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.