Stress Fracture Recovery

Last February, I ran the San Francisco Half Marathon and ended up with a femoral stress fracture in my right leg. I was able to slowly start running again in late July, working my way up to a 12 mile run in October.

I thought I would summarize rules I followed for other runners who have a similar injury:

1. Take it easy - a femoral stress fracture is a big deal. Keep pushing and you'll end up with a full fracture.

2. Don't OD on ibuprofen - initially, I took gobs of ibuprofen to reduce the pain and inflammation. After a month or so, I stopped taking it completely as I was starting to walk a bit and didn't want to mask the pain/over do it.

3. Come back s-l-o-w-l-y - The first few months, I tried to get out and walk a few times a week, working my way up to a mile. I would stretch my quads quite a bit before and after, being careful to monitor for any pain on the interior quad/groin. If it became painful, I would stop immediately.

4. Choose non-impact cardio - Once you can walk a mile pain free, try different types of low-impact cardio (the treadmill doesn't count; too much impact). I tried a bike and the elliptical (another option is swimming and/or aqua jogging) - the bike didn't work as there was too much compression. On the other hand, the elliptical turned out to be perfect as I could get a great workout, vary the type of workout (hills, flat, etc), read (I would look forward to Friday, the day the new Economist would show up) and watch sports (I saw both the Tour De France and the World Cup).

5. Boost your calcium/vitamin D intake - even though my doctor told me it wouldn't help any, I took calcium/vitamin D supplements on a regular basis.

6. Try the treadmill every once in a while - hop on the treadmill now and again and try to do a fast walk (~12 or 13 minute mile pace). If the treadmill has sidebars, use them to support some of your weight. If there is any pain, stop and try again in a few weeks. Once you can do a mile without pain, slowly increase your pace. I would do 3 or 4 miles on the elliptical and then get on the treadmill for 5 minutes. As my pace increased, I slowly increased my time on the treadmill and decreased my time on the elliptical.

7. Run on the treadmill - Once you can do a slow jog on the treadmill, increase the distance, working your way up to 3 miles. Along the way, increase your pace until it matches your normal (non-race) pace. Continue periodically running on the treadmill for about a month.

8. Run outside - Woohoo! Finally, back outside. Your first run should be on something soft (dirt preferably). Make sure your shoes aren't worn out. Run a mile at a bit slower than your normal pace (even if it feels great, don't go farther). Monitor the pain factor pre and post-run. Check it again the next day when you wake up. If you are free of pain, run again in a few days and increase your mileage. Continue like this, slowly building up your mileage. Remember to NOT increase your mileage by more than 10%/week.

9. Return to pre-injury form - Now that you can run again, slowly work your way back to where you were before. Remember to not over do it - the bone in your leg might be healed, but the rest of your muscles need to regain their strength.



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