Stress Fracture - Where Was the Warning?

OR wrote:

That isn't what Malmo is saying. Training on soft surfaces and so on might help, but at then end of the day if you happen to exceed the bodies ability to adapt (which is impossible to know ahead of time) something is going break.

Personally I think it is the whole I need 12 weeks at x mileage in a row that kills a lot of people. Doing 3 weeks a x and 1 week at 2/3 x would work a lot better. The extreme example are the I am going from 50 to 75 by adding 5 mpw every week for the next month people.

Volume doesn't kill people.

I kill people.

"I" meaning "Intensity", of course.

But seriously - intensity will injure you before volume will.

"Well since we have an ACTUAL doctor in Dr. Fullem... is it actually safe/alright/possible/not-career threatening to run on a stress fracture?

There must be some point at which you have to let it heal?

Or can you merely continue to pile on the mileage and it will heal amidst the pounding?"

So what's the answer?

I imagine it has something to do with applying stress at a lower rate than the rate that your bone remodels - output cannot exceed input, that kind of thing.

"Simple. Easy running on grass: left right left right."

I thought you said that's what got you in the first place.

I imagine it was the abrupt transition to soft surfaces and not the nature of the soft surfaces themselves that got you - yes/no/kinda?

Did the "injury troll" hit you withn his "dy/dx stick"?

(dy/dx relating to change in training cond'ns and not trainig volume, just to be clear).

More discussion on this please.

No doctor should recommend it, but I have run on several in my day. Only once did it come back to haunt me and even then nothing terrible happened. (2 tibia, 4 fibula, 2 metatarsal in 32 years). I would never say to a runner to go ahead and run on it, because then they would take that to mean they could run MORE on it. Is Fullem the only actual doctor or just the best?

http://psutafalumnigolf.blogspot.com

Strange that this thread just popped up...

Similar to PJB's complaint..

Last night I went running in wet shoes.. (big mistake number one)... and four minutes into my run I had a numb kind of pain on the outside edge of my foot, closer to my heal My guess is its either Peroneal tendonitis or this cuboid syndrome.. The pain was very acute and very sudden. I can't seem to walk on it without pain, so hopefully a few days off will do the trick?

skwilli . wrote:

No doctor should recommend it, but I have run on several in my day. Only once did it come back to haunt me and even then nothing terrible happened. (2 tibia, 4 fibula, 2 metatarsal in 32 years). I would never say to a runner to go ahead and run on it, because then they would take that to mean they could run MORE on it. Is Fullem the only actual doctor or just the best?

http://psutafalumnigolf.blogspot.com

Obviously you waited until you could walk normally...

Am I right in thinking that all stress fractures are different? I think I had one last year, it had all the classic symptoms: localized, sore to touch, etc.

However I could walk on it within 48 hours and three days later I went for 20' easy around a soccer field.

Within two weeks I was more or less back to normal training.

Again, I'm pretty sure it was a stress fracture, as it didn't fit the description of anything else...

On the other hand, I had one three years ago that had me limping for a week, kept me from running for 2 months.

What's the difference between a stress fracture that keeps you sidelined for a long time and one that you can come back from fairly quickly?

The fibular ones were no problem at all, since the fibula only bears 15 % of the weight. The tibia ones definitely were sore, but were "manageable". The metatarsal ones were the worst and I needed 6 weeks off for one of them. The other one I was able to use a nice orthotic which made it bearable. I even PR'ed in XC States in high school with a metatarsal stress fracture (confirmed with serial x-rays). I would never recommend that to patient's however. They are all different, hence the great variation of outcomes. If I knew which were OK to run on and which weren't< I would be a rich man and not commenting on any internet boards!

http://psutafalumnigolf.blogspot.com

Volume kills people too. Volume and intensity are just different stresses on the body. Exceed your recovery ability for too long and bad stuff happens.

general fitz wrote:

OR wrote:

That isn't what Malmo is saying. Training on soft surfaces and so on might help, but at then end of the day if you happen to exceed the bodies ability to adapt (which is impossible to know ahead of time) something is going break.

Personally I think it is the whole I need 12 weeks at x mileage in a row that kills a lot of people. Doing 3 weeks a x and 1 week at 2/3 x would work a lot better. The extreme example are the I am going from 50 to 75 by adding 5 mpw every week for the next month people.

Volume doesn't kill people.

I kill people.

"I" meaning "Intensity", of course.

But seriously - intensity will injure you before volume will.

This is got to be just about the best post I've seen by Malmo, a real gem.He's the man.

malmo wrote:

pissed off wrote:

Malmo, I know you had a mighty similar experience.

Looking back, should anything have tipped you off?

Yes, I was running on a lot of soft surfaces at the time. I should have known better, right? Afterwards most of my running (95+ percent) was on hard surfaces and at higher weekly mileages. Never had a stress fracture again.

Correlation does not equal causation.

Injury goes with the territory. Every day you lace up the shoes you expose yourself to risk. Shit happens.

both of my stress fractures have been completely without warning. one day i'm training fine. the next day i go for a run and suddenly i'm limping and in lots of pain. stress fracture.

My metatarsal stress fracture just popped up too from running a marathon when it was 5°F on 1/3rd concrete and 2/3rds asphalt!! Since I didn't realize what the pain was I ran another marathon 2 weeks later where my foot really swelled up. A week later I limped through an 8k race. (since I was on vacation)

OP, Take six-eight weeks off and cross train on a stairmaster or eliptical. Start back running slowly. The foot will hurt a little (scar tissue). As you run more, it will take longer before the foot hurts. The pain will eventually go away. I took 8 weeks off. Trained for 6 weeks and started racing. 6 weeks later I was running faster than I had in years. Fortunately, the time I took off was in the winter and spring so I was running great that summer.

Makes me think of Centrowitz at Oregon in the 2009 season. Don't recall the nature of the fracture. Just that he got a fracture in his foot running a race late in the season. Nothing was ever written as to how or why it happened (that I could find at least). It seemed to be brushed under the rug like it was just something that could happen to anyone. Obviously he had some high level coaching monitoring his training. But also, I haven't read anything suggesting that he is injury prone and that he is at high risk for this injury to happen again.

Well I must say that I've trained on 90% pavement for over ten years and never had a stress fracture. I hear that, although grass is softer and an easier impact, it requires you to use a lot more muscles than you would on pavement, a lot of those muscles are in the foot. You probably broke your foot because of the change in surface.

I'm just rebuilding my mileage following a 10 week period of no training as a result of fracturing my 3rd metatarsal in my right foot. This was not a stress fracture but just a regular break caused by stepping on an uneven surface during an easy run during the taper 9 days before my target race. A subsequent bone density scan has shown no abnormalities. So as others have said shit happens and it really sucks but sometimes there is no obvious rhyme or reason. Think the key thing is to stick with it, give yourself time to heal and believe that you will return to kick ass another day.

All the best.