Best way to come back from stress fracture

[Lucia]

I've read Sasha's injury prevention philosophy, Michelle's pool running advice, and got advice from others as well, but wanted to post a question to get as much information on this as possible...

I was training to run a BQ-Marine Corps in October (3:40), but was recently diagnosed with a stress fracture of my lower left tibia. My follow-up appointment with my orthopedic doctor is October 6, and he thought I could probably start to run again after that. Provided that I continue working on my aerobic condition with bicycle and pool running, how should I go about running roads again in October? Should I assume all the work I had done this far is gone and start from zero, or should I just pick up where I left off? How many miles per week should I run and how fast should I increase the weekly mileage?

I am wondering if I could be ready to BQ at the Philly marathon, November 23 (7 weeks from being cleared to run again), or the Las Vegas marathon, December 6 (8-9 weeks from being cleared) or if I'd be better off waiting till January and run Phoenix or Miami... I'm worried about my training in the winter here, since it can get icy and I can't run on the treadmill (really, I just can't).

As always your comments are very much appreciated!

Lucia

[Nick Miller]

Lucia -
I am really sorry to hear about you injury...boo. Being struck by this exact injury earlier this summer, I would be glad to let you know everything about my experience:)! For converience I will break this into sections.

Timeframe: I was diagnosed in early May, and began running at the end of June. I immediately took a week or two off (missed conference for track:( bummer), and put as little weight as possible on it (I used for the boot, but crutches may be even better since the boot does not fully remove weight from your leg). I began running at the end of June, close to six weeks after the initial injury. I began very slowly with small runs, and eased my way back very slowly (I was paranoid when I came back). I ONLY ran on grass where impact was as small as possible. At first it felt a bit sore, but that seemed to dissipate with time (I still feel it a bit after strenuous efforts like long runs, AT's etc...). I also have a nice calcium bump right where it used to hurt (12 weeks later), but I have heard that these can take six months or so to go away.

Cross Training: I opted for aquajogging, and it seemed to keep me in fairly good shape. Initially, I began to aquajog every other day, then gradually built to aquajogging every day (at first this made my leg ache, too). I aquajogged for a month or so, then added the elliptical as a "stepping stone" to introduce my leg to impact again. Even when I began to run again, most of my aerobic work was done in the pool. It took another three weeks before running became my main form of aerobic work. Aquajogging seemed to keep me fairly fit.

Deadline: I don't think you should lose any of the work you have done so far. If you aquajog diligently, I doubt you will lose any fitness (you may get rusty, but pool running & biking will add to your aerobic base). Running will come back fairly quickly when are healed, so I would not worry about it at this point in time. As for planning your marathon, I would not rush it. I know many runners on my team that have been out for 6+ months due to lingering fractures that never fully healed. I believe you primary objective should be getting 100%. After that, you can look at marathons and map out a plan. It is far better to delay a marathon for a few months than to create a long term injury.

Well I guess thats about it! Feel free to look at my blog to check specifics (ascension to volume etc...), but keep in mind that this may be different for every individual. Good luck! You will be back to running in no time so think +! If you have any other questions feel free to ask!

[Lucia]

Nick,

Thank you so much for your reply! I read your blog and it really helps a lot to know how you dealt with your injury. Also how cool that you met Ryan Hall and Deena Castor!

I think you're right that I need to focus on healing and cross-training for now and think about races later. But it is great to know that someone had the same issue I'm having and recovered so well.

Keep on running,

Lucia