Sacral stress fracture not healed?

I fractured my sacrum a few years ago. You're going to feel the fracture for a while. I still feel it three years later, although not as often anymore. It flares up if I do a lot of hard surface running or a lot of hills. I struggle with residual tightness in my lower back, hips, butt, and hamstring.

As long as the pain felt like a deep ache, like a from the bone ache, I didn't get too concerned about a redeveloping stress fracture. I just became more vigilant with my rehab. Cross trained, soft surface running, no hills, stretching, strength work.

If the pain was sharper and caused a limp when I walk, I stopped running completely and did only cross training.

Look into doing strengthening work for the muscles surrounding the sacrum. That should help take some of the load off the injury. Also, I think that people who get sacrum stress fractures have weak hip flexors and/or lower back weakness. Try to come up with a strength routine to address those weaknesses.

Vitamin D & calcium supplements don't hurt either.

Good luck. Frustrating injury but it's manageable.

Thanks for the reply.

How much time did you take off? Did you cross train? I worry that the elliptical is slowing the healing, but my ortho insists that it isn't since I have no pain while on it.

Did you have the standard "pain while putting on pants" that are the sign of sacral stress fractures when you returned to running. That's the pain that worries me the most.

I've taken vitamin D and calcium for years, and I've had blood work done. All of my levels are normal.

I fractured my sacrum in March '11, and I didn't return to running until around July. I did stationary bike as my cross training... swimming would probably have been best but I'm not a strong swimmer and I disdain water running. The stationary bike just made me sore but I don't think it was overly detrimental to my recovery.

I don't remember the feeling the pain while putting on pants. The dull ache was what I remember most after 10+ weeks off.

When I fractured my sacrum I remember limping during every run, and walking. It was especially painful when I'd stand up after sitting down for a while.

I think as a general rule, if the pain is sharp and pin-point then its probably still not healed and you need more time. If its a deep ache then its probably mostly healed and you're feeling phantom pain.

Also, this might be wrong, but I was under the impression that sacral stress fractures are extremely rare. It's probably safe to assume that it probably won't happen again if you're cautious with resuming your training. I also think that the sacrum has pretty good blood flow so the recovery is a bit better than other places you could have fractured.

Seriously though work on your hip-flexor and glute strength. You're probably like me an lean slightly back when you run because of weak hip flexors. If you can strengthen your hip flexors and glutes you'll be much more likely to maintain a slight forward lean posture. This will force you to land with a foot strike more underneath your body and allow for greater force absorption. Plus you'll be more efficient which will make you faster..

Miguel R, I'm in the same place as you. Developed pain in March, ran through it for four weeks, finally had the MRI in mid April and was diagnosed with the sacral fracture.

I had another MRI two weeks ago (8.5 weeks out from diagnosis) which showed good healing. I was cleared to start a gradual return to running and started out with sessions like 6 x 2 minutes jog, 2 minutes walk. I also have access to an Alter G and have been using that 3 times per week on days I don't run outside.

At this point I feel better but not fully so. I don't have the pain while putting on my pants, and my sacrum doesn't hurt at all while I'm running. But after a run, it does kind of ache the rest of the day. I don't know whether that's normal or a sign that I need to give it more rest. I am so eager to train and build my mileage again, but I really want to avoid another long spell on the shelf.

I'm the opposite as far as pain right now...I feel the ache in my glute and outer hip while running, but nothing afterward. When I first started having the pain, it hurt the worst right after a run. It also hurt when I walked.

Although I haven't run in 10 weeks, I had the MRI 6 weeks ago. So, I'm wondering if that fracture (which showed up in the MRI) would have healed in 6 weeks time.

I have been digging around trying to find posts about this and so I hope others in my position will read it. I ran my first 50 miler in March 2015 and out of the blue, developed a stress fracture at mile 18. I completed the 50 miles but every step was painful but, I met my goal... (only other runners will understand the craziness of that comment...!) Up until this time, I'd never had any kind of bone fracture. Just the usual achilles tendonitis, piriformis, etc., which were workable. This fracture did scare me a bit I must admit, because I LOVE to run and can't imagine not being able to. X-ray did not pick up the stress fracture but an MRI about 5 weeks later did. I did what I was told - stayed off running, and worked out mostly on the stationary bike which worked very well for me and kept my level of fitness in a good place. By about end of June I was building up my running base again and most recently, my longest run was about 18 miles. I've been diligent about listening to my body so I am now worried that my sacral stress fracture has reoccured although I know from what I have read from reliable sources, that the area of fracture comes back even stronger thus unlikely to re-fracture. However, in the last 10 days, after each run I am feeling a dull, deep ache close to the area of my original sacral stress fracture - not exactly in the same spot however. It is hard to pinpoint, it's not sharp pain but I can feel it most, if I bend over to stretch out my back over my knees for example - then I feel the pain in that spot. I note other people who've had this type of fracture, talk of residual pain in the area but I am just not sure what's going on. It seems like I can stretch and that helps the spot also and there's no pain doing the "hop" test whereas there was with the original fracture. Any thoughts or guidance/reassurance from anyone out there that might have been through this, would be so appreciated.

