doc. Share your progress here, let out the frustration and you’ll feel better. We are all in it together and remember: you’re not alone!
lizannebarnwall.blogspot.com

Pelvic Fracture

2009-07-23T00:02:00.005+01:00

Hi

My name is Kelly and I'm new to this group. I'm glad I found it. I have been dealing with this awful injury for almost eight months now and I need all the support and advice I can get. I fractured my pelvis the last week of November. I guess most of you, if not all, are athletic and that's how you got your injury. My story is a little different. I didn't do ANYTHING to get mine. Yes. you read right!! No high speed car crash. No fall. NOTHING! I was just doing every day things like walking, housework ETC... Every time I tell people that, they look at me like I'm crazy and before this, I would have had the same reaction had someone told me that. So here's my story...I have arthritis. Have had since I was 25 (I'm 38 now). Anyway, I have to take prednisone. It has many BAD side effects. Among them is it makes your bones weak and makes you gain weight. There are other side effects but, these are the main ones that caused my injury. I am a very small person. My usual weight is 115-125. I am only 5'4. It was the combination of these two things that broke my pelvis. I guess my weakened pelvis just couldn't support my weight so it cracked. During the winter when my injury was at it's worst I weighed 182. I couldn't do anything but lie around in bed and through it all I had to continue the prednisone. So it made the healing process even longer. Plus doing nothing added even more weight. Finally about mid march, I was able to walk without my walker and do some excercising but, almost four months later, I'm still struggling with trying to lose weight. I use my treadmill and excercise bike evey day. So far I've only lost about twelve pounds. I've heard that prednisone weight is hard to take off and I'm living proof of that. As far as my pelvis...it's still not healed. I have pain constantly and it actually hurts more now than it did a month ago. So I'm wondering if i didn't crack it again since it was so easy the first time. I haven't gotten it checked yet. I'm hoping it'll get better. I almost don't want to find out. I don't think I could handle going through that again. I am taking extra calcium and vitamin D plus osteoporosis medicine. Unfortunately I'm also still on the prednisone. I have to stay on it until the docs can find something else that helps the arthritis. I've tried about everything and it either doesn't help or I'm allergic. So I'm very frustrated. I either have to continue the med and risk breaking my pelvis again or I can stop it and lose the use of my joints. Not good choices but I have chosen to risk the pelvis rather than not being able to walk. My doc said that since I still take the prednisone, it may take my pelvis up to a year to heal. He also told me to use the excercise bike but, the seat makes me hurt even more. Does anyone have any advice as to maybe what kind of excercise may help? I'm wondering if the doctors know what the hell they are talking about. To me they have acted like a pelvic fracture isn't that big of a deal but, from what I've read online, it's a pretty serious injury. I'm also wondering if anyone else has had any numbness and if so, did it get better? The front of my thighs have been numb since I broke it. I was numb from the waist down to my knees so it has gotten better but my doctor said he didn't know if it will ever come back on the front of my legs. So that's pretty much it. Thanks for reading...I do feel better being able to share with other people who are going through the same thing.

Pubic Bone stress fracture

2009-07-19T19:10:00.020+01:00

Well, I am glad to have found this blog but sorry so many of you are dealing with this also. For me, it started quite a long time ago, last summer.

Pain in the right buttock and low back. It moved insidiously to greater pain and started then in the groin, pubic and adductor area. Like most addicted runners, I continued with my training only to pull back a bit when it got worse. (oh, I wish I could go back and do things differently). Finally, I could not take it anymore and last December I decided to take 6 weeks off. In 20 years of running I don't think I ever took more than 3 maybe 4 days off in a row, and then only because I was sick. I just thoroughly enjoy running.

Well after 4-6 more weeks with pain I finally went to see my Doctor. (February 2009) She performed a pelvic and prostate exam which yielded nothing and then ordered a MRI of the pelvis looking for a Hernia or Oestatis Pubis. MRI came back normal at which point she referred me to an Orthopedic surgeon. I choose to go to the University of Michigan Health system. They have an extensive Sports Medical program with very knowledgeable Orthopedic Doctors. At my First couple visits in March of 2009, I got X-rays, an ultra sound of the pelvis and then an MRI of the Pelvis. And then I got the news, stress fracture of the Right Pubic Bone, even I could see it as plain as day on the MRI as she showed it to me. From the beginning, my Ortho Doctor said it would take 6-11 month's to heal (sometimes 1 year). She said it was going to take a long time to heal and the least amount of activity I do the better. I was lucky, she is very knowledgeable in this area and in fact her clinical interest are: The female athlete, stress fractures and the role of hormones in injury and tissue repair. This injury by the way is more common in woman than in men. Well, I did as little as my athletic mind would let me. I weight trained some, swam using a pull-buoy and walked a little with my wife. I was told to let pain be my guide.

Meanwhile, my Orthopedic surgeon ordered an array of blood tests looking for deficiencies in calcium, vitamin D, hormones (testosterone) etc. And actually my Testosterone came back low so she ordered a DEXA bone density scan. It revealed some bone loss, classifying it as osteopena, (not osteoporosis), meaning low bone density. I had my testosterone re-checked again after months of little training and this time it came back normal, but she is concerned. Sometimes these fractures are the result of over training but sometimes they are also the result of hormone, mineral and vitamin deficiencies too. And sometimes I guess a combination of the two.

So let's fast forward. The symptoms have gotten better and a follow-up MRI in July, (now 7 months later) showed the bone had healed but there is still alot of edema and swelling in there. And I would have to agree. It still hurts to sit, and I get some pain in the adductor and pubic area. Doc now says its time to start PT with some gentle stretching and then some core stength training. Hopefully in October (10 months) I can slowly start back running.

I can say I am completely disgusted with this injury but quite honestly, I feel as if I could start running soon. I am down to a pain level of 2 (1-10), mostly in the groin area when sitting for long periods of time. I am told that I am at a vulnerable point right now. The bone is healed but it is the muscle that protects bone and absorbs the impact, and those pelvic muscles need time to rebuild and strengthen. When muscle is Weak or Fatigued it no longer protects bone, making you susceptible to fracture. Probably how I got here in the first place.

Anyways, I will say this injury has helped me put things into perspective and I think most of you know what I am talking about. Maybe there is more to life than running.
I wish you all the best and thanks for all your postings. It helps to know that others are dealing with this too.

Take care,
Jim

See Jane Run 1/2 marathon

2009-07-02T22:04:00.002+01:00

I am sorry to hear that so many of fellow pelvic stress fracture runners are having such a long time healing. I guess I was lucky that I felt so much pain from my inferior and superior pubic ramus and acetabulum fractures that I had to get on crutches and stay on crutches for 8 weeks. I returned to running 3 1/2 months after the fractures and run a half marathon with my daughter 4 1/2 months after my injuries. We ran very slowly because this was her first half marathon. Pre-fractures, I usually finished half marathons under 2 hours. We ran this one in 2 hours 40 minutes. I felt great the entire time with no soreness after the race.

I have joined my running group for 3 runs per week of 6 - 10 miles per run. I am much slower than I was pre injury and can not keep up with the faster runners. I am still struggling to lose some of the weight I gained while on crutches. I have cut my pre injury weekly mileage of 75 miles to 30 -35 miles. I am cross training (biking, yoga, zumba, step, water fitness and power weight classes). I am happier with the lower mileage and enjoy the cross training. My next race is the San Francisco half marathon in a few weeks. I plan to run this with some the slower runners in my running group.

Hope you are all back to running soon!
Sue (dog runner)

So bummed

2009-06-29T22:50:00.002+01:00

Okay so now that I have gotten myself up to a bit of the distance before stress fracture-do you get the feeling that all of us think of our lives in terms of before the injury and during/after injury. I was running three days a week with comfort during the run, BUT the last week and a half I have had those darn "groin pull" twinges that I had before diagnosis. Last week I informed my PT who thought not much of it and actually made me feel a little better about the healing (but in my heart I thought this guy doesn't know anything about pelvic stress fractures as I'm his first to rehab-why did I have to be the guinea pig!) Anyway, I went again to PT this morning for a supposed test to see the progress since I started at the first of the month and when I informed him of the pain again. He got up and immediately called the sports doc and now I have an appt. with him this week and no PT exercises either. I know he (sports doc) is going to say stop running-I don't want to listen to him though. I'm just in a pissed off mood as I know these people don't know what they are doing and I want to stop going to them if they just are telling me to rest. I just can't believe that I'm back to feeling that pinch in my leg-wondering if I'll ever not have pain again and ever be a runner again. It now seems as if biking causes a pull in my leg so that exercise is out-haven't tried swimming since April, so I'm headed to the pool in the next few days (after dr. appt.) sorry, about the rambling, just needed to vent to someone who can identify and knows what a big deal NOT running truly is!

I'm back! Update

2009-06-27T16:27:00.003+01:00

Hi guys, I just got back from my 23-day African safari this week. We covered 5-different countries, did a lot of travel and saw so much. The distraction was much needed - for injury mostly. I got back this week to work and civilization again! We were camping out in the bush, cooking by campfires and often no electricity in the nearby villages so we rarely ever got to check Internet, phones or civilization! Physically (injury wise) I’m much the same but my mind is so much better. I will give you my injury update but first I would like to comment on the recent posts here too so be warned, my post is long because I haven’t had Internet in over 3-weeks too!

Tracy it looks like you’re doing great and being able to run again must feel wonderful after being out for over a year with this so far. Of course the times you feel the aching will make you question whether you should be running or if you should take things back. And not even your PT can tell you this. Only you and your body can truly decide. Apparently the aching groin feelings are to continue even post-healing but it’s just so hard to know if your current exercise efforts are damaging or prolonging things further as you say your starting to feel the aches more so again similar to pre-diagnosis. My suggestion would just to do what you said yourself and take things back with more rest days in-between and focus mostly on your PT strengthening exercises and decrease running efforts until aches diminished again. I love hearing your progress Tracy, keep us updated.

