pubic ramus stress fracture healing

I had/have a stress fracture of the inferior pubic ramus. It was caught after one month of misdiagnosis. My doctor had me on crutches for a total of about 3 months with various degrees of weight bearing and instructions to be as sedentary as possible. I had acute/chronic pain which didn't start tapering off until about 4 - 4.5 months after the initial injury. I am about 6 months post fracture date right now and still have some discomfort from time to time, especially if I sit too long. To be honest, this has been a very frustrating injury. It does not heal quickly (for most people) which means a long, drawn out healing timeline with quite a bit of lingering pain. There have been many days over the past 6 months where I truly felt like it was never going to get better. Hang in there! It will get better, I promise.

Thank you, much appreciated. From what you say, I may well be healing slowly without crutches as the pain is not necessarily an indicator. i.e. From your account even with crutches the healing process can be slow and painful.

I'm guessing another MRI is the only way to really see what's going on. Hope you continue to heal up and make it back to normal running.

Thanks again.

I am having the same issue that you mentioned. It took me about two months to go to a doctor and get an MRI. During those two months I thought I had pulled my groin and was continuing to do mild workouts and walk. I have now been on crutches for two weeks and I am in a lot more pain than I was before. Has your injury gotten better? Did you continue using the crutches? Thanks.

I experienced this so badly in the early 2000's that it actually showed up under x-ray. This is a sad, but true story:

My 5k PR was 17:58, from high school. I ran off and on after HS, and was reading letsrun the entire time. As a very misinformed 19 year old who could probably run a 5k in 19 minutes at the time, I worked up to 50mpw, then 60, 70, 80, 100, 120mpw almost all slow. Sometimes I would hammer.

Sometimes I would run 20 miles on Fri, Sat, and Sun (each). I did this for another year and decided to race on a Saturday morning when the dew point here in the south (in July) was 77. I ran a 17:40 5k after running 15 miles the night before the race. Not too bad, I thought.

Fast forward 6 weeks and I had just completed a 13 mile run on some very hilly terrain, off-road, in 81 minutes as my second run of the day. This was still August, and it was still hot and extremely humid.

I felt I was rounding into great form, but after that 13 miler, something just wasn't quite right. My groin felt terrible and I could hardly lift my leg to go up steps. I had registered for a 5k that was 10 days out. I hobbled around during this time, running as much as I could. I remember starting the 5k race ok, but I kind of blanked out and I remember limping (as in dragging my leg behind me) and I ran 17:55 - still hot, still nasty outside. I was done - I could barely walk. I couldn't stand in the shower on one leg. That is when I went to the doctor and the x-ray confirmed my injury.

I was in the pool immediately (as you could imagine any obsessive-compulsive person would) but I seemed to favor the stationary bike a bit more. I spent Sept, Oct, and two weeks in November riding the bike. By mid October, I started walking about 1-2 miles each day on top of biking. I started running in mid November and (I sigh.......youth....stupidity....) decided it would be a great idea to sign up for a local half marathon. I ran 1:25 off of two weeks of running and by the grace of God, did not get hurt. I was very lucky.

I think I put it behind me. It has been 13 years. I don't know if I can say the same about my endocrine and muscular-skeleton systems. I never ran another week of mileage that was as high as those couple of years. I don't know what I was capable of running in perfect weather with a healthy body. It would have been a heck of a lot faster than my 19 minute starting point and a heck of a lot faster than the 17:55 I ran on one leg.

I blame LRC, and of course, my youth and ambition. Luckily I learned a lot from the experience. I did not learn enough to stop reading LRC, though.

Hi Mich2010 - How's your healing going? I've just had my 3rd MRI and it shows no improvement/change from 4 months ago. My stress fracture is chronically painful when resting, but doesn't hurt when I cycle, and the few runs I've previously attempted were ok, although everything felt tight / awkward when running. I'm not sure whether I should rest completely (stop cycling), or return to normal cycling / running and see how things go? Has anyone else got wisdom in this area. When you returned to running were you experiencing groin pain at rest / throughout the day? Thanks

StressedOut wrote:

Hi Mich2010 - How's your healing going? I've just had my 3rd MRI and it shows no improvement/change from 4 months ago. My stress fracture is chronically painful when resting, but doesn't hurt when I cycle, and the few runs I've previously attempted were ok, although everything felt tight / awkward when running. I'm not sure whether I should rest completely (stop cycling), or return to normal cycling / running and see how things go? Has anyone else got wisdom in this area. When you returned to running were you experiencing groin pain at rest / throughout the day? Thanks

