Bone Stress Injuries
/10 Things I Think About Bone Stress Injuries
1. Air Crash Investigation
I think that running injuries are a lot like plane crashes. It takes a number of things to go wrong before one will happen. In my case it involved a pine cone, a fall, a bad cut on a knee, a refusal to take a few weeks off to let the cut heal and trying to run enough mileage to run a marathon. Remove one of those things and there is a good chance that I’d have run 2:32 in Dublin and 2:22 in Valencia. Instead, I have spent the last 7 weeks staring at a screen while cycling a bike and handing out bottles at a marathon.
2. Six to Eight Weeks
I think that the four most feared words in running are “6 to 8 weeks”. This is the answer any physio or doctor will give you to the question how long will it take for my injury to get better? 6 to 8 weeks is actually medical code for “I haven’t a clue, but most minor things get better in two months, go away and leave me alone and don’t be coming in every week looking for some magical treatment that will make it better”. 6 to 8 weeks is scarily accurate with stress fractures of the fibula and metatarsals I have found.
3. Grumpy Old Men
I think that when you get injured you will encounter three main types of people, those that don’t care that you are injured, those that feel sorry for you and those that are genuinely delighted that what they have been predicting for the last two years has finally happened. Talking to either of these three types of people will annoy you, the only type of person that you will be able to talk to without getting angry is another injured runner.
4. The Injury Formerly Known as a Stress Fracture
I think that I will still call my injury a stress fracture rather than a bone stress response in the right fibula. It sounds more dramatic and satisfies the grumpy old men who will be delighted by the words stress fracture. Because of past experience I knew what the start of a stress fracture feels like so I stopped running the week before Dublin Marathon and got an MRI before an actual fracture line developed like would have happened when I was 23 and completely mad.
5. The Protocol
I think that I could sell my stress fracture protocol at this stage. The protocol involves two weeks of nothing, no running, no cross training nothing. Then after two weeks I start Zwift or the cross trainer for an hour a day after four weeks add in a weekly run on the Alter G with some hopping and then after 7 or 9 weeks get back to a small bit of running. It’s a depressingly tried and tested protocol. Bones need loading to heal.
6. Cross Training
I think that it should be illegal to do any more than an hour of cross training. The cross trainer at the gym should alarm and stop if you try go over an hour and people in white coats should arrive to take you away to the injured runners asylum. There are few things as pointless as a cross trainer, at least on Zwift the man on the bike on the screen is cycling around an imaginary island which almost makes it feel worthwhile. All cross training must be logged to Strava, the only social media platform that can be used during injury.
7. Another Week
I think that the best way to cope with an injury is to take it week by week. “How’s the injury?”, “Grand, I should be back in another week or two”. It works even if you know it’s a lie, a week is manageable. 6 to 8 weeks seems too long, it couldn’t possibly take 6 to 8 weeks could it. Saying another week 6 to 8 weeks in a row is much easier on the head. As it gets better you can graduate to “another day or two”.
8. Pain
I think that the hardest part of the injury process is the last two weeks. If I hadn’t experienced countless stress fractures, I’d probably go back running after 4 weeks when the crippling pain was slightly gone but I now know that it’s best to wait for most of the pain to be gone. The pain of a stress fracture is unusual, it’s a deep nagging pain. In my case I can tell it’s all gone when I hop on it pain free for a few minutes and the leg doesn’t have a resonating sensation in it 10 minutes after the hopping.
9. Myths
I think that there are many myths when dealing with stress fractures. One of the big myths is that if you do any running on it over the course of the all-important 6 to 8 weeks the clock resets to zero. This is very untrue and is used by physios and doctors to scare runners into not running. If you have a stress fracture and a dog chases, you it is perfectly ok to run. The stress fracture will be fine, it might even feel better a few days after being chased by the dog due to the loading. Bones need loading to heal so a little hopping towards the end of the 6 to 8 weeks will speed things up.
10. The Fear
I think that once the injury is over it takes around 6 months for the fear to recede. For those 6 months every niggle will be a stress fracture, every ache another 6 to 8 weeks, every run a potential injury. Then gradually the madness will return, the fear will recede, and you’ll wonder how does anyone ever get injured before the confluence of events will occur again resulting in another 6 to 8 weeks of social media silence which is possibly the worst side effect of any running injury.
N.B Don’t take any of this as advice, as evidenced by getting a bone stress response in my right fibula I have no idea what I am doing and most of what I think is completely wrong.
This is what i think mri reports should look likE. tHE TEXT IS FROM MY MRI REPORT.
tHE FINDING NEAR THE TOP OF THE FIBULA IS THE LAST BONE STRESS INJURY I HAD IN 2021. tHIS DOESNT HURT AND WASN’T CAUSING ANY ISSUES BUT STILL SHOWS ON THE MRI REPORT. mri REPORTS OFTEN SHOW STUFF THAT ISN’T ACTUALLY AN INJURY.