Welcome to the group Cam and thanks for telling us your story. If it’s any consolation, you’re lucky that your pubic ramus sfx is superior. The inferior is most frustrating when sitting-down as it’s directly pressured on the bone and it does seem to take longer recovery. You could be right that your new fartlek running efforts were the ‘cause’ of injury but from what I have learned over all this time is that there is no ‘one cause’ but rather a combination of factors (e.g.: still exercising when we feel the first hip/pelvic strain as well as dietary issues/deficiencies, biomechanics etc.) and then it just takes one sudden effort or movement to make it all snap – and to me it sounds like the sudden change in your sprinting gait and strides that triggered this. For me, it was my constant excessive long striding simultaneously with speed, which I maintained consistently for a whole marathon. But with this there were other factors (bones and hormones) that couldn’t take this strain. It is a combination of things. I have read your article on prunes. It’s interesting but I don’t like prunes much so I’ll pass on that one ;-)

Yes Cam most of us can surely relate to the getting dressed scenarios for the first few weeks/months: holding onto furniture for support when putting on pants etc and unable to stand on one leg (annoying when get out of shower trying to life legs to dry etc!). Thankfully I’m beyond this part now and my main issue is the sitting pressure and groin aches and despite being able to go for full power-walking now, the time-limits are still there and I know the twinges are lingering in the background telling me they’ll start if I attempt anything more that what I currently do. Sometimes this is minimum 30-mins walking and if still feeling OK I can go up to hour of walking but again, the sensations are there and lingering in the background. This clearly tells me running is such a long way off it’s not even a consideration – same as cycling still unfortunately.

Sorry to hear about your knee Jessica. Perhaps you should take this time during pregnancy to actually just rest more and use walking only as exercise rather than trying to run – especially that you say you feel the baby pressing against bladder too? Are you still really considering running those race(s) in July? Just take it easy on yourself as your body has even more pressure on it now that carrying another little person on board too!

I have now had this inferior pubic ramus stress fracture (left side) for 9-months. After a very rough time through this personally (as most of you know from my own blog), it was doubly difficult being unable to release stress and sadness through my love of running and exercise. I’ve learned how much our mind and thinking can affect recovery of such injuries also. The more we worry and focus on our injuries, this build up stress alone is impacting our body’s ability to heal and relax. The stress is a barrier for our body to be able to heal itself. So my 3-week safari traveling Africa was wonderful for my mind and I even jumped on board with some of the activities that I knew were risky for injury but I decided I didn’t want to limit myself totally… so I did a day of white-water rafting on the Zambezi river Victoria falls… but little did I know we would have to walk down a very long and steep gorge to get down to the river… then after few hours of (mind-blowing) whitewater rafting on high rapids – we had to climb all the way back up the gorge! My pelvis held out OK and I felt only the mild groin aches. As long as the pubic twinges stay at bay, I’m not so concerned about the groin burning ache sensations. But later that evening I walked around the Victoria Falls too, which took nearly 2 hours…and evidently enough the aching was more prominent later that night and even when sleeping it throbbed a little. But I was really only watching to make sure the pubic twinges stayed away. I knew that it was the most active day that my body had experienced all in the same day… for a very long time. I had done too much at once. But as I said, it was a once off experience and we were at the mighty Vic Falls for only 2-days of trip so it was a risk I wanted to take.

Day-to-day getting around walking is fine but the most frustrating discomfort is sitting directly on the bone. Getting up and moving about is more comfortable and needed when sitting too long. When I got back to work this week, I realised that the all-day sitting upright in the office chair in work is a killer and a cushion makes no difference. So I figured out an idea, which has really helped the past 2 days: I filled a hot water bottle with water (wrapped in pillowcase to disguise from colleagues!) and place this just under my left hamstring. This ensures the left buttock is raised off the seat so alleviating the pressure on the injury. However, I don’t know if this may do any long-term misalignments as I’m kind of sitting at a tilt and causing a strain on lower back. It’s an experiment anyway.

Diet wise I’m still taking the Calcium + Vit. D tablets. I’m not so rigid about the gluten-free thing and my decrease in fiber anymore because I’m back to eating tons of fruit again, especially while away in Africa, as fruit is easy. But I do maintain the high-protein intake each day because this is important. Eating eggs, and turkey, meat or fish most days. While in Africa – everything diet wise went out the window as all food and meals were cooked over campfires and choices were limited. You ate what you were given as always in a rush to get on the road again!

I’m doing my pelvic (core strengthening) exercises on the floor each evening again and a 30-60 minute (max) walk most days again. I know that cycling or any other exercise attempt is still not possible but I am very content to be able to get out for proper walking again. Some people ask if I can try swim at least… but I cancelled my gym membership in January and made a decision never to reactivate membership until fully healed. I haven’t tried swimming since those aqua-jogging attempts back in April causing pain & twinges to return full force. I will only go back to gym when I can really use it again – not just for a pool. It would sadden me to watch people enjoying spinning and pump classes etc and getting down to the groove working out to the fast music – and me just seeing this through the glass windows while I’m going back-and-forth like a silly yo-yo in a swimming pool….

I do accept that I still have limits in what I can do (walking) and I must adhere to them. Sorry for the long post but it’s been a while since I have updated or blogged!
www.lizannebarnwall.blogspot.com

prunes, plums for bone health?

2009-06-27T01:08:00.002+01:00

Hey folks,

I was just flipping through a Reader's Digest this week and they had a blurb that said eating prunes or purple plums is the best thing a person can do for bone health. Apparently, in addition to having beneficial vitamins such as potassium, the humble prune contains special polyphenols which promote bone formation. The Reader's Digest article said purple plums are just as good, but all the medical studies and other articles that I read seem to be based on prunes in particular, as apparently not all purple plums are the correct variety that contains these special polyphenols [but all prunes are].

Here is a short article about the same subject: http://www.bottomlinesecrets.com/article.html?article_id=46926

Anyway, don't go overboard and make yourself sick, but it might be a good idea for all of us to incorporate some prunes into our diet while we are trying to heal from these miserable stress fractures!

-Cam

p.s. Apologies if this has already been covered on the blog!

Weebles wobble!

2009-06-21T03:27:00.002+01:00

Okay, so I have been trying to get back into running. Feeling like things are healed and seeing a PT once a week for exercises and pelvic strenghtening. He seems to think that I am getting stronger. I am able to run about 5 miles every few days (for the past two weeks anyway). But I am noticing that I have that same ache in my groin area that I had long ago (before the stress fracture was diagnosed) and I seem to want to wobble when I walk....does this mean that I am pushing it too much and shouldn't be running yet or just a factor in that I need to take it easy more days? Help any answers would be welcomed..I'm tired of the limping and didn't have it until a few weeks ago when I tried to run more days in the week. Tracy

Not running anymore, at least not how I want to

2009-06-20T00:39:00.002+01:00

I was off running for about a month because in rehabbing my stress fracture, I ended up with "runner's knee." My pregnancy may or may not be a factor, since the joints are loosening.

Anyway, I think I figured out how I hurt my knee. I had an exercise where I was stepping off my bottom step and bending my knee. But the step is more steep than the step I used at PT. That doesn't really matter though because the injury is there and now I'm doing PT more for the knee than the stress fracture, though my PT says I'd be doing similar exercises for the stress fracture. And I still feel a little sore in that spot afterward, so I'm sure there is some benefit.

Its frustrating though that I still have some of that soreness. Its been eight months now. The good news is its only after the exercises. So I do believe I am healed.

In the time I was off running, baby has started pressing on my bladder, which would make it difficult to run anyway. But I've found a happy medium. I discovered last weekend the treadmill isn't as hard on my knee, and that way I'm always close to a bathroom.

Since I've really started with the PT for my knee, I can feel it improving. It really only hurts after I do my exercises, which I've finally managed to start doing consistently. My goal for right now is to get to where I can function without the knee hurting and then go back for further evaluation after I have the baby. But since I've found I can still run a bit, I'll do that too. There are a couple races I wanted to run in July. I'll just have to see how everything is feeling closer to them and decide at that point if I will. I probably can't do them both because they're only a week apart. But they're two of my favorite races to run!

So I'm not setting any speed records, but I am still running a bit!

Hi Folks, I'm the New Guy

2009-06-18T09:51:00.003+01:00

Hi folks, when I started googling about pubic bone stress fractures I found this blog and it has really been a lot of help!

I did my pubic ramus stress fracture in January, and it has been a very frustrating injury so far. I did not realize how serious of an injury this is until the past month when I finally started researching it myself. The orthopedist that I went too was very blase about it and said 8-12 weeks rest and I would be healed, in the mean time he said I should do a lot of bicycling to maintain my fitness.... Too bad he apparently didn't know what the hell he was talking about. All the research I have done on this injury, including the posts here, indicates four months as an absolute minimum heal time, and usually much longer. One extensive medical study from the 1980s that I found said, "stress fracture of the pubic ramus has been known to take up to three years to heal".

Anyways.... It's the same story as most of you, I think. This injury is fairly rare and it seems like a lot of doctors don't know much about it. I guess I am one of the rarer men who suffers from the pubic ramus stress fracture, since it afflicts you ladies more than us dudes [for unknown reasons?]. Also, most people seem to fracture the inferior pubic ramus, but mine is the superior pubic ramus. It seems like the inferior would be even worse, as it takes pressure when you are sitting. Sitting hasn't generally bothered me, I am thankful to say.

I am a recreational football [soccer] player, and I developed a special program of fartleks to increase my stamina and sprint speed, this is how I did the stress fracture I am pretty sure. I thought up this new program and just went at it 100%, without taking much time to acclimate to the new stresses on my body. Well, it felt good, so I didn't see any reason to worry about it. The fartleks I was doing were on a series of steep hills, and I would do 30-50 meters run at maximum sprint, then 5 seconds walk, then 20 seconds slow jog, and repeat this cycle for about 2.5 miles. I only did this fartleks workout two times, and after the second time I had quite a bit of pain in my hip joint. It was just a nagging pain, though, and I didn't think too much of it. But then after my next football match my hip hurt a lot and I wasn't able to do any training that week at all. After the next match after that my hip hurt so bad that I had to stop before the game ended, and for a few days I could barely lift my leg to get in and out of the car. Putting on and taking off pants was the worst!

Of course I quickly developed the trick of leaning on one knee while sliding the pants legs on and off, taking the pressure off of my hip joint. A lot of you I'm sure have done this one, too. It's a habit by now, needless to say. Otherwise I could only get my pants on and off if I was laying down, ugh.

