Sacral stress fracture recovery

Final update: May was a total of 47 miles because it was really just the 4th month of recovery. June was the slow build and 120 miles total. July was about 190. Raced a marathon in August and didn’t have any issues with the SF. I was in more pain than any other race ever, however, likely due to the severely limited training. Was able to hold about 6:48 pace for 18 miles before slipping to 7+ as cramps all over my body, especially the quads, took over (even my forearms cramped up, no joke). This was about my marathon pace prior to the injury when I was a few pounds lighter as well. The takeaway from this is that even with 3 months of no running plus 1 more month of very little running didn’t destroy the MP speed, only the muscle endurance. I was so worried that it would take months, if not longer, to get the MP speed back but it really wasn’t a problem. I was only able to do a few longer runs in July/August and none were anywhere near MP because I didn’t want to put too much additional stress on the bones since it took so long to heal.

1 month later, in September, I ran a mountainous 100 miler in Oregon and was able to pull off a pretty respectable finish in that race as well. Didn’t have any (known) issues with the stress fractures and am actually less sore than I was after the marathon. This was 7.5 months after the SF occurred. Even despite the lack of training I was able to muster a decent run/shuffle through the final miles.

Although my SF was slow to heal and seemed to hang around much, much longer than with most others, I was able to come back with decent speed for a marathon 6.5 months post injury and a 100 miler 7.5 months post injury. Not only that, my speed wasn’t markedly reduced, just the overall stamina for a marathon. Had it been a shorter distance then perhaps I could have held on with much less noticeable effect. For anyone who is struggling with this injury, you can make it back - even if you’re 9 weeks in and your doc says you’re still not healed and you’re really questioning if it will truly ever heal at all. I’m not a big fan of stretching but it’s mandatory for this injury as the muscles and soft tissue will tighten up on the injured side. I’m still getting a bit of tightness on the injured side but different from the SF. Stretching definitely helps - without stretching, my gait changes ever so slightly and could result in an overcompensation injury on the other side. I’m noticing that the wear pattern on my shoes is now a bit different so be cognizant of that in your recovery. Overcompensation is so subtle that you probably won’t notice it while you’re running.

Best wishes to all!

I’m 6 months in and back running lightly but the dull ache pain is killing me. I’ve had 3 MRI’s and 2 CT scans. I’m osteopenic in the hip region. I’ve read all the threads just wondering if anyone has found the key to recovery.

I was riding about 250kms a week up until I had the fracture. Now I am unable to ride due to the fact that the right side is unable to put too much pressure on pedalling. So I agree the bike is not much good.

How long did it take for the dull ache to dissipate? I’m over 6 months since injury and I’m running okay but the dull ache is there at night when I’m sitting or lying down. I’m also a bit scared to push .

I’m sorry to hear that! Bone injuries suck and I understand the concern about not wanting to reinjure the bone. Unfortunately it sounds like your injury is VERY different than the one I had. You didn’t state you age, sex, weight, prior injury history, rehab plan, prior training history, etc so it’s hard to say what would be analogous. Even assuming everything was the same, however, you’ve gotten 3 MRIs and 2 CTs so you know much more about your injury than probably any of us knew about ours (it’s difficult to convince doctors and insurance companies to get that many follow-ups). Considering you have osteopenia I don’t think it would be a fair comparison to anyone who doesn’t have to unfortunately deal with that as well. If you’re still having the dull ache then I would be very concerned and definitely not listen to anyone on LetsRun - your doctor has access to much more information and experience than any of us. The fact that biking caused so many issues is especially concerning as I was able to ride for 10+ hours per week without issue, even once I got back into running. It might have slowed the healing a little bit (and that’s only a maybe) but it didn’t result in significant further damage.

I don’t mean to be discouraging but it sounds like your injury and recovery is and will be significantly different than what I and most others experienced. I’m sure you can come back from this and still be a strong, healthy athlete but you gotta be patient with the recovery. It sounds like it’s been a long and complicated road - spending the crappy winter months recovering, and I mean really recovering - will allow you to come back and really enjoy the grind again in the spring. I hope you heal up soon!

Hopefully the last update - it’s been about a year into the recovery and I’ve run more miles than ever. Have averaged about 360 per month for the past 4 months (85-90 MPW) after a steady buildup and a nice break in December 2019-Jan 2020. I’ve been taking a calcium/vitamin D supplement every day for the last 16 months or so because it’s cheap, easy, and may make a difference during the rainy months in the PNW. I’ve had basically nothing other than a minor soft tissue flare up here and there and am on a 100+ day run streak during this time. Oh, and I even ran a caloric deficit and cut about 15 pounds of fat without further issues (considering I wasn’t high body fat to begin with, that’s tough to do without getting injured, specifically bone injuries).

