Comeback from a Femoral Neck Stress Fracture

hey,

there's some good stuff in this thread, it was just up recently:

http://www.letsrun.com/forum/flat_read.php?thread=1832879&page=0

just type in "femoral stress fracture" in the search and there's tons of other stuff.

Good luck with this. you want to be as careful as you can with something like this... they can be really bad.

bump

Hang tough slightly broken girl. I'm currently going on 11 weeks since the diagnosis of my femoral shaft stress fracture. If your fracture is in the neck, then it could take even a little bit longer to heal. You are right, I've dealt with stress fractures in other parts, but the risks associated with the femur are really scary.

I spent 6 weeks on crutches full-time, and then 3 weeks after that using crutches part of the time, ie. I would use 1 crutch to walk across campus and any time I had to walk a long way, and around my office or around my home, I wouldn't use the crutches. I built up to walking more and more gradually. I wasn't feeling any pain while walking around at all.

It was at the 6-7 week point that I was able to start cross training, by biking, water running, and swimming. I think that the water running and swimming are your safest options, and if you decide that you want to bike (I hate the pool and I some days I just have no desire to go) be sure that you aren't standing up on the pedals, just stay seated and keep a high cadence. I started off with 20-30 minutes on the bike, and worked up to an hour over a few weeks, but I wasn't really going hard.

After biking, I would typically walk for 5 minutes, with one goal being to stretch out the quads after the biking session, and with a secondary goal of building up some leg strength and add some "impact." According to the doctor (I haven't worked out the physics) your femur takes the force of 2 times your body weight when walking, but close to 7 times your body weight while running.

I worked up to walking a mile, and then 1.5 miles, and 2 miles (1/2 an hour).

I also started to add the elliptical trainer after a few weeks. Start off by doing 5 minutes, building up to 15 minutes over a week or 2, and then up to 1/2 hour.

After 10 weeks my coach gave me the ok to re-introduce running. I've run for 4 days now. I am running 5-7 minutes per day on grass surfaces. My schedule over the next 3 weeks has me building up to 14 minutes of running, all on level soft surface, like the fields by my school. These runs aren't really to gain any fitness, just to introduce the body back to running gradually, allowing the muscles to strengthen. It's also a really refreshing thing to be able to go outside and run, after the last 11 weeks.

In addition, I am keeping up with the biking and pool workouts, but adding a few quality sessions, like 8 x 3 minute efforts with 90 seconds rests on the bike, or 12 x 2 minute efforts with 60 seconds rest on the bike... (These could also be done in the pool while water running, but I hate it...) These are basically to keep it interesting, and from feeling stale.

The most important thing to remember is that everybody's injury is different. What works for one person may not work the same way for another. You need to listen to your body. A little bit of soreness is OK, pain is not OK. Your legs will be a little sore when you first start back. If you ever feel pain in your injury area, that is a big clue to back off a little. You also need a little bit of stress on your bones to make them heal faster and stronger. But you need to know where the line is, and it is way better to be on the safer side of the line. If you feel like something is wrong, you need to know when to stop.

So far for me, I've been feeling great. I got my fracture diagnosed pretty early, and I've been playing it really safe through out my recovery. I think that it has been working for me so far. My only medical coverage is through school, and they don't even need for me to go back in to see them, only if I have any pain... An x-ray may show the fracture now that it's healed, but my understanding is that it isn't the best tool. An MRI would help, but I had one of those already, and it was expensive, and they won't have me do it again unless totally necessary.

Above everything else, keep a positive out look on life. Your bone will heal, and you will run again. In the mean time focus on the other parts of your life. Be smart and listen to your body. Remember to be patient. You will not be able to force yourself to heal, you need to give it the proper amount of time. You want this to heal, you don't want to re-injure it.

Best of luck to you, and I hope that you have a speedy recovery.

that was a really smart post right there about returning from a stress fracture. great cross training plan and shows a lot of patience. im impressed.

Thanks so much for that post...I actually posted a while back on another femoral stress fracture thread, but was really just looking for some details on comebacks since this just seems a bit more risky then the other stress fx. Once again I really appreciate it! :)

"Not too hip", great advice! Good luck in your recovery.

Hang in there, "slightly broken girl"... just remember the big 3: Health, Consistency, Patience. :)

Thanks for the kind words. I'm glad to be able to share a little wisdom that I have been able to obtain. I've learned it the hard way.

Come back here and let me know if you have any other questions, I can try to share with you anything that I have learned.

Stay strong and healthy.

I can tell you something about "Not too hip right now." I'm lucky enough to know him personally. Having talked to him since this last post of his he had said how nice it was to get a positive response to his post which can be unusual at times on this site. He really enjoys sharing his knowledge and hopes it will help others.

He has learned a lot about recovering from injuries and has shown great patience with this one. He is right about fractures to the Femor. Their not to be taken lightly and can become a career ending injury.

"Not too hip right now" will be running in New York with me in November after his recovery and will be way ahead of me where he belongs. He will suprise everyone except for his coach and myself who both know he has the persistence and determination to work toward his goals.

Remember when you have an injury like this and you come back from it it makes victory so much sweeter. The greatest things in life don't come easy. Good luck to both of you and keep your head up.

I had a femoral neck stress fracture. Took 4-5 months off from running. Did plenty of biking in the meantime. Introduced running very slowly, never bothered me again.

