Injuries. They are every runner’s worst fear and one that, unfortunately, will come true for everyone at some point. Since starting to run in January 2008, I’ve suffered shin splints, plantar’s fasciitis, achilles tendonitis, and a mysterious hip injury. It may seem like a lot, but I have actually remained healthier than many runners. A blogger at Robertson Training Systems conducted a literature review to gain an estimate as to how many runners are injured at any one time. His cursory research of revealed that roughly 45-65% of runners are injured at any one time, with more than half of runners experiencing at least one injury a year.
As I mentioned a few days ago, I have not been running for the past month due to what I thought was an ankle sprain. Indeed, an ER trip a week after the injury, and a follow-up ortho appointment a week later, could find nothing on my X-rays to suggest that it was anything else. However, after a month of excruciating pain that has not decreased, I decided to seek out a second opinion. I’m glad that I did. Yesterday, I learned that my ‘simple sprain’ is, in fact, a stress fracture of the fibula. This is one of the less common injuries among runners since the fibula is a non-weight-bearing bone. (Tibial stress fractures are much more common.) On the down side, this means that it is going to take longer for the bone to heal. And if I am, as my doctor put it, ‘stupid’ about my recovery, then I may end up in an walking boot for a few months. Having spent the spring of my sophomore year of high school in an aircast, I can honestly say that I am eager to avoid one at all costs. After all, I’ve got some graduation photos to take in a little over a week. I try to avoid any tendency towards vanity but I believe this is a special circumstance. How many times in my life am I going to graduate with my master’s degree?
Despite the fact that I am not going to be running for at least another , I can rest in the satisfaction that it was probably not my running that actually caused my injury. Fibular stress fractures are usually caused by repetitive twisting motions so the blame for this injury falls on my zumba classes, TurboJam, and the way that I get into my car.
What is a stress fracture? To learn more, I consulted OrthoInfo.
A stress fracture is an overuse injury. It occurs when muscles become fatigued and are unable to absorb added shock. Eventually, the fatigued muscle transfers the overload of stress to the bone causing a tiny crack called a stress fracture.
Symptoms
Stress fractures are tricky because they tend to mimic other injuries. In the foot, it may me mistaken for a broken bone (typically the metatarsals), or tendonitis. In the ankle/leg, it can be confused with an ankle sprain (as mine was). Typically the most common symptoms are intense pain while performing the activity, minimal swelling, tenderness to touch, and prolonged pain for more than a week.
Treatment
The most important treatment is rest. Individuals need to rest from the activity that caused the stress fracture, and engage in a pain-free activity during the six to eight weeks it takes most stress fractures to heal. If the activity that caused the stress fracture is resumed too quickly, larger, harder-to-heal stress fractures can develop. Re-injury also could lead to chronic problems where the stress fracture might never heal properly. In addition to rest, shoe inserts or braces may be used to help these injuries heal.
Exercising during Recovery
As mentioned above, continuing to run/play soccer/zumba/whatever-caused-the-stress-fracture-in-the-first-place while in the recovery phase is not advised. At the very least you can prolong your recovery time. In the worst case scenario, you could permanently injure the bone, preventing you from ever comfortably being able to run again. However, this does not mean that you have to forgo all exercise. Indeed, maintaining a low-impact exercise routine will not only diminish emotional distress caused by the injury but will help you regain total fitness once the injury has healed.
Since most stress fractures are caused by repetitive high-impact activity, things like running and aerobics are out of the question. Replace running with aqua jogging, cycling, swimming, and using the elliptical (if your doctor OKs it. Specific injuries may rule this out.). At the first sign of pain either reduce the intensity of the activity or stop.
Prevention
1. Cross-train. Runners as a group tend to be reluctant to stray too far from running as their main form of exercise, often to their detriment. Running works certain muscles but allows others to go underused. For maximum fitness, it is suggested that you replace at least one day of running each week with a different activity. Cycling, swimming, zumba, yoga…all are good choices. Runner’s World has published an excellent series of articles on this very topic.
2. Strength train.As with cross-training, strength training tends to be neglected by runners. Running makes muscles, especially the leg muscles, strong, but it also exposes muscular weaknesses. Weak glutes, for example, can cause knee and ankle injuries. A weak core often leads to poor running form. Incorporating strength training into your regular workout routine can improve your running, prevent injuries, and increase your overall health.
3. Increase mileage/training slowly. The traditional rule is no more than 10% per week. So if your weekly total mileage is 20 miles, the next week increase your mileage by two miles. It is all suggested that you take a ‘step back’ every 4 weeks or so.
4. Do not ignore warning signs. Pain is the body’s way of telling us that something is wrong. Learning the difference between a dull ache (such as that accompanying a sprinting workout) from a sharp stab is of the vital importance. A sharp stab of pain or pain that persists even after walking or icing is usually an indication that something is wrong. If the pain occurs during a run, stop for a second to walk it out and evaluate the situation. If it occurs later, R.I.C.E. it (Rest, Ice, Compress, Elevate). Prompt action may mean the difference between one day off and a month.
5. Make sure that your running shoes are not too old. Worn out running shoes often tend to be the culprit behind minor injuries. The experts recommend replacing your shoes every 500 miles or so. (There are loads of articles debating this online). I tend to replace mine every 4-5 months.