I went to the doctor pretty quickly, because I had been on prednisone that winter and had been warned about the risk of developing hip necrosis. The pain really seemed to emanate from my hip joint, and I was terrified that hip necrosis was the problem, which almost always requires a total hip replacement. My doctor had me rest for a month and when nothing had improved he ordered an MRI [X-ray had shown no anomalies]. During the MRI it took twice as long as the technician said it would take ahead of time, he had to do extra scans, and he kept asking me repeatedly about the prednisone and how long I was on it for. Afterwards I felt for sure I had the hip necrosis, but I couldn't find out until I got word back from my doctor. Thank the good Lord that was not the case, the hip joint was fine, and I got the word that there was a pelvis fracture. Since I was afraid I had hip necrosis, hearing about the pelvis fracture was a big relief, but I never imagined it would be such a stubborn injury and so difficult to get over.

Oh yeah, the other bad thing I did when I started my fartleks training was I also changed my sprinting gait, because I had worked out a way to sprint faster. This fartleks workout in the hills was so incredible, I did the workout on Tuesday and Thursday, then in the game I had on that Saturday my stamina had increased ~50% and my sprint speed increased ~10%. From just two workouts!!! I have never received such incredible gains from any kind of workout/training before, it was just unreal. This was almost the most frustrating part of the injury, because I was really entering a new zone of athletic potential, like I had totally broken through a wall. If I could have kept this same workout for a month....... Oooohhh. I probably could sprint faster than Usain Bolt then. ;-)

The other thing I was doing at the time which probably contributed, besides playing a lot of football, is I started practicing this new dribbling trick that required really hard pivots while sprinting. It put a lot of torque on my hips [if I hit the pivot wrong I would go flying through the air], so I think this also contributed to the pelvis stress fracture. It is really frustrating, because with my football I was really entering a new zone, reaching a new level in my ability just before this stress fracture happened.

So anyways..... By the time I got the results from the MRI back I had already rested for a couple months with only one football match during that time. The orthopedist didn't seem too concerned about it, he checked my walking gait and made sure everything was in order and showed me the MRI where the whole top left section of my pubic bone was all lit up white like a Christmas Tree light. He said give it another month rest and it would be good, and told me to do bicycling in the mean time. So that's what I did, except I didn't do any bicycling but just rested it. After a month, unfortunately, it was only a little bit better. I played another football match and my hip/pelvis was really sore afterwards.

Then I rested it for another month and came back and played a few matches along with some light training. It felt good for one game, but then pretty quickly the injury regressed back to what it had been months before, as if there had been little healing at all. Since then I have been resting and it still hasn't seemed to be healing up very well.

Then I got frustrated about it and finally started doing my own research which I should have done in the first place. I was horrified to discover how much difficulty people have with this injury when they get it, and how stubborn the injury can be. I've now stopped all exercise except pull-ups, I even had to stop doing ab work and I had recently developed a new kind of intense ab training exercises [yes you can see a pattern here] that were working really well..... On the pull-ups I am careful to keep my legs down so I don't stress the pelvis. It is extremely frustrating, because playing football and working out were the main things I did for fun, and also my main social outlets. Also my main stress relievers. Ugh.

So basically I am taking the whole month of June off from everything physical, maybe July too. Already it is half way through June and my pelvis still feels twinge-y just from everyday activity, like putting on and taking off pants still hurts and I have to be careful and lean on one knee sometimes still, etc.

I'm taking vitamin D and calcium, and trying to get plenty of sunshine, maybe that will help a bit.

So that's my story. Thanks to all of you blog posters for sharing your experiences here, I have really found it helpful personally, and there must have been a lot of others who have, too. And hopefully it is a bit cathartic for everybody to post their struggles, it feels kind of nice writing about it right now for me. :)

And special thanks to Lizanne for taking the initiative and starting this group up!

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[Edit: ehh, on second thought maybe that joke's in poor taste, lol.]

Where is everyone!

2009-06-17T23:53:00.002+01:00

I think with Lizanne out of the country on her African safari, everyone else has stopped blogging. I am getting better mostly...I have days where the aches and some discomfort make me question if I should be running. I am now up to 5 miles every few days. I am also seeing a PT once a week and faithfully doing the exercises he recommends to strenghten the pelvis. Right now my left knee seems to be giving me a fit with running and the exercise so I think I should slow down some. So grateful to have this site and runner's world to check everyone's progress. Hope others are feeling some improvement....it is so nice to have pain free days after a year of having it! Tracy

Hooray for the little things

2009-05-24T23:04:00.002+01:00

Hi guys, haven’t written here in a while but have been following your posts. It’s wonderful to see the great progress some of you are making (way to go Jessica & Tracy!). But it’s still a long-road ahead for me & most of us unfortunately. It’s now 8-months since I got this pubic ramus fracture. Being told that I wouldn’t be able to run for 8+ months this time last year would simply be unimaginable! But this is a very clear reality for a long time now and looking more like 12+ months! However I definitely feel I have improved and strengthened over this past month but one thing for sure is that I’m not even near full recovery and I am more aware and accept this now. I was very limited for so many months but now I can do a lot more in terms of day-to-day living and walking no problems. I am now very aware of my limits and what they are – and NOT trying to test the limits and going beyond them. So here is where I am now…….
Day-to-day getting around is absolutely fine with only the usual dull-ache sensation (you know what I mean) in the groin/buttock when walking about for a certain length of time but finally the pubic twinge is rarely there. But I do know the twinges can return easily if I try pushing the limits but I finally know what these are and not to go beyond them. The most irritating thing now is the same usual sitting discomfort of sitting directly on the pubic ramus bone - particularly long days sitting in work and if driving for long period. After months of total-rest, I can now go for normal walks…. but here is where the awareness of my limits play a huge part. I’m only going for a 30-40 minute fast walk maximum most days, which is so great to be out in the fresh-air again every evening after a long day in work especially. During my walk the groin & pubic ‘sensation’ and the fragility of the area is still clearly there – but it’s not a pain, more of a dull sensation. This ‘sensation’ is mild and in the background but it will gradually get stronger if I push the limits in terms of walking time and especially power/speed. I did try this one-day (very fast walking) and the twinges returned at about 20-min marker which was such a downer. But when I do get the rare twinge, its not anywhere near as strong like it was a few months ago. I’m still walking fast but I know the limits and then the twinge no longer returns. When I come towards the 30-min marker, the feeling in the groin clearly tells me it’s not recovered yet but if I want to keep walking, I can… but I know it’s time to stop, unless I want the twinges coming back to haunt me!

So unlike the first few months of this injury last year, I no longer try to push beyond and test the limits. When doing this I would end up in pain again and feeling back at the start. I just know deep down that if I were to risk bringing the walking time up to an hour long, there’s a big chance of twinges returning quickly again. It’s amazing how much fear this injury puts in you. As a runner (well x-runner sounds more correct now), I’m such a headstrong person and the normal mind-set (before this injury) would to be to run through any discomforts with a no-fear attitude. I do have hope and belief that I’ll get better eventually but I’m much more accepting of the long-term nature involved. I decided that until I can SIT for a long period comfortably and can go a few weeks of walking without any experience of a twinge – it’s only then that I will try increased activity (e.g: I would love to be cycling again). I find the core-exercises for strengthening the groin and legs are very beneficial (mainly the wall squats, side leg raises lying down and front+side planks) which I do most evenings. A drastic change in diet is also showing to take effect, which is evident in nails and other things – which must surely be contributing positively to injury recovery too. This is very high-protein rich and high-calcium rich foods and greatly fiber-reduced diet, in order to better absorb vits, minerals, protein and calcium which are much needed for bones. I use to eat meat/fish only twice a week – but now everyday.

I feel closer to this injury now in terms of gaining a little more control again and understanding of what I can / can’t do. I’m more positive that I will / am getting better. But unfortunately with this, I also know deep down that it’s going to take at least another good few months before I can actually say I’m close to recovery. Therefore, running is a long-way off yet but who knows, cycling/swimming maybe soon. I’m just totally forgetting about it for the next 3+ weeks while taking a much needed 3-week holiday touring Africa :-) When I come back from holiday end of June and the injury has not worsened, I will be very-very happy. I will update you here again when I return & look forward to reading your progress and experiences then!
http://lizannebarnwall.blogspot.com

Happy Cheering Jessica

2009-05-22T21:45:00.002+01:00

Way to go on helping at the race event. I KNOW it will be hard for you (unless you are stronger emotionally that I am or farther in recovery to know that running times are coming soon.) I had registered for Virginia Beach Marathon in December and event was March-I had to drop out of any running event, but decided to tag along with my running group to cheer for them. It was absolutely the hardest thing going to the expo and having everyone wish me luck for the next day and then seeing everyone with pre-race jitters before and all the goodies after the race. I know that if I get injured again that I can't really do all that race stuff as it was too emotional for me. But I was also so far from being healed that I wasn't sure I would ever get to run again. anyway, great attitude that next year will be your year! Tracy

Just can't seem to win right now

2009-05-22T21:34:00.002+01:00

So in the rehabbing of my stress fracture, I hurt my knee! I have patellofemoral syndrome, the "runner's knee." One of my PT exercises just overdid it on the knee, and pregnancy may or may not have accelerated the injury (hormones loosening the joints). I find it funny its called runner's knee though because I can still run. I would have run today, except my stress fracture has been randomly painful the last two days!!

My PT isn't terribly concerned with having me do a bunch of exercises since I'm at the level I want to be at, or rather the level my body will let me be at right now. And obviously its stupid to rehab the hip at expense of the knee. The knee has been in varying levels of pain for the last two weeks or so. It was actually better until yesterday when my PT examined it and got worse again after I went swimming today. I went swimming for the first time in ages and my therapist told me to just do flutter kick stuff, front crawl and back stroke. But I'm terrible at front crawl, so I did the breast stroke. It felt fine in the pool, but not so much since I got out.

Anyway, its sort of a slap in the face that I'm so beat up going into this weekend because Sunday is the race I had decided I'd run as my first full marathon. This was back in October, coincidentally the weekend I got hurt. So the full was out when I got the stress fracture diagnosis, I thought I could do the half. But I stayed hurt since these injuries take forever to get better. Then I thought I'd do the quarter marathon but my body just doesn't want me running that far right now. I'm not even really sure my body wants me running right now.