Here is my experience. Stress fracture of the inferior pubic ramus occurred beginning of March 2017. From March - August, I was almost completely sedentary other than doing necessary actions (going to work, grocery, etc). This was per doctor's orders. Finally cleared to do minimal non-impact activity starting in August (5 months after injury). It took this long for the everyday, chronic pain to start fade. Still had pain from time to time but the worst had definitely passed. Was finally cleared to run at the end of middle of October 2017. I have had phantom pains since returning but in no way did they feel like the pain of the actual stress fracture. They came and went and didn't linger at rest or throughout the majority of the day as you are describing.

Did the doctor clear you to run and cycle, even with the MRI results and chronic pain? If so, that surprises me. I know everyone heals differently but the pelvis is a serious bone to break/stress fracture and can take a really long time to heal. Again, in my experience, 4 months would have been way too soon to start running or heavily exercising given the pain level and chronic nature of it. It is super hard to rest completely but I felt like in doing so, it made my return to running pretty seamless for such a traumatic injury.

Thanks for the speedy response. Doctor has said all along that any exercise that is pain-free is ok. Cycling has always been pain-free, but I live in a hilly city, and I love pushing it (whether running or biking). Initially they suggested trying very light running after 12 weeks, but that didn't feel right. Given the chronic pain, I'm currently taking the complete rest route, and considering hyperbaric oxygen chamber (5 days a week for 4 weeks) which has been suggested. From what you've said, the pain matches the MRI and I should steer clear of any exercise till I'm pain free. Thanks again for your help. Not sure if anyone else has a different experience?

Hey StressedOut - I have been on crutches for over two months now and have had scans every 2-3 weeks. As of last week the scan finally showed imporvmemts. I just started cycling with 0 resistance and doing a few leg excerises to build back muscle but still non-weight bearing. The doctor said the bone typically needs 8-10 weeks of rest to heal especially since it’s in such a tough spot. He also recommended taking Calcium Citrate to help bone heal quicker (my calcium levels were normal but still recommend so might be worth taking)

I would definitely hold off running until it has completely healed. Very long and frustrating process!

I was diagnosed with PR stress fracture in January... it took two and half months for me to get an MRI to get the diagnosis. At the end of February, orthopedic dr told me bone healed beautifully and I can resume all activity. I have been having lots of trouble getting back into running. My injured leg is stiff, muscles are weak and I still have pain... not unbearable pain but considerabem discomfort that makes me reluctant to push harder. I’m only running a slow three miles a couple days a week and am wondering how much longer this discomfort is going to last! It’s so frustrating.

Hi,

I am so relieved to find this site. I injured myself March 2018 and ignored pain and ran marathons and could not understand problem. I had a MRI done in May and it reported major inflammation around pubic area but no fracture ( i was given a disc of this result). My doc suggested no running for 4weeks and anti inflammatories, which I did. As soon as I returned to running pain returned. I continued training..running up to 4 half marathons in a month .. hoping pain would settle but it didn't. My GP sent me to a consultant who looked at the CD of my MRI and just shook his head" whoever read your MRI missed a very clear fracture..look" he said and pointed it out to me. So I am now 7 weeks into recovery, I went for my first bike ride today. I still have lower abdominal discomfort and tightness getting out of bed. I am really concerned I will never run again after being oblivious to this fracture for nearly a year of continuing to run on it. Has this happened to anybody else? I would love any advice

How the hell were you able to race on it so much? I had one and when I tried to run, my easy pace shot up from 6something to around 9-10. I could immediately tell something was wrong, as my leg just wouldn't function. I could see limping through an easy run, but races? I don't know if you'll have complications or not, I'm not a doc. I had 3 of these fractures. They took 6 months, 4 months, and 5 weeks to heal. You might want to do aqua jogging over cycling, but I'm not your doctor so, be careful. I imagine it will heal for you, but could take months-half a year. I don't know why mine took so long, other than I was young and impatient and would try to run for a couple days every 2-3 weeks.

May I ask what you did during your recovery time? I am on month 6 of this inferior pubic ramus fracture injury and just am looking for some positive feedback

Hello!

