I used Precision Diagnostic Imaging in Medina. They got me an appointment within one week of calling them and I only waited 15 minutes to be taken back for imaging. I wasn't prepared for the half hour to 40 minutes in the machine as all the images were being taken. Or for the intense magnetic tingling in my leg! The stress site even started hurting from the vibrating. They shipped the images off to a radiologist and Dr. Leo had the report by that evening.
Here are a few of the images:
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| Dark area is the stress site. |
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| More contrast. |
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| Cross section. |
Week 1:
22.59 mile long run in 3 hours. This was a "time on feet" long run at an easy pace. At 10 miles my right leg collapsed. I thought it was strange but I didn't fall, didn't stop and ran 12 more miles on concrete.
Monday morning to Tuesday night - stepped out of bed and realized something was very wrong. Hurt to walk, pin-point pain, visible bruising, slight swelling, hot to the touch. Swam instead of ran. I didn't dare run. Aqua jogged and swam on Tuesday. By Tuesday night I knew it was a stress fracture. It was throbbing constantly by this point.
Wednesday - already had an appointment scheduled with Dr. Leo so I limped in and got the official diagnosis of tibial stress fracture. He tried the tuning fork test and I nearly jumped off the table. Also did cold laser treatment and Game Ready ice sleeve. It was really hurting by the end of this day and I only got through practice with borrowed crutches.
Thursday-Sunday - crutches Thursday and Friday as much as I could stand. Found out on Friday that biking was a no go. Awful pain Friday evening from the bike. In a boot starting Saturday. Pain levels diminished daily from the time I got in the boot.
Nutrition: Started on a strict supplement plan with 1700 mg of absorbable Calcium, 5200 IU of vitamin D, 1000 mcg of B-12 and 100 MCG of Vitamin K2. I also started tracking my caloric intake to make sure I did not pile on 10-15 pounds with the drastic drop in exercise. My body seemed to adjust seamlessly to the reduced training and within a couple of weeks I stopped worrying about gaining weight.
Week 2:
Monday-Thursday - leg continued to heal while in boot and the "big blur of swimming soreness" began. Suddenly jumping into thousands of yards of swimming a week is a shock to the upper body, especially with the form issues that I have. I attended practice on Thursday and committed to going back to practice every week to work on my technique with the coaches. Tried biking again Wednesday and again it hurt me.
Friday-Sunday - More swimming, aqua jogging and core. I had my first 90 minute pool session on Sunday. After the workout I laid on the deck, aching and famished and feeling like I couldn't even make the short way back to home without calories. I logged 8000y of freestyle this week and 7.5 hours of cardio total. I struggled with energy levels at the end of this week and that trend would continue. Swimming is hard!
Week 3:
Monday - first experience on the alter g. Five miles in 37 minutes. I kept it at 40% for this session but severely suppinated the entire run. I was afraid to run and tense. Double workout at the pool in the evening. First full day out of the boot, round 1.
Tuesday-Wednesday - monster swimming yardage. Felt like I needed to keep the boot on so I did. This was the first week that I felt like healing stalled. I think the main factor was refusing to compromise on exercise minutes as I was transitioning out of the boot.
Thursday - on the alter g again. More pain at 40% than on Monday but I was off Ibuprofin for the first time. The boot started causing ankle issues and I worked hard to transition out of it.
Friday-Sunday - Went back in the boot Friday to get through work and practice and the meet on Saturday. On Sunday I biked next to Amanda for 12 miles while she did her long run and at one point I turned sharply to avoid running into her on a turn and fell of the bike onto my shin. It didn't break and I was encouraged by this. By this point I walked around on egg shells afraid that at any moment my tibia might snap.
Week 4:
Log entry on why I stress fractured:
"Saucony Zealot 3s - too wide and loose, movement all over the place every run, re-tying them half way through but didn't fix it. Probably led to...
Achillies tendonitis - both left and right but worse in the left...limped the first 5 minutes of nearly every run in July and August. For sure compensated during this entire training cycle.
Swift rise in volume and intensity in August - averaged 45 miles a week in July, more like 75 in August. So stupid in hindsight but I pushed Becki's mileage and paces way over the top. I was determined to perform well at Akron. I'll never make this mistake again. Marathon training needs a three month buildup.
Concrete training - pretty sure I'll never run on concrete again.
Fixes: I threw away my Zealot 3s and bought Brooks Ghost 10s. When I start running again it will be on grass. I may never go back to 7 days a week of running but I'll play that by ear."
Monday-Friday - I bought the week on the alter g, which is a great deal but it was a mistake on my part. I didn't need the temptation of unlimited running placed in my lap. I logged 25 miles on the alter g on Monday, Wednesday, Thursday and Friday and did double workouts in the pool.
Saturday - I finally gave in and got an x-ray after being in pain all Friday night and Saturday morning. The image showed a possible stress injury on the distal tibia with a linear line of calcification, signalling healing. Massive weekly exercise totals of: 8 hours 35 minutes of cardio, 2000y of aqua jogging, 8,900y of swimming, 25 miles on the alter g.
Week 5:
Monday-Tuesday - started incorporating more low impact with biking and walking. None of it was completely pain free. The only thing that was pain free was swimming.
Wednesday - alter g again and I got impatient with the ease of the workout and went way too fast. 6 miles at a 6:40 average. Frustrated that I had to keep it at 45 percent still.
Thursday-Sunday - More low impact incorporating, including rock climbing on Friday night and a long, fast bike on Saturday. I was feeling so good by Sunday that I jogged around the course at my kid's cross country meet. This was the beginning of the serious set backs. Running on it was not wise.