So instead I'm volunteering at the race I had hoped to run. I'm helping at a water stop. Should be crazy but interesting and fun too. This is my race next year. Its decided. But this Sunday I'll just watch and help take care of the runners.

another one starting back

2009-05-22T03:06:00.002+01:00

Just an update that I am starting to get back into running finally since Jan. diagnosis. I did a three hour walk for Relay for Life last weekend. I was extremely sore after the three hour mark, but thought that that time frame was a bit much (overdoing it a bit since doing nothing for all these weeks). I had signed up for this long ago and felt it was a test to see if I could handle it. Nice part was that it was a slow pace and it was on a track surface. I did fine the next day after the walking so on this past Sunday I ran a 1/2 mile (in grass)...decided to walk a bit and then ran another 1/2 mile --- ONE MILE TOTAL! I gave myself a day off then Tuesday I ran for 3/4 mile, walked, ran 3/4 mile - I should have probably repeated the half mile thing but was feeling good and so ready to get back to 6 mile distance. Next day was a bit rough and I have to learn to talk myself out of ramping up too quickly! Anyway, I think I smiled the whole time I was running and look forward to waking up early Friday and running before work on my own. I still feel twinges and have some achiness (only hours after the physical activity) so I still need to take it easy, slowly and give myself the resting time. Cheers for all those who are getting back and FAITH to all those who are still waiting to be able to lace up again. TRACY

Close to healing

2009-05-13T00:12:00.003+01:00

Sorry I haven't updated here in awhile. I ran my goal race two weeks ago and it was great, but I had some soreness afterward that made me think I hurt myself again. But thats gone away though and I'm feeling good!

Anyway, my goal race was an 8K two weeks ago. The weather was terrible but I was determined to run it. I was soaked to the core but it was totally worth it. The Crazylegs Classic is a hugely popular race here in Madison, WI. They had a record 18,000 runners. It was still a great and fun experience in the rain and I'm sure its phenomenal in good weather.

I didn't pace myself well at all, which didn't surprise me. After all, I'd only been running about a month at that point. Including my walk breaks, I was averaging about 12:30 per mile, while my usual mile time is about 14 minutes. I was feeling pretty good, but getting toward mile 4, I had to slow down. For the last mile of the race I walked when I needed to and ran when I could. I'm still happy with my race. My final time was 65 minutes, 17 seconds, which beat my predicted time by almost 5 minutes. Its a far cry from my previous 5-mile time. The last race I ran before I got hurt was a 5-miler and I ran it in 49:15. But I'm just starting out, not to mention pregnant. I'm learning to be patient and do what my body will let me do.

After the race I had some hip soreness that concerned me a bit just because I've never had hip issues before. But in talking to other pregnant runners, I think the hip soreness is because of pregnancy hormones. The soreness also hasn't keep me off my feet or anything, and I haven't had any in a couple weeks now.

I've changed my form a bit, which has helped. My PT told me when I run I don't bend my knees/hips enough, which may or may not be why I got hurt. Not bending the knees/hips jars my body. I also don't get winded as quickly either.

I've been really happy to notice too that I'm not having any recurrence of old injuries. I had some achilles tendonitis last year that I'm sure has been remedied since I'm not running fast.

I asked my PT last week when I'm considered healed from this injury. He said there's no clear definition, but a good guideline is when I can run with no pain or soreness during or after. And I've been delighted to realize in the last few days I have very little soreness after runs these days! I had a little soreness yesterday during my run, but I think its because I had a couple little hills in my route. It didn't linger and I'm still really encouraged about my recovery. I'd say I'm very close to being healed!

I'm still a little disappointed that I am not improving as much as I would like. I'm not trying to go faster, I know thats not a good goal for pregnancy. I'd just like to not get so tired! Perhaps run over 5 miles every once in awhile. But I am glad to be running at all and I'm going to keep running, however slow, as long as I can.

Watch yourself!

2009-05-06T21:11:00.002+01:00

Sunny runner, I agree with Lizanne. Rest means rest! I tried to keep up the cardio with swimming but found that even pushing off the wall kept bothering things(not during the activity but later on). You have to think of all things you do with core strength as causing pressure on the stress fracture site. I had a PT tell me that you have the gravity of everything head to pelvis creating pressure and then the body weight and movement (and any extra weight bearing) that can also cause pain, discomfort, pressure. Lizanne, is also right that the gals that listened to docs and got early diagnosis and really rested are starting to run. Us gals, that thought oh this doesn't hurt I'll keep in shape while not using the feet pounding exercise are still healing. I'm trying to figure out myself how to get back to the cardio I had 4 months ago. I'm getting through everyday life without pain. It is almost weird to think a month ago that it still hurt to put pants on! The MRI's are so expensive that it can't be repeated to check progress or healing, but I want to see about a bone scan (not density)as I have had a few walk sessions (while not as cautious as I should have been) that have not been painfree. I'm going to try again tonight with slow pace and short stride. Anyway, welcome to sunny runner (so sorry that you are hear though)but this blog along with runner's world long term recovery-insanity posts help keep the light on for those of us that can't see the end. Tracy

Thanks, well done, update etc!

2009-05-06T09:51:00.004+01:00

Firstly Lisa, thanks a lot for your advice on the Exogen bone healing system. However I have since decided against this following research on the effects of ultrasound over fracture sites. I would rather allow my body heal itself as naturally as possible. And I completely understand what you say about listening to your own body. Nobody else, no doctor can truly advise to when you’ll be fixed as this is totally unique pain, almost indescribable to those (inc. docs) who have not directly experienced. Lisa, if I were you I would not rejoin running group in July - just my opinion. It’s typical of us runners to always be setting goals & determined to reach them, despite not being ready or the consequences playing detriment to our bodies/health. My utmost philosophy now is absolutely listening to body. I won’t even consider run/jog until 101% recovered no matter how long more that takes!

Jodie, thanks a lot for sending us that article. Really very interesting & educating indeed! Another positive is how much more educated we’re all going to be from going through this ordeal. But remember that nothing lasts forever & we all will come through this, like Jodie here did & it still continues to educate & interest her!

Mel, well done. You’re successful return to running encourages all & gives us hope that there iS light at the end of this tunnel. Remember not to get too carried away & stay cautious. I guess being overly cautious when returning to our previous activity after so much time & anguish with this forsaken injury is all we can be… for fear of the pain / injury returning. Luckily for you your recovery has been short in terms of what it usually takes for most. But again this depends on many combinations of factors: mainly in how we continued our lives when first got injury… as most of us continued exercising through it thus further damaging… From reading your first post you got it diagnosed quick & were smart enough to start resting to allow proper healing from the start. I know you will continue success but it would be lovely if you return to us in a few weeks to update us on your continued success :)

SunnyRunner, welcome to the blog. Sorry to hear about your story & dissapointment at Boston marathon. We can all relate to similar incidents. Jumping straight to your questions, the answers are no, no and no…. seriously I asked all the same questions: What CAN I do? Swim? Elliptical? Cycle? I was constantly told no & to rest only. But I thought surely I should be able to do some cross-training. Anyway, after MRI diagnosed fracture (October) I continued very light exercise - literally only gently swimming or 20 min max elliptical or cycling. I was told I should be totally resting but I considered this minimal activity to be ‘rest’ compared to usual. Another scan 3 months later showed same inferior pubic ramus sfx, only worse. That’s when total solid rest started, gym cancelled & bike sent away! I know I should have done this from very start. And from reading stories from others (here & RunnersWorld), it’s those that obediently followed total-rest (Yes I know this is v-tough to hear) that are the one’s who are recovering & returning to exercise/running quickest. I wish I listened properly from the start but it’s so difficult for our breed to stop all activity - totally, full-stop & for so long! But it’s your decision, your body. Do ask a physiotherapist / doctor though, I’m sure they will say same but I’m not a doc. Quickest recovery = rest, rest & rest. Exercise = core strengthening pain-free only.

I have since posted my final update with this on my personal blog which summarises overview from the start-to-date. In the meantime, I will continue my recovery progress here on the group blog. I won’t repeat my recent update here as it’s on my own blog if interested: My Blog here

PS: I’m half-way through reading the Paula Radcliffe autobiography. She had similar injury to this & found a reason why not healing & solution. Very interesting, may be relevant to me or others here. Check it out, very worthwhile interesting read for any runner

My story and questions

2009-05-05T23:51:00.002+01:00

I came across this blog several days ago and found it very interesting. I was recently diagnosed with a pelvic stress fracture in my right femoral neck (inferior part of the greater trochanter also affecting the lesser trochanter - compression type). The fracture is about 50% of the bone. I developed the fracture right before Boston on April 20 but didn't know it. Thursday before the race, I felt pain in my right hip area everytime I landed my foot. Initially, I thought it was a muscle pull or a strain. I nursed it with ice, motrin etc. until race day. When I started the race, I felt the same pain from the start. However, with the excitement of being there for the first time, I kepted running in hopes that I can run through it. I did motrinize myself 24 hours prior. Unfortunately, I ran 13 miles with pain and off balanced strides until I couldn't bear weight on my right leg any further. I had to pull out which was very painful. I went to the ER and had an X-ray which didn't show anything. Once I got home, I was seen by a good sports ortho MD who thought that it was a stress fracture. I got an MRI a day later which confirmed the fracture.

Now, like everyone else, I'm trying to sort out what could have caused this. I have been running long distance for the past couple years and have ran 3 marathons in a year and half timeframe. I did add interval training at the track with a running coach 12 weeks prior to the race to work on my speed. However, we were pretty conservative with our regimen to prevent injuries. I do have a pronation issue with my right foot and do have family history of osteoporosis. Also, I have been on a low fat diet to maintain my weight. Based on all these factors, perhaps, I was at a higher risk for this to happen. Now, I'm trying to focus on my recovery but feel I need to think about what I can do proactively and prevent future fracture from occuring. So please advise if you have any thoughts.

I am now swimming like a maniac since this is all I can do. I was wondering, can I use the rowing machine at the gym. I tried it this morning and it didn't bother my pelvic area. I don't think it requires weight bearing. Have any of you got on the machine before you were cleared to cycle and get on the elliptical machine? I was instructed not to anything except swim at this time. In two weeks I will see my ortho MD and get an x-ray which will determine what I can add to my workout. Hopefully, I can spin and do elliptical. Once I get the clearance, I will start aqua-jogging but have any of you done anything else to keep up your cardio conditioning?

