"I've been diagnosed with a stress fracture... Now What?"

Brace yourselves because this blog isn’t going to talk about specific exercises or rehab progressions. If you are fresh off a stress fracture/reaction diagnosis that’s probably what you are looking for… Some way to miraculously speed up healing or keep your fitness. Heck, I bet you are even willing to swim at this point. But that may not be what your body needs right now. Your body is telling you that the bone needs a break. So… I’m going to provide some non-exercise ideas of things you can do that will have a positive effect on your healing.

 
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1) Lemons into lemonade

In Matt Fitzgerald’s book the comeback quotient, he talks about how accepting the hand you’ve been dealt preserves your ability to make choices. It puts you in the driver’s seat. He uses the cliche of “if life gives you lemons…”. If you’re stuck wishing you got oranges you’ll never get on to making the lemonade.

I get it… getting this news can be really hard and it’s normal to be upset about it. Running is a huge part of people’s lives and it’s a huge part of mine. The times I have been sidelined from running were rough. I specifically remember a nagging IT band injury many years back. I kept trying to train through it and was ultimately in denial of my situation. It wasn’t until I accepted my “lemons” that I got control and things started to trend better. I’m not saying this will be easy, but it’s a critical first step.

2) Reframe your situation

This isn’t the end of your running. In fact, you're actually in good company. There is a long list of my patients that have recovered from these injuries and have gone on to be a better/healthier runners than they were before. We can also look at the pro level for several examples. One would be Emily Infeld’s story. She had x2 sacral stress fractures in 2 years but then went on to win bronze at the 2015 IAAF World Championships 10,000 meters. This injury is just a chapter in the larger narrative of your running story. Maybe it’s even setting up a chapter of epic victory.

3) Broaden your identity

Hi I’m Steve, I’m a runner. I’m also a husband, dad, business owner, dog lover, amateur pitmaster… you get the idea. What else do you like to do besides running? Dig deep, I know there is something else there. Maybe you enjoy cooking big breakfasts on Saturday mornings but never do because you usually wake up early for a long run. Or maybe you like to read books about wizards and dragons. What about that home project you have been putting off? What did you do before you liked to run? Broadening your identity as more than just a runner makes temporary the loss of running a little less painful. Don’t forget to stay connected with your running friends, you can still hang out if you’re not running :)

4) Set the right timeframe expectations

Bone healing takes time, there are no shortcuts here. Being patient upfront saves you time in the end. Talk with your healthcare provider to understand the timeframe expectations for your specific injury. Here are some general timeframes below.

  • Return to run timeframe for bone stress injuries. (Not necessarily return to 100% training)

  • Low-risk site: as early as 8 weeks

  • High-risk site: up to 5.5 months

  • *Keep in mind the specific bone, as well as the severity, dictates the specific timeframe. See this blog to read about the different high, low, and medium risk sites and the grades of severity.

5) Focus on another aspect of your wellness

Focus on what you can control. Fuel well, prioritize sleep, mitigate stress with breathing techniques, talk to a therapist for your mental health. There are plenty of things that make your wellness that you can have a positive impact on. Improving these will improve your ability to heal and adapt. They also could have played a role in your bone stress injury so now is the time to address them. Seek help here, don’t go in it alone. Find a nutritionist or a mental health professional, or physician to help you.

6) Maintain what you can safely

Ok… I’m gonna talk about exercise a little bit. There are situations when you can maintain some fitness via cross-training. This largely depends on the location and severity of the stress reaction/fracture. If your healthcare provider determines there are some safe exercises that you can do great, use those to maintain your fitness. Just don’t make the mistake of over cross-training and further delaying the healing process. Remember that too much too soon is part of what got you into this situation.

I hope this helps and feel free to send this to someone that may need to read it. As always reach out if I can be a resource to you on your injury journey.

Steve White, PT, DPT, OCS, CSCS

Steve White