For anyone who has struggled with stress fractures, know there is hope to come back stronger and more resilient than ever! I was worried I couldn’t do high milage without injury but this is as good as it’s ever been for me! If I had to recommend 2 things - it’s the calcium/vitamin D supplement because it’s just so cheap, easy, and has virtually no risk of side effects of taken as recommended. Second, and perhaps more important, is that I just do consistent shorter runs rather than many long runs. Over the past 4 months I’ve done maybe 4 runs over 13 miles. One was a mountainous 35 miler where I still felt super fresh at the end despite essentially no long run training and then an even tougher mountainous 50 miler where I had my best performance ever. I’m no longer worried about doing 20+ milers regularly despite my preference for longer distances - it seems that consistent medium range runs of 10-12 miles (and lots of short easy morning runs that mean I do doubles most weekdays) has done wonders for my longevity and performance. I think the routine 20+ milers may have played a role in the stress fractures because I’m running a bit more than my peak when I got the stress fractures and have done so for about 4 months.

I wasn’t sure if I’d ever be able to run the way I wanted again but things are looking good right now. If you’re feeling the way I did when it just wouldn’t seem to heal, know that I was in that bad place too and have come out better than ever. Stay positive, be patient and deliberate in recovery, and hopefully you can too.

I really appreciate these updates. Thanks for filling us in on your recovery! There is so little out there about sacral stress fracture related issues. This is really helpful. I hope you continue to progress and crush your goals!

I’m currently in Week 4 of no running after being diagnosed with a sacral stress fracture/reaction in mi-May. Doctor thought it was osteitis pubis before the MRI, but after that confirmed it was the stress fracture.

I was in severe pain for about two weeks before I could finally tolerate walking & once that dissipated a bit, I have been able to see a PT and get into cycling. Maybe my injury isn’t as severe as others since I have been able to cycle without too much pain. I’m up to 330 miles this month on the bike.

My doctor told me today that he wants me to not run for 2 more weeks to put it at a full 6 weeks since the diagnosis and then after that I can run twice per week, but no more than 1 or 2 miles at a time for a bit.

Thanks for updating this thread. I felt like I was alone out there for a while. Now I know it’s something that others have dealt with.

Murdock, I just want to say thank you very much for sharing all of this information from your recovery phase. I am a few weeks into the recovery after having been diagnosed with sacral stress fracture and it is so frustrating with all the different advises you get on this. My main frustration has also been to understand the pain picture - what is actually pain related to the fracture and what is just muscular pain due to all of the changes in the every day activities etc. After reading your posts, I see that I have a very similar pain picture as the one you describe and it gives a bit more comfort in how to handle it.

I see that your posts are from two years ago and it would just be interesting to hear if it has all been ok throughout the period? I could clearly see the light in the end of the tunnel after reading your posts ;-).

RLAW, I’m glad it helped and I wish you a quick recovery. I posted a 1 year update about a year ago and things had gone well. It’s been about 15 months since that last update and I’ve had no issues despite running about 5200 miles during that period. Am on an 18+ month run streak of at least 3 miles and raced several times, including multiple marathons and 100 milers. Have actually made huge breakthroughs in racing and dropped my marathon PR down to 2:33. Sciatic pain is still present sometimes and I’ve discovered it can be more easily aggravated by deadlifts and squats than I realized. I didn’t have sciatic pain prior to the stress fracture so it was a new issue for me. Early in recovery, I was concerned that the sciatic pain was another stress fracture but it’s been fine. The sciatic pain is simply an infrequent nuisance, particularly when sitting for long periods at work or on drives, but the stress fracture has been fine.

Yea this thread is great and provides some much needed optimism.

Going through this injury right now and mentally it’s a rollercoaster. Through 8 weeks of no running (but regular walking, for work) and it was showing few signs of improvement. Weeks 9-10 I’m finally at almost no pain walking / sitting / pants, but putting any sort of ‘stress’ into it (5 x 200m jogs/ surges on bike for example) still seems to set it back 3-4 days which scares me each time. Patience is extremely key with this one I think.

stresshaver1 wrote:

Yea this thread is great and provides some much needed optimism.

Going through this injury right now and mentally it’s a rollercoaster. Through 8 weeks of no running (but regular walking, for work) and it was showing few signs of improvement. Weeks 9-10 I’m finally at almost no pain walking / sitting / pants, but putting any sort of ‘stress’ into it (5 x 200m jogs/ surges on bike for example) still seems to set it back 3-4 days which scares me each time. Patience is extremely key with this one I think.

Hey man, I fractured my sacrum back on Feb 2019. It took me 12 weeks before I was able to run properly and for no achyness. If you are cross training hard though, I promise you will come back just as fit. The sacrum isn’t going to mess your stride like a leg break. Within two months of returning I was in 5-10 seconds of my 5k PB. Since then I haven’t missed a day of training and haven’t run consistent 90 mile weeks all on pavement. It heals really well. I had a lot of phantom pain on the OTHER side for a long time bc I was so scared I would break it again, but it’s just phantom pain.

Stay patient, keep cross training and don’t test it. You’ll get through it and come back strong.