Thanks in advance for the information and speedy recovery to all of you.

Happy to be Running Again!

2009-05-04T19:27:00.003+01:00

I had my first test run on 4/18, with just 1/2 mile, and now have 5 runs totalling 6.3 miles in the log. The first couple of runs caused a lot of tightness in the left adductor region, but, happily, that didn't happen on the last run. I still have a strong awareness of the fracture area when I run - not painful, but not exactly comfortable yet, either, so I'm keeping the runs short until that lessens.

But - in addition to running I'm also biking, swimming and doing Pilates a couple of times/week each, and have done one or the other for the last 10 days. Some activity every day definitely helps keep the adductor loose and I still have a lot of conditioning to regain. I really feel out of shape when I swim, but that's my least proficient area so I'm not really bothered by that.

This will probably be my last post, and I want to thank everyone for sharing their experiences here and on the RunnersWorld forum - all the info was incredibly helpful during my recovery. Best wishes, all.

Bones and hormones

2009-05-01T04:46:00.003+01:00

Hi all,

I just read this article and thought I'd pass it on:

http://www.nytimes.com/2009/04/28/science/28angi.html?_r=1

It had some interesting stuff I didn't know about how bone is repaired. No PSF cure or anything, but still!

Cheers,
Jodie

Exogen bone healling system

2009-04-30T22:55:00.002+01:00

Hi,
I finally went to the orthopaedist that had originally diagnosed this as a groin strain, after a bone scan had said it was ok. He first ordered me the bone healing system over the phone after I forwarded him my MRI results. 2 1/2 weeks later, even though he said 4, I went to see him. He did an x-ray and it showed some new bone. It didn't show that it was all healed. I think you need the MRI to see that. He said I don't need physical therapy, but to wait another 2 weeks to try running, but I could try cross training. He said that he has seen enough of this type of injury and to keep using the machine another month after the 4 weeks. I do believe cross training is the best idea, but I am worried about the imbalances. Naughty me made a mistake of doing a light one mile on soft surface. I went very slow. Not the best idea. A set back, my own fault. Hope became disappointment. I believe the machine really helps, but common sense and very slow progress forward is the best idea. He said these things can take a year to heal fully and I am at risk of reinjuring myself. It is frustrating and there are no exact guidelines. You need to listen to your body which, I don't know about you, but I have ignored mine for so long that you question if a twinge is really that or just my paranoia. I guess it was a twinge and I need to listen. Lizanne, any of the type of ab work that you were talking about with lifting the bunns off the group usually causes me some discomfort. I have steered away because of that. How is it working for you? I need better guidelines. Running group starts up officially in July. Maybe I should except that it isn't a good idea. If I ask the right doctor I will get the answer I want to hear. Well, just frustrated. Hope that you are all doing better.

Update: Now 7-months with pubic ramus stress fracture

2009-04-30T11:47:00.002+01:00

Hi all, it’s been a while since I added to the blog because I was waiting to see if any improvement from meeting with the much recommended physiotherapist. I had 1st appointment last week. He had my full running and health history, I explained where pain is and when feel it etc (the typical groin sensation in buttock. The pressured feeling sitting on the bone and the famous pubic twinges we can mostly all relate to)
He checked everything: physical, for any imbalance etc and then went through a number of stretching exercises to do each evening at home which would aim to strengthen the legs, groin - pelvic area of injury. I did these each evening as instructed and hoped that the follow-up visit a week later (yesterday) would provide more information and exercises - basically hoping he would provide a treatment plan of action to better sort out this dreadfully slow healing injury. I admit that these exercises did help stretghten feelings in legs and groin but one particular exercise really aggravated the twinge. This involved lying flat on back, knees bent up and lifting pelvis (bum!) off the ground. Then leaning on one leg, you lift the other leg off ground and extend it in and out - 20 times each leg. When I leaned on left leg (pubic ramus sfx on left), I could feel the twinge a lot but continued because of the strengthening and tightening benefits I felt in groin after.

But I must report that the only progress from yesterday was to increase the 30/60 second stretches on each leg/side up to 1 minute… with no new exercises to add. I explained how I’ve gone 7-months so far of total unable to run or any impact exercise…. and now 3.5 months of total, solid complete rest, as advised since isotope scan in January. I am now really having enough of this sedentary lifestyle. Particularly these longer, brighter, sunnier summer months: I’m needing and missing doing any form of exercise. I don’t even care so much about running anymore. I just want to be able to walk/cycle and get out in the fresh air and daylight after sitting 9+ hours at stuffy office desk all day long each day! I need a holiday so badly after past year of a lot of stress and other sadness but I can’t even book a holiday until able to walk normally - pain free physio said. Some people may suggest a sedentary beach holiday lying by a beach reading all day long - but I know you will understand how insane us running/exercise junkies would go lying around all-day-long. I just want (need!) a holiday in exploring cities, walking around and taking in everything. I start my part-time masters course while continued working full-time this August. Therefore this summer (next 3months) is the only time to take a much needed holiday. But will I be able to walk pain-free to enjoy this?! I can’t predict this so it’s not wise to book anything which is a real bummer. I now fully believe that this really is going to take at least a year. If I knew this before injury I would have literally laughed and never believed!
Over40Runner - thanks for telling us your story and for the great advice. I have read the article links you provided and I’m sure many others here have too but like me - probably reluctant to add to blog until they have some further progress update. It’s utterly confusing though as to why we can’t show some improvement after so much time! Can I ask you if it is worth investing in this “bone stimulator” I’ve heard others mention too (on RunnersWorld) to speed up bone healing??

Link between Low Fat Intake and Stress Fractures in Female Runners

2009-04-25T15:00:00.002+01:00

They did a bone density test when I was diagnosed with the pelvic stress fractures and that came back normal. However, they did have me increase my calcium and vitamin D intake.

Then I found a link between low fat intake and stress fractures in female runners. Everything I ate previously had been fat-free. I also found a mention of this in a sports nutrition book.

Here's the study:
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2235827

Anyway, I started adding the "good" fats in my diet (e.g. almonds, sunflower seeds, walnut halves). I'm going to see if it make a difference next time around.

Monique Ryan's Sports Nutrition for Endurance Athletes has various recommendations for carb, fat, protein intake. For my weight, my fat intake on a low intensity workout day (e.g. cross-training) should have been about 56g and I was getting maybe 2g. Matt Fitzgerald's sports nutrition book has even higher recommendations for fat intake.

I'm looking at fixing my running form as well, but since I went for 3 years without any stress fractures/serious injury and suddenly had 3 within 3 months, I think it may be diet/mileage related.

Exogen Bone Healing System

2009-04-25T14:47:00.003+01:00

Just wondering if anyone has healed their pelvic stress fracture with the Exogen Ultrasound Bone Healing System.
http://global.smith-nephew.com/master/EXOGEN_ULTRASOUND_BONE_HEALING_SYSTEM.htm

http://www.medicalnewstoday.com/articles/47604.php

My insurance paid for this and the lady came to my house and showed me how to use it for my fibular stress fracture. My fibula had healed 4 weeks later!

I originally thought it was just a bunch of marketing hype when they said that it heals fresh fractures 38% faster and heals 86% of non-unions. I also told them that I had one of those portable ultrasound devices (Sonic Relief) that I had bought over the Internet and wondered if that would work as well. But the doctor said my Sonic Relief device wouldn't give the same level of treatment/ultrasound.

I did the bone stimulator at home every day for 4 weeks and it healed my fibula. The good thing is that you get to keep it even after the stress fracture heals. I thought I would never need it again, but then the pelvic stress fractures happened.

The doctor didn't say whether to use it on my pelvis. The stress fractures in the pelvis are a little harder to treat because of their location.

Anyway, I thought I would put this out there. It's pretty expensive - I wouldn't have been able to afford it if my insurance hadn't paid for it. The lady that came out to the house and showed me how to use it said that if my insurance hadn't paid for it that they have no-interest payment plans.

I may try using it on my pelvic stress fractures.

ray of hope and a light at the end of the tunnel

2009-04-24T21:56:00.003+01:00

I have been experiencing several days in a row of no pain for about two weeks now (just a day or two each week of that wow! the stress fracture is not healed yet feeling)I still really notice it with any weight bearing...groceries or laundry!
I made the sports doc appt. on Tuesday morning and would you believe that Tues night and all day Wed. were the days that hurt the worst, but I went to appt. anyway yesterday (Thursday)...we discussed starting to walk for 15 min. a few times a week and working up to 30min. If I can do that without feeling pain then I can add a bit of running into it. He would like me to wait until Memorial day, but I want to go week by week, if I'm feeling good I'll know I should start back (I'm optimistic that within a week and a half I will be out walking). I know that I shouldn't set those goals because everytime I've done it before the date comes and goes, but I do feel like the end is coming soon. We talked about the why it happened (I brought up the running style, longer leg, Morton's toe issues from coach's blog) but he felt that there are 18 or so different reasons it could have happened and it is too hard to pinpoint what the combo was. Anyway, he felt that once I have started back into running that he will video my running style and look to see if my mechanics are off so that I can prevent this. I hope this doesn't bring anyone down if they are having a "painful or down" day, but I want to give you hope that things will look up.
I never knew it would take over 13 weeks especially when I was originally told 6-8 but had he said 13 at first I think the depression would have been more severe. It's the little milestones that are keeping me going. Keep the faith-hold fast! Tracy

2009-04-22T22:04:00.005+01:00

WoW. Click the below link and go down the page about half way RE pelvic fractures. Hmmm. What you think? Skeptical? Or desperate to try anything at this stage... like me! Click here

Question?

2009-04-21T21:42:00.002+01:00

Can a sports doctor help with the torque of body position...figuring out one leg shorter or running style to help decrease the chance of another pelvic stress fracture (helping figure out the way this happened) or do I need to see a physical therapist to help with these issues. I have a great shoe store that will help with the pronating issues and will get me into the correct shoe for when I do go back. I have an appt. Thurs with sports doc and plan to take the issues that sf/john raised on previous post, but wanted to have some idea if he will be the one to help or if I need to go else where for the "long" term correction process....any answers by Thurs. will be most helpful. I am hoping that we will talk about starting back into running (1/2 mile sounds right for the first few runs to me!) Tracy

Test Run Okay!