I am dealing with a stress fracture on the inferior pubic ramus for 3,5 months. I had an MRI last week and it showed only minor healing process. Have long did it took to completely heal for you? I am kind of lost here because I am off any kind of exercise (besides some walking) for 2 months (no running, biking, swimming, gym... nothing).

Thank you.

I have the same injury and I continue to be confused. Avid male runner (35 - 50 miles per week) who has ran several marathons. Injury came on in early December and finally diagnosed went MRI in February with R & L pubis stress fractures. I'm now 4 full weeks in with no running. My PT says spin bike, walking and gym are ok but that's mixed messages with what I find on this blog and others. Difficult to get definitive answers. Plan is to take 8 weeks off and slowly return to running if no pain. I continue to experience discomfort in groin/hip area at times. Obviously more important things for medical people to deal with these days but trying to get clarity from an expert on what I can/cannot do. Very annoying injury.

I had a pubic ramus stress fracture 11 years ago. Once it was diagnosed, I was on no activity (other than like necessary walking and maybe some swimming with a pool buoy between my legs) for ~3 months. I started aqua jogging and elliptical in months 4 and 5, returned to running in month 6 . I did run(on and off) on this injury for probably 3 months. I was probably overly conservative in my comeback plan but I was also mostly self-guided because I was a college freshman and my coach and athletic trainer were not helping me.

I had a second pelvis injury that I caught super early--only a stress reaction in the pubic ramus and one other bone. I had much better medical care at this point in time. My doctor put me on crutches and said no activity at all for 4 weeks. Like not even core work because it was possible it would pull on the area.

I have run 15 marathons, my PB is 2:52, and I average about 70-80 mpw consistently. I've had one stress fx 5 years ago and little bouts of tendonitis, but I am typically not injury prone. I do my strength training, recover well (I think) between sessions, and haven't been doing anything super crazy.

I am being evaluated and tested for a possible pubic ramus injury. I'm not in excruciating pain doing regular activities around the house, but I have every single symptom of a stress fracture to that bone. Mine came on at the end of a long run (out of nowhere with no previous hip injuries whatsoever) and presented as soreness/lack of responsiveness on the back side. Tried an easy run later in the week (last Wednesday actually) and made it through 30' but not great. Pain moved around inner thigh and has now stayed in the pubic ramus area. I'm able to pool run and cycle lightly without any pain and had no problems jump roping last week (double leg stuff). Still hurts to do anything on that left leg by itself and running (push off and landing) is not good at all. Just that dull ache around the clock and pinch feeling when doing anything that requires more stabilization on the left side. I had the protocol X-ray today (and bloodwork since I deal with hypothyroidism and missed winter lab work) and MRI has been ordered. I guess my question to you is that since you caught your second one as a stress reaction, which hopefully is where I am (if any stress injury), how much of a difference did that make to your recovery path? It seems really ugly if caught as a stress fx or total fracture. (Of course I'm holding out that it's neither, but after enough research and a few sets of eyes, we're all pointing in one direction). I find myself having a hard time giving up the non-impact activities like other posts have mentioned but not sure if I'm in the worst range either. I want to expedite healing! Thoughts?

I'd lay off any impact workouts till you get the results of the MRI. Be lazy for the next couple weeks. If you truly are a serious runner, a two week break is needed once a year any way. If it turns out to be a reaction or fracture, you could be damaging it further and majorly prolong your recovery. If it isn't a bone injury, you only lost a week or two of training. Think of it as a break from training, and you'll come back fresh and ready to train strong again.

Keep us posted about how the MRI turns out, since it will help other runners in the future who are struggling with these symptoms.

I had one of these several years ago. Doc told me I could do anything that didn't hurt. So I cross-trained like a fiend. Elliptical, stair master and rowing machine. Sometimes for hours. After about 8-10 weeks I eased back into running. I started at like 14 min pace and was so excited the day I ran 8 min pace weeks later.

Since then many good miles and races. I have not gotten back to quite the same level -- off a few AG percentage points -- but that is probably because I've gotten more careful about mileage and more wary of injury.

I was able to elliptical as I recovered, no running for 12 weeks, and then about 12 weeks of gradually building up to around a one hour run. Once I hit an hour, the doc let me return to normal. It sucked.

What worried the doc most is how/why it happened, since it’s a non impact bone issue.

I think it was from running through a bad pain until I couldn’t move - dumb move when I was young, I’ve learnt my lesson quite well since then.