I’m 16 weeks out today and 4 weeks into my return to running protocol - took 12 full weeks off.
This is only anecdotal but it might help someone down the road, and, if anyone has experience, feel free to offer advice. I expected a somewhat straightforward recovery since it was a bone injury but that hasn’t been the case.
I think I needed 12 weeks for sure, maybe even 13-14, I really don’t know. My ortho doc doesn’t know for sure either because I haven’t gotten a 2nd follow up MRI even though I saw him and suggested it after experiencing pain. We both think it’s PROBABLY non-bone pain but it’s still worrisome as my initial sympotoms manifested in a similar fashion. I basically felt general glute soreness until severe pain came on after about 1.5 miles into a run and I stopped by mile 3(ish). Only did one more run after that which was about 1.5 miles before I finally realized this was something serious that I shouldn’t run through. Even then, it still took 12 weeks to start running again and I had a LOT of bone marrow edema. In fact, the follow-up MRI indicated I actually had 3 total stress fractures, 2 of which were in my left and right pubic rami for which I may have been totally asymptomatic. Weird, right? Just shows how hard it is to identify whether pain is alright vs definitely not alright.
The first runs were short - 1.5 mins on, 1.5 off or so for a total of like 12-15 mins. Only did so every other day for a week. Bumped up to a mile, break, then another mile after about 10 days (but again, remember that I took 12 weeks completely off). Each one resulted in all sorts of weird pains that may persist for a minute but then go away or sometimes a bit longer. It didn’t feel the exact same as before so I’ve continued to run through without any (known) bone issues. The beginning of week 3 was a 5ish miler with some walk breaks that didn’t result in any pain until the very end. Had that deep soreness again but I’d been experiencing it even while sitting at my desk after 12 weeks. It dissipated by the next day. The following day I did my first run without stopping - 3.1 miles at my prior MP just because I felt good and wanted to see how much fitness I had lost. Even after 14 weeks I was able to run a 5k at pre-injury MP. Had no pain during the run and was on a major high. I wasn’t running that much faster than on my other runs up to that point - it was only about 30 seconds faster than my 5 miler 2 days before which had a walk break in the middle. My PT, who has a lot of experience with runners, thought 40-45 mins would be fine and even up to an hour would be acceptable so long as there wasn’t pain. Thus, a simple 5k at a brisker pace shouldn’t be that big of a deal, right?
Unfortunately, the next morning I woke up and had some pain in the lower back when bending over to put on pants. It didn’t feel the same as before, it was in a different area, and was relieved when I put moderate pressure on the area while bending over. I had pain with the hop test, however, which was a major concern. It didn’t hurt to run, just with certain motions, but it was replicable every time. After being hypersensitive to every ache and pain for 14+ weeks at that point, I was pretty freaked out. It got worse through the day but had mostly dissipated by the following day so I ran another 3 miler without issue. Same for the next day.
Scheduled an appointment with the ortho again but he didn’t want to do any follow up imaging because he thinks it’s non-bone pain. This is in large part because moderate pressure relieves the pain which probably couldn’t happen if it was a reoccurrence of the stress fracture. Also, he doesn’t think the pain would have calmed down so quickly if it was bone. Yeah, that makes sense, but anyone who has has a lengthy recovery from a stress fracture knows how you almost lose your ability to use common sense in recovery because you’re over analyzing everything.
I’ve continued to run but haven’t done more than 45 mins. Heck, last night and this morning I had some significant low-back pain due to a 42 min run last night, pain that I haven’t had at all up to this point. It’s the kind you have after helping a friend move - the one who has a tons of heavy stuff and lives on the 3rd floor of an apartment without an elevator. It was a beautiful day so I did only my second back-to-back and did 5 miles at a comfortable but not slow pace. Basically no pain during the run and I feel like 16 weeks might be the turning point. That being said, I’m still in a little pain in the glute area when sitting for a while which was the exact pain I had leading into the stress fracture. Yeah, 16 weeks later even though some are totally fine after like 7-8. Gary Robbins, an elite ultramarathoner had to take 16 weeks off for the same injury earlier this year and I’m not sure if he’s even up and running again yet. Some people just heal from this way, way slower for some reason.
I hope to update this thread in the future as well once I have a better idea of the recovery process. FWIW, my PT prefers longer runs over shorter ones on consecutive days. She was pretty aggressive even though my ortho is much more conservative and they have a history of working together. I’m basically being told 2 different things and trying to use how I feel along with their advice to figure this out. It should be noted that I’ve never had the same pain while running as I did before and it’s never been that “hurt with every foot landing” since I started running again. Those would be major red flags and indications that the bone isn’t ready, which is exactly what happened to me when I tried to start running again at 8ish weeks and had to get the follow up MRI. The key is that I didn’t try to run through that pain and immediately sought medical advice and imaging.
One other thing I would suggest for anyone dealing with this - seriously, take the extra week or two of recovery. You’re not going to lose hardly any more fitness from 9-10 weeks off (or more) versus 7-8. Once I wrapped my head around that I definitely was missing my “A” race, a 100 miler I’d basically spent the last year training for after a spectacular blowup the year before, it was a lot more manageable. It’s SO hard to give up on a goal you’ve been working on for a year but you simply can’t force your body into doing something it can’t handle. I can’t even tell you how many times I thought about that race when I was trying to get through tough, cold, miserable runs (I was hitting 100 miles weeks in January 2019 when this happened) but it is what it is. By taking the extra couple of weeks off I may be able to salvage my fall “A” race and hit the other one next year. Once you’ve truly come to terms with the fact you have to rest for what seems like forever, it’s a LOT easier to give up that extra couple of weeks. The first few were the toughest, weeks 9-12 might have been the easiest ones of all (and the ones where I possibly had the most important healing occur).