Wednesday, May 1, 2013

And the verdict is....


Yes, you read that right.  There's an "s" at the end.  Plural.  That photo over there?  That's what my pelvis looks like, except the fractures are on my right side.

In retrospect, the February streak was probably not the best idea.  I decided that I was going to run every day that month without a break.  I ran every single day in February.  And on February 28, following my 4 mile run, I was limping.    Guess I got a break.  Or two.

Apparently this is a very low-risk injury, and accounts for less than 1% of stress fractures in athletes.  Both my PT and my sports injury chiropractor have never treated anyone for fractures in the pubis ramus bone.  I am delighted to give them that experience of not just one, but multiple pubis ramus fractures.  According to my best friend GOOGLE, here are the risk factors:

Pelvic stress fractures seem to predominately affect females.   BOOYAH!

Bennell et al8 found pelvic stress fractures only in female track and field athletes, mostly mid-distance and long-distance runners.   BOOYAH!

Participants in this study had an average BMI of 21.  I'm 5'5'' and weigh 125.  BMI - exactly 21.  Hmmm....

and were running 40 to 53 km/wk (25-33 miles/wk).   I was running 70.  I guess  that might up that risk factor.

In both collegiate and military studies, a history of amenorrhea has been found to be a risk factor for stress fractures in general.   This is a big ????.  TMI perhaps, but for you ladies, DOLMP was 9/9/2010.  Yeah, that was pre-Jack.  But, I'm also taking preventative measures to stop at two children, AKA Mirena. So again, a big ???.

This may be due to direct effect of decreased estrogen on bone and subsequently low bone mineral density.  Last stress fracture, incurred in 2010 during winter marathon training -- diagnosed on March 18, so pretty much exactly the same time -- revealed osteopenia, AKA very low bone density.

A history of previous stress fractures may also be a risk factor in the development of recurrent episodes.  Did I mention I had a stress fracture in 2010?

I had a long talk with my PT today.  We concluded that perhaps 5 weeks where I barely got four hours of sleep in order to make sure I got in my 70 miles a week, while completely giving up strength training, was probably not the best plan.  I trained smart in the fall.  I trained stupid in the winter.

In the fall, I followed the Pfitz 12 week/ 70 miles per week plan to a T. Yes, there were 70 miles a week involved, but I also had a rest day in there, two strength sessions a week, and only one day of speedwork.  Most of the runs were done at an easy pace.  I ran my fastest races ever last fall, and qualified for Boston.  The Pfitz plan has my utmost respect.

In the winter, I got this crazy idea that I could do two speed sessions a week, run every single day (my idea was that not taking a day off would allow me to do less miles on a given day, as long as it all added up to 70), throw in a ten mile "tune up" race after I'd already run 60 miles that week, and totally give up strength training....

Lesson learned.  Self:  Do not think you know how to train better than someone who wrote the book on how to train.  You don't.

I meet with my new ortho, who is a hip specialist, on Monday so we'll see what he has to say.  Treatment could be some time on crutches, perhaps some time of complete rest, perhaps I've healed enough that I can continue to walk around and swim and bike...

For now, I'm popping vitamin D and calcium citrate like it's candy, drinking my milk, and trying to get more sleep.

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