2009-04-21T21:35:00.001+01:00

I'm happy to report that my test run Saturday went reasonably well, and I now have mileage on the books for 2009. Coach asked me to run the same 1/2 mile (yes, only 1/2 mile) loop to see how it feels in the same places. On Saturday, I felt tightness in the left upper thigh/adductor right away, but I expected that. No pain or tightness on pushoff, just when carrying the left leg forward after pushoff. Not really worried about the tightness as long as it's not continuing afterward or increasing with other activities, and I think it'll ease up as I move into longer runs.

I've been adding a workout day/week each week this month, so will be at 6 workout days this week - so far everything feels great. I even had a major breakthrough with swimming last night and feel much more comfortable swimming freestyle than I ever have (self-taught swimmer, never learned to breathe properly). Hoping I'll do a 3rd run this week and be able to get up to a mile next week, gradually increasing from there. It's tedious, but I'm looking forward to it.

Vanessa Help?

2009-04-21T20:12:00.002+01:00

You have a major abducted foot on your right side. You are going to need to see the podiatrist after seeing the ortho MD. This foot type places a major torque load on the hip joint. I would purchase that sacral belt today. If you are going to the Baylor Center get the them to videotape you walking barefoot.

The Fibular SFX was the "warning" sign on your current injury. All sfx are torque. Now you will not be able to swim (the kicking from the hip joint will aggravate the hell out of your hip. You MAY be able to swim with a pool buoy using ONLY arms NO legs. I do not like telling you this, but you are going to need to wait some time for everything to quiet down. I think an active rehab right now may do more harm than good.

The podiatrist combined with Physical Therapist needs to view you walking barefoot. They will have to support your foot and watch the internal//external rotation in quad to see what degree of adduction vs abduction. You will long term need a major strengthening program, one leg at a time to maintain balance. Your form appears to be too much landing with a straight leg (as opposed to a bent knee). This forces the impact right up the line from foot to back. Once healed there are good people in your area and I would suggest hiring someone (TCU?)for coaching and form drills.

Two Pelvic Stress Fractures + 2 Tendon Tears

2009-04-21T19:00:00.002+01:00

I am so disappointed. I should have been running the Boston Marathon 04/20/09. I qualified last October, signed up, had my airfare and hotel all arranged.

When I went to the doctor last Wednesday 4/15 to check on the fibular stress fracture I had 8 weeks ago, I mentioned severe hip pain.

The x-ray revealed that the fibular stress fracture had healed, but showed a pubic ramus stress fracture. The MRI revealed:

(1) Stress fracture in the right pubic symphysis
(2) Stress fracture in the right inferior pubic ramus
(3) Partially torn right hip adductor tendon
(4) Torn left hamstring tendon at the ischial tuberosity

My bone density test came back okay.

I was able to do deep water running with my fibular stress fracture, but I’m not sure about the pelvic stress fractures and the torn tendons.

I go back to the doctor on Wednesday to see what he recommends. I'm almost 47 but I only started running 3-4 years ago. But I think the increased mileage on the Pfitz Advanced Marathoning Plan was too much for my bones and soft tissues.

Vanessa
www.over40runner.com

Thank you!

2009-04-20T17:09:00.002+01:00

Thank you for all the information. I find it very hard to find a doctor here that has seen much of this injury. No one has talked about my body mechanics. I know that has to play a big role, considering that all my injuries are on the same side. I'm bow legged, too much sway in my back and I was told I do slightly overpronate when I run. I too was told one leg is longer than the other, but no suggestions were made as to how to improve any of this. My guess is to ask my orthopaedist where I can get physical therapy. There is a place that has aquatic therapy and they sound like they would be leading me on the right track. I need to get a prescription next week from my orthopaedist for this. Sometimes it feels like the blind leading the blind when you go to the doctor with this. I have learned so much from your blogs and really appreciate all the support we share. Thank you.

great ideas

2009-04-19T20:09:00.002+01:00

Thank you sf/john for sharing all those ideas with us. I printed them off and will take back to my sports doc at next appt. I have been wondering about the why it has happened and what can I do to avoid it...it is nice to hear that I won't have to decrease the mileage (will add more cross training though)but that I have to figure my style of running and possibly make some changes there. I found your info helpful and I do believe that there are a lot of us pelvic gals out here now (good for us to share our highs and lows and it came at the time of my diagnosis, but sad that we are having so many weeks of struggles). We are truly wanting to be healed overnight and not able to be the best resters either, but then I think my doctor could have given me an undetermined heal time..I was told 6-8 weeks and I am heading to #13. Maybe he said that low number so I didn't freak out, but I'll be letting him know that true healing will take much longer for any other patient he has to deal with in the future.

Maybe Some Answers

2009-04-19T17:12:00.002+01:00

I have been trying to help Lizanne with some suggestions (Former Track&Field Store Owner/Long time runner and coach). I have pulled out a lot of the "old school" texts to try and find some answers so I hope this post helps some of you out.

The reason that this sfx is hard to diagnosis it is not sometthing we see in a normal day/week/month/year. There are more on here than I have ever seen and I am determined to find out why. We start with things we know. Women have wider hips so they are more prone to inuries in this area. We know that the growth in running has been women. I have been fortunate enough to have been around many good (Olympic Trials Runners) and they do NOT have perfect bio-mechanics so at the end of this post I will try an OPINION on you as a group.

I thought I could help Lizanne because there a photos of her running so I could see the bio-mechanical flaws. If you have photos/videos of yourself running/racing please bring them to your Podiatrists, Physical Therapist, Orthopaedic MD. they are very helpful.

First to start we define our terms. I do not like the fact theat everyone on this board and the RW Forums thinks this is a mileage issue. I would prefer to use the term "time spent torquing." I believe that all SFX are a torque injury. So I start with the first two issues, reduce the torque and stabilize the pelvis. I would initally place everyone in some type of Motion Control Shoe with at least an over-the-counter arch support/orthotic if you have one. Second a lumbar support belt. I want something with substance and wider should be more comfortable. Yes, all the time. If seated for work a small pillow in the upper back may help.

We start with a very simple format of trial and error. Better-Same-Worse if it hurts STOP. Some things may help some may not.

Now we start the testing to see bio-mechanically what is going on. Walk in front of your therapist ...shorts and barefooted so he/she can see the internal rotation and the footstrike. Lizanne has knock knees and this creates a torque. There are a number of people on this blog that have a Morton's Toe (Longer 2nd toe). A few of you have the neuroma. This foot type is inherited the real issue is that the #1 (big toe) has a short metatarsal you have to pronate the foot over at toe-off so that you can get that met head on the ground. Podiatrists make small pads called Morton's Toe Extensions to help this out. You will also need some arch to help support your foot during the healing phase (and maybe longer)

Now for the gym, standing barefoot, or very flat shoes (Therapist watching) do a squat with a bar and NO weight. We are looking to see how much "tilt" there is. This tells us that there is a muscle imbalance (Insert torque right here). If you tilt/torque at rest and we place this body in motion (insert running) the torque now accelerates and something on the kinetic chain can snap (SFX , but also notice all the hip issues on RW Injuries Forum). Next test..barefoot balance book on you head and walk across the room (think runway model). You will be trying to "stabilize" your pelvis, but most,,if not all will find this impossible. Do you stand on one leg? This gives you the "high hip" and the "low hip."

Now you need the therapist to check the leg strength on each side separately. The literature on old texts seem to feel that the dominant side (normally right) will be stronger, but SHORTER (insert stretch needed). The longer side will be much WEAKER( strengthening needed). If you are using machines, legs together (as most if not all of us do) it "MAY" not correct the strength issue. If this is PART of the answer the pelvis should start to balance out over time (I cannot tell you how long).

Now for one hypothetical scenario: runner is running with abducted foot/feet (toed out off the mid line) runner is weak in the hips and adductors (inner quad) to maintain balance and pace foot will move farther from mid-line for stability setting up some serious torque. Good News is we can correct (or hopefully modify) enough to get you back closer to mid line.

Now I am going into the OPINION part. If the ilio-psoas muscle( strongest hip muscle) is too strong (right side?) it pulls DOWN the pelvis creating lateral pelvic tilt. This is either the root cause, or a major factor in all the injuries. The runner (especially) doees longer runs 1.5 hrs and above will have a tendency to roll over in the back creating a curvature (lordosis) ideally we would want runners to be running tall so that your butts are tucked under not OUT. The Power is from The Push of the foot/ankle NOT from the Pull (lead leg too far in front). You have to strengthen the muscles in the upper back and form drills, after strengthening, to hopefully adopt this new posture. If you have any friends in Dance/Ballet they may have some exercises that are more specific. You will need the Physical Therapist to work out this program.

Now for all the twitches, tings, pulls etc. I know you are checking the injury site a hundred times a day ( and that number is on the low side). I also understand the OCD of runners (I see it every morning in the mirror). Runners DO NOT DO PASSIVE HEALING. We have to devise an active recovery program. There was a hand crank machine (sailboat crank for raising sails) that I have seen and runners with pelvis stabilized should be able to do that one. Second aqua jogging/interval pool work might be too soon. Try this pool buoy between legs to hold your butt up, it is a total arm pull stroke. Take your time on this one because it is hard and will fatigue you. I have been thinking on an exercycle we "MAY" be able to add something to the pedal to compensate for this short leg, but check with your therapist. We DO NOT want the runner to be on a seat rocking because it can irritate the injury site. If you can do the arm pull you may be able to flip over and do the backstroke same thing with buoy. I also am thinking you may get better results on the weight training portion of your regime with free weights (balance), but you will need to work with someone. Ask your therapists about "dead lifts."

The piece of this puzzle that has been driving me crazy (short drive) is why you? why now? This is another off the wall opinion. I suspect that the "PELVIC TILT" may be interferring with the blood supply so the healing is not going as fast as you would like (overnight!!). I also suspect that the current training shoes are too high in the heel and are "TILTING" you even more forward. This is just a thought and I do not evidence on this one.

I apologize for the long winded post I hope it helps a few of you out. You can e-mail at this address sfjohn16@gmail.com and I can try to answer anything more specific. I am still talking to people because I think there is more to this puzzle. Everyone is going to get well and everyone will be back to running. Lizanne has given some great info on diet (please follow it I know what the ED or disturbed pattern can do).

Update!

