Femoral Neck Stress Fx: worried about healing

This is one type of stress Fx not to mess around with. If you run through pain too far you could complete it, and you don't want screws. That being said, it isn't likely as long as you quit when you realize what it is you have, and listen to an orthopedic doctor.

Generally, you can't do impact exercise for any length of time, and pain is you guide to what is too much. At first, it will probably hurt the next day if you walk to far. So don't walk too far or your healing timeframe is just being postponed.

What most orthos tell you is if it hurts a lot to walk, use crutches. If walking doesn't hurt a lot, but you have achiness the next day after walking or standing long periods, then minimize walking, and don't do ANY running or elliptical. All of those put full body weight on the hip.

So for about a month for most people, you will be limited to swimming, upper body weights, and sitting. If you really don't have any pain walking, then you can bike, but don't stand up and jam on the pedals, again, that is full body weight.

Your timeline may vary, depending on severity and pain level. But typically it is a month of swimming and weights, then about 12 weeks of biking or other nonimpact exercise. After that you progress to a walking, then walk/run program. The key is to gradually build back.

If you have a major relapse, you are back to square 1, and with a 4 month to 8 month layoff, that is just wasting your time to come back too quickly and start over again.

Sorry my response was off-topic. You asked if anyone had minimized activities without complete layoff.

The FIRST one I did not use crutches because the severe pain phase lasted less than 2 weeks and by the time of the ortho visit I didn't have pain walking, so he said no need for crutches. However, I did layoff everything including longer distance walking -- the first few weeks I didn't even do 1 hour trips at the grocery store without leaning heavily on the cart.

After 4 months I was starting a walk program, about 5 months later had a mild relapse. This time I caught it early - so early the pain level went away after about 7 days and the level was only 2 out of 10. That time I tried an experiment, but keep in mind you results may very.

I took 10 days off, then jogged really easy on a treadmill one hour -- very even, almost a shuffle. Then I jogged easy on the treadmill twice a week for 7 weeks, then every THRID day (one day jog on treadmill very easy, then 2 days rest) for 10 more weeks. Then I went back to 3 runs per week for about 3 weeks, then transitioned outdoors.

Well, 2 months after that I was doing speedwork -- two sessions in one week on blacktop, and it came back a third time.

This time I'm seeing a sportsmedicine doc instead of an ortho. An ortho just wants to see you get healed and isn't inclined to help you figure out WHY you got the stress fracture so you can prevent it happening again.

Keep in mind I'm 50 years old - a younger runner may heel faster. Also, the first one was confirmed by MRI - showed a stress reaction in the lesser trochanter, which is kind of at the bottom end of the femoral neck. The second one I didn't bother with the doc, knew the rules of what to do, and it was getting better. This time I just had another MRI and will also get a gait analysis after I come back to running to try to prevent a relapse.

With a stress fracture, its all about cumulative impact over time. So during rehab, you test the waters one tiny increment at a time, and wait a full 2 weeks to see if your bones can handle it. There is some evidence that there is an approximate 2 week cycle to the body's response to increased impact stress by increasing bone remodeling.

Thank you. That is really helpful. I've laid off significantly. No running/treadmill at all, and mostly just sitting down to study (am a medical student, tried using crutches to and fro work, but when seeing patients just walked around, and also fear of scary complications comes from line of work). The pain of walking has never been too bad. started at a 3-4/10 about 8 weeks ago, now walking is about a 1-2/10 pain, but occasionally I get funky cramps in the hip area and worry. I have a follow up with the doc this friday, so hopefully some follow up xrays will be reassurring. Thanks for your help and feedback, and congrats on your patience with your own injuries and being able to get back to full speed!

My wife had this same stress fracture a few years ago. After diagnosis with MRI and X-rays...she had surgery to insert three screws, then walked on crutches for several weeks. Today she is fine and has no lingering effects.

You really need to stay on crutches and not bear any weight on the fracture. If it doesn't heal, you will need surgery.

My wife's biggest problem was getting in and out of a car. That's when we knew something was wrong and went to Doctor for x-rays.

Speaking of being med student with a femoral neck sfx, I know a med student on RW.com who had a compression side femoral neck sfx and with all the constant walking she had to do, hers went over 6 months and was not getting better (possibly due to inability to cut back activity level). She eventually had the screws put in about a year ago, I think. She's not back to running yet.

Sorry to hear about this.

IF I recall, FNSFs are common in women in the military because they tend to overstride while walking in formation.

This is not a common injury, and it is unlikely that it was caused by faulty footwear. I hope you get back to running soon enough, but when you do, focus less on big open strides and maybe more on something like stride rate.

Hope things go better.

While it isn't a common injury, I have also known a few people who have had this injury. I do know someone who saw a podiatrist which thought that in his specific case, the injury could be in part due to him needing orthotics. But there are numerous reasons including diet, running on soft surfaces, proper increase in training stimulus, ... . A little bit of impact (i.e. walking) may help the bone be stimulated to heal, but this probably shouldn't be done right away. The exact progression back to walking,etc. should be discussed w/ your doc. There have been some studies that suggest ultrasound can help stimulate the healing of the fracture, but again this would be something that you would need to discuss w/ your doc. (this EXOGEN machine is designed for this specific task). take care, and please be patient w/ this.

Thanks for the help. I've been pretty conservative about walking around with the occasional climbing of stairs, daily chores stuff. My appointment with the doc is on friday, so I'll see what he says. I have never been on crutches before, and when I made an earnest effort to use them. But, so many things were just impossible to do. I live on the third floor oof an apt complex without an elevator. Couldn't carry anything up the stairs with the crutches except what I could fit in a backpack, so I'd just walk slowly up and forget the crutches. I just wonder how many people are real strict with the crutches considering how difficult they are to actually integrate into lifestyle. Although I don't wish this injury on anyone, it is reassuring that others have made it through! thanks again for all the help/advice.