I had one too. Ended up having to take almost 9 months off running (not totally because of the stress fracture, but I went absolutely insane with x-training biking and got a different injury from it, and it was a bad one stress fracture, requiring 3 pins now in my hip). But now I am almost 3 years removed, have demolished all my pre fracture PR's and am doing better than ever. With no stress fractures anywhere since then. It's hard stuff to deal with, especially since many runners partially define themselves by their running, but be patient and best of luck to you!

seriously it is great to hear positive advice/experiences. I had never really heard of anyone dealing with a femoral stress fracture, until recently. And unfortunately the doctors I have dealt with thus far haven't been particularly supportive you could say, or given a very positive outlook. Which is unfortunate. So it is super encouraging to hear from those in the running community. I am willing to take it as slow as I have to, and do whatever it takes to turn things around, I know my best running is years away.

Very much would being updated on your comeback "Not to Hip Right Now"...very awesome insight.

It sucks that doctors can be that way. Look on the bright side, you know that it is a stress fracture, and you know that if you are patient it will heal. There are so many other injuries out there that are problematic for people. It could be something that won't heal over time, or you don't even really know what it is. Your femur will heal, and when it does it will be stronger than ever.

You've got the right attitude. Stay positive. I ran for 8 minutes yesterday, and you know what, all of the patience is going to be worth while. Email me if you want to know any more.

I had a stress fracture of the femoral neck (compression side as well) about 2 1/2 years ago. I was advised by my orthopedist to go 8 weeks non weightbearing on crutches and to do no physical activity at all. i followed his advice really strictly, and never went without the crutches during that time. My follow up MRI showed about 95% healing, so the MD allowed me to start walking without crutches. I spent the next week just getting used to walking without them...i got through my day but didn't add anything extra to it. One week out i started going for a walk after work. I started with 5 minutes and over the course of 6 weeks, worked it up to 60 minutes at about 14 minutes per mile. The doc said that when i got to one hour i was ready to slowly start running.

From that point on i started walking 15 minutes to warmup, then started with 1 minute of running, 5 walking and rotated it about 3 times. Not much, but it felt good to be back on it. I basically just really slowly moved it up from there. I ran 1 mile for the first time about 2 months after getting off of the crutches and just followed the 10% rule after that.

The one really great piece of advice that my ortho gave me was this: He said that if i had any pain (as opposed to mild soreness etc) that i should take a day off and then start back at where i was one week prior. Because i went conservatively, i only had to do this once in the entire buildup. It took me about 6 months after the crutches to run a 70 mile week, and now i'm averaging about 85, and i've had 3 weeks of > 100 miles. Basically you just have to go slow, use pain as your guide and be conservative. I'm assuming you're young, and planning to run for your whole life. A few extra weeks to do things properly never hurt anyone! Good luck.

One other point about the doctors giving poor prognoses. My experience with this is that they want to scare you into being conservative with your recovery. Runners by nature are very obsessive about their training and very often will go above and beyond overdoing it. How else do you manage to fracture your hip without direct trauma right? i would give your doc the benefit of the doubt. He/she probably just wants to scare you into taking it slowly so that you don't end up in the OR. Unfortunately that is the course of action if you don't let it heal properly. Like i said before...if you're planning on running for your whole life then what is a few extra weeks to make sure it heals right?

...Ript how long after your diagnosis did you get your check up MRI? I am scheduled for the end of May (conveniently right before my 23rd birthday...aka off the parents insurance), which will be 3 months, so just wondering.

My follow up MRI was 7 weeks after going on crutches. Like i said, it showed 95% healing. Basically the radiologist is looking for bone marrow edema and fracture lines. The edema is what tells them that there is likely a fracture there. Sometimes a fracture line is also visible, but not always. My F/U MRI showed very minimal edema indicating that the fracture was well on its way to being healed. That being said...just because the bone is healed doesn't mean you can start working out hard on it. Bone builds up in areas where forces are put through it. Standing is roughly 50% body weight, walking i believe is 2x and running is anywhere from 4-8X from what i've read. Basically your bone at baseline will be healed up just enough for it to get used to you standing/walking on it without injuring it. Now you have to slowly allow it to build back up. The body is great about responding to changes in stress, but you have to give it enough of a chance to make that response. Therefore if you start with a walking program and work it back to running slowly, the bone should respond well enough to build right back up. Take it very slowly though. You're really young...no need for screws or a hip replacement at your age!

Make sure you note the stress fracture in your exit physical (assuming you are a D1). The school will still pay for any complications that were occuring during your career there. At least thats what my trainer told me.

After eleven weeks on crutches from a femoral neck stress fracture like yours, I just now decided to conduct some research on returning to running. I am impressed by how quickly your doctors allowed you to get off of the crutches! I am jealous! I have been on them since January and will hopefully finally be rid of them this Thursday. I, too, was scared by my doctor into abstaining from really any physical activity for the majority of the time I have been nursing this injury. This has been very hard for me since I am used to running high mileage--I injured myself in between back-to-back marathon training cycles...however, I now appreciate just the thought of being able to walk! I don't want to come back too quickly and reinjure my hip, but I do want to introduce my weakened muscles to movement again! I have not been cleared to ditch the crutches, but cheated a little this weekend and went for two walks (around an hour each). But judging by the other postings on this site, that was a mistake...I will heed the advice of the others and ease slowly into the walking. I just wanted to say that I am encouraged to read stories of others and their recoveries, as it appeared at first that this was a dooming injury for my running career. Good luck with your rehibilitation!

I would think that it would be best to re-introduce walking in stages. I was off my crutches and walking around at home and in the office for a few weeks, and then made short walks, then switched to just using 1 crutch, and then got myself off of crutches gradually, until I was able to go for a few miles. I never felt any discomfort in the injured area while doing this. You are right, you need to strengthen the muscles, but be patient about it. Remember that walking is an impact activity, it's less impact than running, but your legs are still absorbing something like twice your body weight. Have you tried to do anything in the pool?

Does anyone with a stress fracture ever feel aches depending on the weather? I thought that I had over done it last week, but as soon as the weather got better the ache went away.