2009-04-17T22:10:00.014+01:00

Thanks so much for replies to my very disappointing update. Your words are truly very uplifting and helpful through this sheer feeling of isolation through this pro-longed non healing fracture. Because as you know nobody else really understands! Family, friends and colleagues see me eventually starting to show some improvement after so long… you can finally start moving around a little quicker and easier… then the next day you could be set back in pain again. It probably almost looks like you’re faking it?! And how can you explain this when it’s such a vague and changeable injury that we are unable to properly explain the how’s and why’s

I do feel setback quite a bit both physically and mentally after the aqua attempts (explained in last post). However, I have a much clearer understanding now from some solid explanations received yesterday and I really hope these will help you too. But you should not treat this information as a solution for you too – as these are the causes and solutions established for my fracture, which may not be relevant to you. But it is quite probable that they are relevant for most here to some degree! I spent a few hours with a highly experienced professor in the area of this pelvic stress fracture who has successfully treated top athletes with the same injury. The limping and pain is now worse than has ever been. But I now know the underlying reasons why

I first got the DEXA bone scan. Thankfully confirmed NO osteoporoses but deficient in Vit D which is essential for calcium absorption. All scans (MRI, isoptope bone scans etc) were studied and a very long chat detailing everything. Below are the two reasons I have learned. The 1st reason is more specific to me and only maybe for you too. The 2nd reason is very relevant to anybody with this type of fracture and definitely worth looking into if the first reason isn’t also relevant…

1. My highly excessive fiber diet (common with runners/athletes) is inhibiting absorption of essential vits and minerals, mainly for bones – calcium and Vit. D. I am extremely low in vitamin D with probably none at all. Vit D is essential for absorption of calcium. Why am I deficient? Because of excessive fiber intake which inhibits absorption of any calcium and Vit. D – essential for bones and therefore fracture healing!
I was prescribed very high level calcium + Vit D tablets and a gluten-free and highly fiber reduced diet to aid absorption of these... I got the blood tests done for all vits and minerals to re-confirm this too but there’s no doubt that this is the case. Each day I always eat 10+ whole fruits (v-high fiber). A lot of porridge, wholegrain cereals, seeds, nuts and vegetables - ALL these are the highest fiber foods resulting in about FOUR or more times more the recommended fiber intake. Therefore NO absorption of calcium and Vit. D necessary for bones. Too much fiber runs through you, taking nutrients etc with it...

2. The main underlying cause of getting this fracture in the first place is bad biomechanics. This is what must be first addressed before fracture can heal. Suggested that the main cause of fracture is from a muscle imbalance (shorter left leg therefore weaker left side) causing pelvic tilt. (fracture on left side). My right side is much stronger in every aspect. Standing on right leg is much stronger and left side much weaker. I have always had bad balance and more injury prone on left side over the years. This causes a pelvic tilt on left side causing knock knees at different lengths resulting in a lateral pelvic tilt and increased pressure on left side of pelvis / hip – therefore constant shearing causing fracture!

The long meeting I had yesterday was with the founding professor in anatomy and sports science at Trinity College Dublin and is much experienced with this injury. This is where 1st reason will be sorted. I really am going to do whatever I’m told now despite my love of fiber rich foods! They have also referred me to a physiotherapist who also has much experience in treating this type fracture. Here is hoping HE will sort out the muscle imbalance (left side).

I DO hope this info helps you too. Please try to get down to the root causes first guys…. I ignored this for too long but damn I don’t care how much more time, money and patience this takes. I’m getting this sorted and WILL run as soon as possible and healed!
I know that the aqua jog attempts were too much activity at once after so much rest and inactivity. I should have started with just 10 mins… and gradually increasing every few days rather than starting out at 50 mins full effort in the pool. I have that typical hard-core mentality where I find it hard to ease in gently. I got too excited too soon at the prospect of finally being able to exercise! I’m back to total rest again but with proper guidance and solutions to the main causes now, the recovery road is brighter and once pain free again I will start very gentle recommended activity at a sensible level this time!

Lets continue the support. All posts my last bleak post – a big thank you. You’re miles away but you don’t realise how much your words are supporting and uplifting us all in our shared understanding. KEEP healing, we all will. Lizanne

Fear Of Not correcting original cause

2009-04-17T19:10:00.002+01:00

First I want to say that I was sad to hear about your setback, Lizanne. You did bring up some good points. The correction of the muscle imbalance. I have osteopenia and one leg is longer than the other. Any injuries that I have had are on the right side of my body. There is a definite imbalance. I'm glad that you have the right doctors and are seeking the right advice. I started on a bone stim machine last week. I also tried swimming, but had right hip pain. I think that all my muscles are tight from the lack of exercise and stretching. I don't have the best guidance so I don't know what is a bad idea to do. Not many doctors have seen this. Once it is gone, I don't want to do this again. I know crosstraining is the best idea. There is no aqua jogging around here. I will ask about rehabilitation at my appointment in a couple of weeks at the orthopaedist. I think we will all be smarter, more educated runners when we are back on track...and stronger. I hope each day brings alot of healing. Keep us up on your progress and I appreciate the information and I know we all need the support.

Totally can relate to Lizanne (and others)

2009-04-17T17:51:00.003+01:00

It is funny how just when you think you've got the healing in the bag and you are looking forward to the old way of life getting into running routine...the tweaks and pains come back. I have also been setting time frames for myself and they seem to be coming and going. I didn't think they were unrealistic, but maybe it would be helpful to talk with medical side of things. Lizanne, I read your last blog and I was having a real set back day too. I totally related to all you stated. I am glad others responded quicker and hope you are feeling more lifted up. I was hoping to be running by the end of this month..I have had about a week on no pain (only one more I thought before I can get appt. with sports doc). I needed to move quickly from one place to another with my class on a field trip, so I put a light jog to speed the distance and I truly paid for it for a day and half! It was like God said, I'll show you who is not ready to run. I am only 12 weeks into this but why can't it just hurry up and heal already. I am ready for a consultation I think from someone about what else I can do...bone stimulator, exercises, shot (last resort). thank you Lizanne for creating this blog as it really helps my emotionally healing! I hope your day is brighter to know that so many send their healing wishes to you. Tracy

The pelvic people are with you, Lizanne

2009-04-17T13:32:00.002+01:00

Lizanne, I can only hope it cheers you up a bit to know there are a bunch of 'strangers' around the world hopeful for your recovery. You've helped me just by sharing your experience and creating this blog and being so passionate about getting back into running - and my fracture was 'best case scenario'. You've done something good here and I hope you feel some of that coming back to you.

When I sustained my injury in 2007 and Googled 'inferior pubic ramus stress fracture' a bunch of medical sites came up, but nothing personal. This is the kind of injury where personal support is really important, even for me as a 'recovered pelvic person' because I still feel a bit in the dark about it. So thank you, and please be hopeful.

Well done Mel, officially cured! And Jessica - I too tried to keep a running schedule while pregnant, but found that relaxin and running just don't mix. I started having knee and ankle issues that had never surfaced previously, so opted for walking, swimming, yoga, etc. However, I can understand you not wanting to give it up now that you've just come back. Good luck.

Today's the Day.

2009-04-16T23:08:00.006+01:00

Like Jessica, I wasn't sure about posting today after reading about Lizanne's setback. As a group, though, we're all on different healing tracks and working through different issues. I've been thinking today about timelines for healing, and how determined I was early on to heal on my timeline, or failing that, on the 8 - 12 week timeline I'd seen in studies of pelvic stress fractures. My orthopedist told me it would be 3 - 6 months, which horrified me until I began reading stories of others struggling with this for upwards of a year.

It's now 15 weeks since I ran, 4 months since the MRI confirmed the stress fracture, and 3 weeks since the cortisone shot to address the associated muscle/adductor tightness; since the injection I've been essentially pain free. Tightness came and went for the first two weeks post-injection, but over the last week there's been significant improvement.

When I left the gym last night to walk home after Pilates class I noticed that I finally feel strong again, so I'm declaring myself healed today. I rode my bike in to work today with NO tweaks, twinges or tightness, and the same for Pilates last night.

I have an appointment with my coach to try a 1/2 mile test jog Saturday morning. Going forward I know I'll continue to cross-train with swimming, cycling & Pilates in addition to running - I used to only run, so this is a big change. Instead of being a runner again, I'll be a runner with benefits!

Gaining confidence

2009-04-16T22:05:00.006+01:00

First I want to say Lizanne, I am SO sorry you are still having so much trouble. How long are you trying to work out when you do work out? When I was starting back to cross training, my doctor told me to limit to 15 to 20 minutes at a time, every other day. And I never had any trouble. But I know your injury is a lot worse than mine was, so I'm sure you're not in the same situation. I just feel so awful reading about your continued struggles (and everyone else's too) and then writing about my running. But hopefully this is keeping everyone hopeful. Because you will ALL recover, even if it seems like its taking forever.

I had a really rough workout on Monday. I think maybe writing about my insecurities here that day kinda jinxed it! But the reality is I am already needing to modify my goals for running in pregnancy. I'm disappointeed, but this wasn't unexpected. I just didn't expect it this soon. My husband doesn't think its such a big deal. He says I'll be running great after I have the baby. Well yes, maybe I will, but I had to wait six months after being injured to run at all, and now waiting another seven or more months is quite frustrating! Even if its for such a great reason.

Anyway, I decided after Monday's workout that I need to go back to interval running. I was hoping to just start right into an all-running routine, but that just isn't working. So today I ran seven 7-minute intervals, 5 minutes running and 2 minutes walking, which is the method I used for my first half marathon. I ran outside again today too, but luckily I ran on a much easier trail! Completely flat and unpaved. So I just had my legs and my lungs to battle with. I've had an asthma flareup in the last month and a half that I think I'm finally recovered from, so from a breathing standpoint, this was one of my better workouts in a long time.

Overall it was really great. I had a total of 49 minutes run-walking and went 3.28 miles. I was trying really hard to slow myself down. I didn't go as slow as I do on the treadmill, but I stayed slower than my body wanted to go. I usually do 14-minute miles on the treadmill, and I averaged 13 minutes during running intervals today. With the walking mixed in, I ran 14:40 miles. A little slower overall than I want to be, but it was only my second time outside. By the time I made it to the last interval, I wasn't sure I'd make it! But I did and I felt so good afterward.

