Tuesday, May 7, 2013

Pelvis Repair Time!

I had my first doctor's appointment with Dr. Parker this Monday.  He's an orthopedic surgeon with specialties in sports medicine and one of the few people trained (and with stellar reviews) in FAI and labral tear surgery, which is the main reason I sought this referral.  Luckily, I do not need the surgery.  Nevertheless, I'm happy I am under his care. He knows his stuff, and he seems to truly care about my recovery and understand my need to get back out there on the road.

Since then, I feel like a huge weight has been lifted. I know what the injury is, I know what the timeline is for recovery, and I know I'm on track with this recovery.

So this is my pelvis.  Apparently the white is where the bone marrow is swelling.  My doctor said they were some pretty impressive fractures.  Of course they are.  Would you expect any less of me?

Dr. Parker gave me a chart showing the different stages of healing for stress fractures in in different parts of the body.  One month post-injury in 2010, my metatarsel was almost halfway healed.  One month post injury, a pelvic stress fracture is 0% healed.  Well, no wonder that marathon hurt and I had to quit after 2 and a half miles.  At 2 months, the foot is pretty much healed, while the pelvis is only 29%.  At three months, the pelvis is still not even 70% healed.  It's a long recovery.

There are three stages to healing, and I think I'm nearing the second.  In the first stage, you have pain while sitting, standing on the injured side, and walking.  You may walk with a limp.  I did limp around for a few days, and I remember when I went to my conference in CT just three and a half weeks out from the initial injury, I couldn't sit through sessions because it was so painful.  Walking hurt.  In stage 1, swimming, pool running and cycling are encouraged to improve blood flow.  As long as you aren't limping, crutches aren't recommended because studies have shown this actually prolongs the healing time.  You graduate to stage 2 when you can walk for 10 minutes without any pain.

So really, I think I'm closer to stage 2, but my doctor is not letting me "graduate" until our appointment on June 3.  In stage 2, you begin the transition to running.  I will start physical therapy again, and use the AlterG treadmill to acclimate my body to running on a percentage of body weight.  I also will work with Heather on running form to prevent muscle imbalances and foot strike issues that probably led to this fracture in the first place.  To graduate from stage 2 (approximately 1 month) I need to be able to run 3 minutes without any payback pain.

Stage 3 is pretty much the "Couch to 5K" program.  It's a 4 week program to get to 30 minutes of pain free running.  At this point, the pelvis isn't completely healed, but it's getting there (it may take an entire year til the fracture no longer shows up on MRI) and can handle the transition to land running.  So hopefully this will happen in July.

Then the literature says very clearly "Any runner with severe hip and groin pain should immediately be put on crutches until an MRI or Xrays can rule out a pelvic or femoral neck stress fracture.  Femoral neck fractures especially can cause long term damage and need to be treated seriously."

Hmmmph.  I told both my PCP and my first ortho that I had severe hip and groin pain.  Hmmphh again.

This is definitely the biggest running setback I've ever had.  But it could have been worse.  FAI or labral tear would have put me back to square one and required an even longer recovery time and more PT.  Really, even though this totally stinks, since getting the diagnosis I feel like a huge weight has been lifted off my shoulders.

So my May looks like a lot of swimming, pool running, strength and cycling.  Not too shabby.  I'll get through this, and I'm going to use the time to work on some of my tri weaknesses.

Life is good.


  1. Take care!! I'm glad you don't need surgery, but it still must be pretty scary all the same!

  2. Good luck to you! I have well had a fractured pelvis and the doctor says I am completely healed but I am still in pain and I don't understand why.

    1. Melanie - Are you still having pain? My doctor said it can be 8-12 months before the bone is completely remolded, and there is scar tissue/ nerve inflammation that can case an ache, but it isn't the fracture. People who have had the injury tell me that ache can last up to 18 months post fracture.

  3. This was really interesting for me. My doctor does not want me to even attempt to run until I have had 2-3 weeks of ZERO pain. I can definitely already walk 10 minutes with no issues and I think I could probably run 3 minutes with no issues as well. Harumph! For me this is tough because I wasn't in that much pain to begin with. I could always hop on one foot with no issues and it mainly always felt as a tightness in my adductor/groin. I wish I had more pain symptoms in day to day life so I could monitor it better. I feel as if I don't know if my pain has improved until I can try to run which I am not supposed to do.

    1. My doctor was very much "If it doesn't hurt, you are probably okay." He was very supportive and I probably wouldn't have stayed with him otherwise. At my first appointment, of course, he told me not to run at all but wasn't against me swimming and riding however much I wanted as long as it wasn't causing pain. So the first month, it DID hurt, and I monitored myself and didn't do much. After that I built up to some pretty long rides and swims with no issues. After my second appointment, when he could see bone callus but still see the fracture line, he gave me permission to do the AlterG based on what I could tolerate, under the guidance of my very awesome PT. When I could handle 85% body weight without pain, I think we knew it was a good sign. The x-rays were good and he told I could run - not to build mileage aggressively, and basically to let pain be my guide. If I go out for 5 miles and it is starting to hurt, it's probably time to stop at 5 miles. Right now my biggest issue is actually muscular endurance - I don't have it right now. So while 8 miles used to be my shortest run of the week, it isn't something I can do continuously right now. I'm of course eager to get back into everything but trying to be good... rest day today!