I had a sacral stress fracture 2 years ago, and my time off/build up is similar to yours. Like you, I definitely could not hop on it without pain and basically any weight bearing caused pain. There was a period of time last year when I was feeling pain in that same area, although slightly different than the original pain. I worried at first thinking the fracture may be back, but it didn't hurt to hop on it and bothered more with back movements. It ended up coming from my low back (which was really tight) so when I stretched it, it felt better. I also stretched my hip flexors too (which connect to your back) and that also helped. So I can't say for sure that yours is 100% not a fracture, but it sounds different than your original symptoms and may be coming from your low back or SI joint. Would get it looked at though just to get a correct diagnosis if it persists.

Thanks Klo98! This is great information and great advice. I will definitely get an appt with the doc though to follow up. At least, that'd put my mind at rest too.:)

I had the same fracture and had absolutely no pain when coming back. I am not trying to make you feel bad but would encourage you to take another three weeks off. It's better to take three weeks off now then have the pain coming back here or there for the next two years.

I would also suggest deep massage or dry needling in the hip and lowr back region to increase the blood flow to that area. Good luck to you.

Hey man,

I feel for you, last year while at my first year at college I got pushed to hard in my training and wasn't taking care of myself. Eventually after being in the new program for 6 weeks and pushing mileage I developed a sacral stress fracture on my left side. At first I thought it was just some tightness so my coach told me to take my two weeks off now so I did. After the two weeks I ran again and felt the same pain right away. The next day I went to get an MRI and thats when I found out I had a stressy.

After receiving the news the awesome trainer approached me and gave me the option on what we could do. Either take a month off then start cross training and then run after two months. Or take two months completely off and cross train for another two months after that and start running at the four month mark. If I chose the first option I could threaten to push back to early and not let it fully heal and chance it getting hurt again. If I chose option two he said I would let it fully heal and hopefully not have to ever worry about it again as long as I take care of myself.

This was my first 'big' injury ever and I wanted to make sure I did everything right and didn't want to have to deal with it in the future so I went with option two. So for two months I did nothing, of course the team gave me crap and called me a baby for babying my injury but I didn't want to take anymore risk so I trusted the trainer. After two months I started to cross train starting with 20 min bike sessions. By the end of the first cross training month I was up to an 1:30 min on the bike everyday going hard, along with a lot of strength work. The following month I added aqua jogging until I could manage hour on the bike and an hour in the pool everyday. Then I switched the aqua jogging to underwater treadmill. When I started this I went back up to hour and thirty on the bike and 10 on underwater treadmill till again I built up to hour bike and hour underwater treadmill. When I could manage this we maintained for a week and I finally got released to run.

Again I would still cross train hour on the bike and whatever I ran I would take off the underwater treadmill. So ex.. 1 hour bike 50 min aqua 10 min run, so everyday I was doing two hour cardio. After a month I was done aqua jogging and back to running a hour or more a day. 6 months after the injury I was finally back to full strength running 75 miles a week doing workouts and back to the good life.

Its been a year now and I have transferred from my last school because I didn't like how intense the everyday grind was. Im at my new school were the coaches are more about mileage and aerobic base rather than hammering workouts and I would say Im back to the level of were I was in high school. I have no pain and never have experienced phantom pains "knock on wood". while others guys at the same school had the same injury and they talk about how they still feel theres.

Overall just do it right. take the months to heal the injury and be done with it. Tips: take multivitamin vitamin d, recoverite hammer nutrition to help recover bones and muscle after runs. Also make sure the shoes you are wearing are the proper fit. and use your foam roller as much as possible.

Hoped this help.

Cold as Ice wrote:

I had the same fracture and had absolutely no pain when coming back. I am not trying to make you feel bad but would encourage you to take another three weeks off. It's better to take three weeks off now then have the pain coming back here or there for the next two years.

I would also suggest deep massage or dry needling in the hip and lowr back region to increase the blood flow to that area. Good luck to you.

THANKS Cold as Ice. No - absolutely know you're not trying to make me feel bad. I'd rather have some honest and direct opinions so I can refocus and get healed if it is in fact related to my prior stress fracture. I'll look at the deep massage for sure. :)

Do It Right - thanks for all the information. Some great ideas for cross training. Seems the obvious theme is slow and sure - heal properly. Thanks also for all the advice about workouts, and vitamins etc.

It's great to hear your story of how you are once again enjoying running.

:)

I've just been diagnosed with a sacral stress fracture on the RHS and have been told absolutely no running, riding or eliptical for at least 8 weeks. I can do some easy swimming for the next 4 weeks, then bring in some faster swimming and easy walking. In 8 weeks I may be able to get on the bike. Apparently riding puts too much pressure on the sacrum. I must admit that I felt the spot a bit on my last ride. I've also been told that there will be no running at all for 14-16 weeks. A very tough pill to swallow.

Interesting that we are all getting differing advice on the same injury.

Did you ever end up finding out if your fracture reoccurred? I am in the same boat right now. I suffered from a sacral stress fracture almost two years ago and it pretty much healed up normally and I returned to running after a few months. I haven't experienced any problems with it, but all of the sudden last week at the end of a run I started feeling pain in that area again and a little in my lower buttock. It doesn't really feel like the same pain as when I first injured it; at that time I could barely walk and thought I pinched a nerve or something. Right now it mainly hurts if I've been sitting for a long time or when I first get up in the morning. There's also some pain when I walk or put my weight on that leg, but when I try the hop test I don't really notice any pain. Not sure what else it could be, though and I'm really concerned I've re-injured it.

Did the pain ever go away/what ended up happening with your injury? I’m in the exact same boat as you and have the same pain that you described. I want to keep building up my mileage but am a little concerned about the residual pain. Any advice you have would be really helpful!