My 8K race is a week from Saturday. I had to predict a time for it because its a wave start, so I predicted 70 minutes. I am fairly certain I will work up to 70 or more minutes of intervals in th next week and I will be able to run all or at least most of the race on my intervals.

The soreness that I had last weekend has pretty much gone away too. I honestly am more confident than I have been in a long time. It feels good. I look forward to when the rest of you can experience this too. I hope its soon!

My update not good BUT.....

2009-04-16T11:08:00.002+01:00

My fellow supporters who keep me sane by your true understanding and experience of this awful pelvic fracture ordeal: My update is not good at all but there are at least some answers as to why my healing (and possibly yours too) is taking so long. And finally I am getting these looked into starting today. Firstly, my report from the aqua jog attempt is very bleak :

I went to the pool Tues evening for aqua jog to ensure I would be OK for meeting the aqua jog group for the 2nd time last. I got through the 50-mins on my own on Tues fine. Just had the usual mild buttock/groin awareness sensation but twinges staying at bay. Excellent. Went into the sauna, showered and walking gently out to car park. BAM - it was back, full force, and the aching pain down inside of upper left leg and into groin. It was the strongest I had felt in a very long time. The twinge was minimal but I hadn’t felt any pain this strong in about 2 months. I was distraught. I expected this to subside somewhat after over that nights rest but it was actually worse yesterday sitting in work. I am limping and moving very slowly again. I met with the aqua jogging group last night simply to hand back the gear and admit defeat. But it was these retired pro athletes who setup and coach the aqua course that have sent me in the right direction, as I will explain now. The worse thing about this injury (pubic ramus stress fracture) is that you can take 10 steps forward with recovery by finally feeling pain free with just gentle groin aches. When feeling OK, we can then get through very gently activity (swimming / aqua jog) without any setback… but then after a few more small attempts…. Your setback another 20 steps.

What is the worse part of this for all of us? It’s the confusion and frustration as to why this is taking SO damn long. We start feeling OK and ready to start a small bit of gently activity… then we’re set back again. But the most confusing part is that there are no answers or reasons why. So now I have two main reasons for me that may be relevant to you so I hope this helps.

(1) Muscle imbalance - pelvic tilt on left side causing knock knees at different lengths (left leg slightly shorter) resulting in a lateral pelvic tilt and increased torque (pressure) on pelvis.

(2) Weak bones: osteoporoses (or osteopenia) are very likely as I have the full history and symptoms for this (not all but many runners do) despite me only 26 years old.

(1) It is suggested that there could be a muscle imbalance on left side (slight short leg affect) which causes a shearing stress & therefore weakness causing fracture. If pelvis is tilting downward causing inward rotation of the leg on the opposite side - this causes a knock knee internal rotation (very evident knee’s knocking inwards from my running photos), resulting in a lateral pelvic tilt… and therefore stress fracture! After all this time (6.5 months since my fracture), it doesn’t matter how much rest and gently activity attempts I try, nothing will change until the underlying problems are addressed: First: the imbalance.

(2) Bones: I have an osteoporisis dexa scan and consultation tonight. Through the right contacts, I am delighted to have got a consultation with the founder & president of the Irish Osteoporosis Society and founder of the Sports and exercise medicine anatomy lab. The very first thing will be the dexa scan for bone density. I know a magic wand cannot be flashed but this is a big ray of hope for me as professor O’Brien is the most experienced and reputable person in the country of sports anatomy. I also feel that this is the last ray of hope I can find.

I must admit that I am at an all-time low after all this time and constant non-stop rest for 10 weeks thrown back in my face after just 2 aqua jog attempts. I was so happy this past week being able to walk crutch free again and get around generally irritation free. Despite still resting a lot in-between these small bursts of aqua activity, the pain now feels the same as it was over 6 months ago. Here is hoping I will find some answers from the above two possibilities.

Big Appreciation

2009-04-15T17:56:00.002+01:00

I too want to say that I am so thankful to the people that post on this blog. My running group also is supportive, but really no one understands what is wrong...meaning why aren't you healed yet? The nurse at my orthopaedist said she has been there for 15 years and has only seen this twice. When you see your healing goals come and go without materializing, it is great to hear that you are not alone and that in time and with more patience than we knew we were ever capable of, you heal and are able to exercise and then, eventually run and maybe train again. This has been a very humbling experience and I have grown a new, much deeper appreciation for my body. I swam yesterday with some hip pain. Taking today off. I'm not sure if it was just tight muscles because I haven't been stretching. We will see, but being cautious. I can't find aqua running classes here. Take it day by day and happy healing and positive thinking to all of you!

weird affirmation

2009-04-15T03:16:00.002+01:00

It is so weird how similar our stories are...I wish I would have been looking for what those signs of stress fracture were back when I was first starting to feel the twinges, aches, sharpness and especially the butt bone ouchies. It took from Oct-Jan to get mine diagnosed so I went back to a few of the people along my "figuring it out journey" to tell them the signs so that they could be more aware for someone else. My massage therapist and chiropractor had never dealt with this before. It seems like these are classic symptoms for the pubic bone sf....This group has come to me so many times on those down days...I read many posts on runner's world site (and now this one)to know that I was not going crazy...my running circle was so supportive at first, but really this group of "pelvic people" has been the stability for my emotional dealing and healing...so a big thank you for sharing your stories (highs and lows)because you never know who is quietly reading them and shaking their heads in acknowledgement of their experiences. To those who are still aching...one day the pain will stop! I didn't believe that for the longest time...to those you are running or able to do physical workouts...do a little extra for us "resters" but don't overdo! To everyone...may your tomorrow be tremendous!

Thank you. Lets continue the support!

2009-04-14T11:19:00.005+01:00

Wow, the experiences we are sharing here are so similar that we can all completely relate to the sheer frustrations & feelings as each other…. Despite most of our family, friends and “non-running” acquaintances probably seeing these posts thinking… what a crazy-ass bunch of people they are! Not able to run or exercise? Big deal, enjoy the rest, relax, chill etc. Oh my god… the immense confusion, isolation and frustration caused by this on-going injury is simply indescribable to those not affected - even to other runners - like we once were (and wiLL be again). Runners can always expect the occasional injury that would last a few days or weeks before running again. During standard injuries, we can usually substitute with other cross-training (swimming, cycling) etc until better again. This is often easy, manageable and bearable.

Tracy - thank you for your earlier post (“one step forward, a few steps back”) relating to my failed 1st aqua jogging attempt and your advice on how you managed this. It was v-helpful. Like you, my only real pain now is when I’m doing general daily activities: sudden unexpected twinge sometimes when taking heavy groceries out of car or a sudden turning movement etc. I have attempted the aqua jog on my own last Friday after failed attempt Wednesday which was followed by 3 days total rest again. Friday (2nd attempt) was successful and aqua jogging irritation free for 40 mins :) Took next day off completely and check this out: Sunday went for 50-min gently cycle. The only discomfort was sitting (buttock bone pressure of injury on saddle) but after cycle, no return of twinges etc. The same burning groin/buttock sensations were there but not worsened. So I have been fully resting since. Yesterday I was OK but slight limp & slow moving simply due to general aches and stiffness from body getting all this sudden activity that it hasn’t felt in so many months now. I’m going to try short aqua jog tonight before meeting the aqua group tomorrow night. If no increased pain tonight or aftermath of twinges, I will continue 2-3 times week aqua jog only but no more cycling. That was just a test but I feel it’s a little too soon to get into cycling yet.

One thing I really noticed from this weekend (first cycle & cardio exercise in near 3 months) was the feeling of absolutely no fitness. I was out of breath within 10 mins easy pace on the bike. I guess the lack of muscle tone, no prior exercise (and of course Easter indulgences etc) made me ultra sluggish. I felt like a total newbie.

Mel - Thanks for your update 2-weeks port cortisone injection. I really agree with your comment on how you feel that some activity helps keeps things loose - despite not over doing it (and of course NO jogging attempt!) After the 6-week mark of total solid rest and even avoiding trips to supermarket with my crutch, my whole pelvic area and down legs was SO tight and stiff. I suspected this was part of the fracture healing process but now I understand it was simply down to body seizing up in stiffness from being so still for so long. Mel - let us know how you get on with the return to bike and elliptical next week?

Lisa - “Needing the Support”, I’m sorry but I laughed out loud picturing you out for a walk, feeling confident and ambitious. A sudden stop to ‘sneeze’ then baM - the famous sharp twinge shows up. Sounds like the next day you’re still feeling some pain? Yes, I would definitely say give the crutches a shot - even if just using for a week or two to see if you feel much difference? I needed to reduce all weight-bearing with crutches as to give fracture some chance of starting to heal.

Jessica - well done. I’m so jealous yet delighted & hopeful to read your successful return to running. I can totally understand the nervousness. When I do eventually (hopefully) return to jogging in a couple of months (wow!) I will be so cautious and nervous of fracture reoccurrence. When we all do (and we wiLL) return gradually to running we will probably all be experiencing more nervous feelings than feelings of joy for the first while - constantly focusing on body feelings & any pains returning. But I have read from other posters who are at this stage now (on runnersworld) that the general phantom aches will continue for some time after healing and this can be expected… as long as it doesn’t increase or the twinges re-occur. We really just need to listen to our bodies but not get so consumed with worry. It really is a v-long and vague road for us all but wiLL come to an end.

Jodie - again thank you for sharing your story with everyone. It’s amazing how your pelvic fracture has affected you quite differently compared to most. Because it seems you never had to give up all forms of exercise and assume complete constant rest for an extended period throughout the whole time? Throughout aLL this (nearly 2 years since you first got pelvic fracture) have you always been able to maintain some form of activity? Your initial fractures must have been ‘mild’ as you said… and I say this without minimizing your experience whatsoever as I know this too has been a very long road for you. I guess it shows us that we are all different and a combination of factors (age, sex, history, prior running biomechanics, fracture site, diets etc) will uniquely determine different healing times and recovery strategies - despite same underlying principles and feelings of this horrible... horrible injury!

Tip: I bought a vibrating car seat a few days ago which I’m finding great for both upper & particularly for lower back which is directly connected to pelvis. Vibrations are very strong from protruding cushioned balls along the back and padded seat. It’s connected to car cigarette power supply. Then I take from car & bring into work for office chair and connect to the mains power. MUCH difference to sitting comfort for over 8.5 hours sitting in work each day.