Week 6:
Monday-Thursday - I paid for my indulgent jogs with pain for most of the week. Despite this, I hiked on Tuesday, jogged at 100% on the alter g on Thursday and hiked the Buckeye Trail loop in Peninsula. By Thursday night at the conference meet my shin was throbbing but I had no choice but to walk at least three more miles on it getting around the course.
Friday-Sunday - hit 100 minutes in the pool for the first time! Epic levels of exhaustion were setting in with all the pool hours. Despite warning signs from my shin I jogged more on Saturday to get back to my house on time after a hike and then figure skated for the first time in 12 years for 1.5 hours. I had to sit and do nothing Saturday night because I couldn't put weight on it at all. As I got to the six week mark I started feeling discouraged. I think part of the reason I was pushing the activity level was because I couldn't mentally face more weeks of incessant cross training.
Week 7:
Monday-Tuesday - a full hour on the elliptical on Monday then an attempt at a run/walk on Tuesday that left me hobbled. I took the rest of the week off cardio to get my head on straight and get the pain under control. By Sunday I was mostly pain-free and ready to face another week of intense cross training.
Week 8:
Monday-Thursday - No more messing around with hiking or walking or test jogs. I would say I started behaving like a proper stress fracture patient starting this week. Pool on Monday, stationary bike on Tuesday (that hurt my shin), pool on Wednesday, swim practice Thursday. The last of my running fitness started to fade this week and I wasn't sad to feel it go. I started embracing swimming and the fact that I was mastering another sport.
Friday-Sunday - Swam again on Friday. Out of nowhere, my shin started hurting on Saturday. I swam again on Sunday after the pain went away but I ruled out running for the coming week.
Weekly totals: 11,100y of freestyle, 2600y of aquajogging, 14.4 miles of stationary bike, 7 hours, 20 minutes of cardio
Week 9:
Monday - first run at 70% on the alter g. I only did three miles with a new approach to limit my introduction to low impact. No hour-long sessions! Leg was stinging and tingly that night but not painful. I took the kids to the pool and refused to set my right leg down as I leaned against the edge of the pool, not because of pain but because of the stinging. Also swam 1900y. That's nothing these days!
Tuesday-Sunday - lifted heavy on Tuesday and biked long on Wednesday, which led to some pain the rest of the week. I found that lifting before swimming killed me and the weight bearing was too much. Shin hurt all day Thursday and I started feeling resigned to it. But it got worse by Friday morning after a sleepless night of throbbing. I cancelled my alter g appointment and put the boot back on. I was pain-free in the boot by Sunday. I started working on my butterfly stroke and got excited about swimming all over again.
Weekly totals: 10,950y of freestyle, 2000y of aqua jogging, 3 miles on alter g, 14.5 miles on stationary bike, 7 hours 30 minutes of cardio
Week 10:
Monday-Sunday - started practicing starts out of the blocks and began pushing off the wall with both legs to prepare for a swim meet later in the month. This produced very little pain, much to my relief. I also started doing intervals with aqua jogging. My attitude is not good towards these. I reached 1:45 in the pool for the first time but all these hours in the pool began to take a toll on my skin. I developed a chlorine sensitivity by the end of this week. On Sunday night I hived up and couldn't get it to go down. The boot also started hurting me by the end of the week.
Weekly totals: 12,750y of swimming, 2,635y of aqua jogging, 6 hours, 55 minutes of cardio
Week 11:
Monday - first run at 100% on the alter g! Three miles at 8:00 pace. I had no issues with this run or from it later in the day. If only I had been satisfied with this for the week! Dr. Leo tried the tuning fork test and there was only slight tenderness on the site. He did find that the bone felt "spongy" on the site. Of course I swam that night. There's no doubt about it, I am a compulsive exerciser.
Tuesday-Friday - Swim practice on Tuesday left me in hives over 80 percent of my body and I knew I couldn't go back for a few days. So I jogged 1 mile on Tuesday and finished on the elliptical. The elliptical hurt my shin. But I jogged two more miles on Thursday and stubbornly hiked 5 miles on Friday to mark the BBA50k course. I was in agony by Friday night. Unable to put weight on my right leg. I sat around my house and willed myself not to take Ibuprofin because it restricts bone growth.
Saturday-Sunday - on crutches for most of these two days. Level of pain was an intermittent 5-6, at least a 3 all the time. I had to work a lot and got by at the store with crutches.
Week 12:
Monday - back to the pool and my skin and shin dealt with it! Only using one crutch as needed.
Tuesday - pilates and boxing but keeping cardio to 45 minutes or less.
Wednesday - 45 minutes in the pool. Shin has fresh bruising from running last week.
Thursday - off
Friday - my first swim meet with the Medina Masters Swim Club. Let the personal best chasing begin!
Saturday - off
Sunday - tried to get to an hour in the pool but energy levels tanked by 50 minutes. Dragged myself home to get some calories and a nap.
Week 13:
Monday - 1 hour of pilates that kicked my ass. First pain-free day!
Tuesday - most difficult swim practice so far. 3200y, including my first completed IM (individual medley: fly, back, breast, free), 50y sprints off the blocks. Day 2 pain free.
Wednesday - MRI!!! Did another hour of pilates that hurt my shin. Are you sure it's just a stress reaction?
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| Official diagnosis. |
Don't worry about gaining weight. Your body will adjust to the new activities. I started this injury at 107 pounds and I am currently 107 pounds! After the first few weeks of worrying, I realized I was not going to gain weight and quit counting calories.
Don't give up on the supplements. The absorption rate is low but you're still getting extra calcium and vitamin D by taking them.
Find another low or zero impact sport that you can develop a passion for and enjoy. For me it is swimming but other options would be yoga, boxing (support one leg) and pilates.
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