For me, the hardest part of recovery wasn’t the inactivity
on crutches. Well, I won’t kid you – that part was mentally difficult. The
hardest part was the uncertainty in starting to exercise again. The docs won’t
be able to tell you what pain is normal and what is not. The aches I
experienced were concerning, but they were different than the pain associated
with the original injury and subsequent month. I had naively thought that
returning to running would be pain free, but that of course wasn’t the case. Most likely the fracture itself (and external
callus”ing”) had caused irritation of the tendons which slide over that area.
That, combined with the tightness brought on by disuse, created a recipe for
irritation. This made sense to me in late October, but in the absence of a soft
tissue diagnostic test (e.g., MRI) there was no way to know.
I trusted my orthopedic specialist, and I trusted my
instinct. I also took to heart the scary advice of others (internet posts) who
emphasized the need to be careful. I
know I am lucky. I respect that the bone takes a long time to heal. I’m not
kidding myself. Full remodeling of my bone won’t be complete until sometime in
the winter(?), I imagine. I know that aches will continue to come and go, but
hopefully as I learn to use my hip again and again, things will settle down as
before.
On November 23rd my wife and I ran a trail half
marathon in New Hampshire. Nothing fancy, and we made a point of taking it very
easy. I was injured on July 12th, and nearly 4 and a half months
later I was able to run this distance again. I may experience tightness and
aches for months, if not longer, but I feel I am coming out of the woods.
Looking back, several things:
1.
The internet is both helpful and frightening. There
are terrific sites on diagnosis of the femoral neck stress fracture. There are
also plenty of patient chat sites (e.g., runner’s world has a thread dedicated
to FNSF). The thread sites are scary, and my heart goes out to so many who had
it worse than I.
2.
Find an Orthopedic specialist you can trust, and
obey her/his advice.
3.
Do not cheat. Repeat. Do not cheat. Do not go
off crutches until you are released. Do not try to exercise until you are given
permission. This is a very serious injury.
4.
Eat well. Take vitamins. Put Elmer’s Glue in
your milk (ok, just kidding – but my friend Billy suggested this).
5.
Come back slowly but surely.
6.
Expect aches & pains - but be cautious.
7. What seemed to help during the NWB healing: Heat. I'd take a hot bath nearly every night, and I purchased a small electric heating pad.
8. What didn't seem to help: Cold (Icing did nothing). Stretching - this made everything worse.
9. Biggest difficulty: Learning to recognize the ache of the iliopsoas snap. Certain exercises seem to make this worse, particularly biking. The ache is right over the same area as the fracture site. With a certain movement, I can get the tendon to snap over, and the ache releases.
7. What seemed to help during the NWB healing: Heat. I'd take a hot bath nearly every night, and I purchased a small electric heating pad.
8. What didn't seem to help: Cold (Icing did nothing). Stretching - this made everything worse.
9. Biggest difficulty: Learning to recognize the ache of the iliopsoas snap. Certain exercises seem to make this worse, particularly biking. The ache is right over the same area as the fracture site. With a certain movement, I can get the tendon to snap over, and the ache releases.
Good luck to anyone who goes through this.
My heartfelt thanks to the staff at Harrington Hospital in Webster (particularly the orthopedic folks and the radiology folks). I felt confident each time I visited, and this helped my healing.
My heartfelt thanks to the staff at Harrington Hospital in Webster (particularly the orthopedic folks and the radiology folks). I felt confident each time I visited, and this helped my healing.
If I can help you (advice, sharing, listening), don’t
hesitate to contact me. Remember, I am not a physician. I am only a patient.
Hi there! Thanks so much for starting this blog! I should have done more research on my FNSF, I have a grade 2 compression side, happened July 4th weekend but didn't actually go to the doctors till August and was diagnosed August 23rd. I'm 29 y/o female this has been extremely difficult to deal with, along with the weight gain. I battle with depression and running has always been my "balance", so for this to be taken away, has been more than a physical battle. Just getting cleared to exercise a week ago, praying for a solid return but looks like a personal trainer might be in order. Any recommendations or advice would be amazing:) Happy New Year!
ReplyDeleteHi Caitlin - Of course I am so sorry to learn that you have been diagnosed with this. Congratulations on your graduation to returning to exercise! I know how difficult inactivity can be, and it will be tempting for you to push things. Be very careful, and make sure to obey your timeline. I felt very good (entirely pain free) when I started doing light static cycling and swimming, but my orthopedic stressed to me (actually sternly warned me) that it was critical to reintroduce exercise slowly. It's likely that your tendons (e.g., iliopsoas) have tightened from disuse on your injured side, and you might experience some inflammation when you do begin to exercise. Be mindful of aches and pains - expect some degree of protest from your body, but be very, very aware (hyper aware) of any deep and sharp pains. If you experience anything of this sort, stop immediately and go "back a week," on your clock. I still have a snapping hip problem, where my iliopsoas is just tight, and it causes an ache from time to time right over the same area of the break. I've learned now, with the benefit of months, to recognize it for what it is. Seated positions for long periods of time (e.g., a long car ride) or aggressive bending over (e.g., using a tri-bike with a trainer and extending over the aerobars) tend to make the ache worse. I've been told it is because the iliopsoas is in constant flexion, and the release to being straight (i.e., legs extended) irritates it. Still, having aches is now scary (and it may be for you). I had never gone to Physical Therapy in my life before this episode, and my orthopedic strongly recommended it. Truly, it was very beneficial, as the PT was able to target certain strengthening exercises to help bring back areas of the hip that were simply weak. Ok, enough about me ... do you have any aches?
ReplyDelete