Wednesday, October 28, 2009

What I've Learned About Stress Fractures

I've been fortunate enough in my years running to have experienced numerous mild injuries, that were enough to gain some personal insight but not so bad that I missed much time running. As they say experience is the best teacher. It is one thing to read about an injury, another to treat numerous people with that injury, and quite another to actually have the injury yourself. When someone comes in with a tight back, sore hip, strained hamstring, or plantar fascitis, I can feel their pain.

Now that I am back running (hallelujah!), and having seemingly fully recovered from my stress fracture, I thought I would share a few new things I have learned:

1. I debated getting a pneumatic boot when the injury first happened. Even though they seem to be the standard of care, the only studies I could find said that they didn't make any difference in healing time (although this was for tibial stress fractures and mine was a metatarsal fracture.) Wanting to avoid any additional muscular atrophy, I decided to just listen to my body and go with what allowed me to get around without pain, which turned out to be a built-up, motion control running shoe I dug out of the closet. I wore these daily for 1-2 weeks until I could transition out of them.

2. In surfing around for stress fracture related info, I came across a product called the Exogen Bone Healing System, "the only bone healing device approved to accelerate fracture healing of indicated fresh fractures." I had heard of using electric currents to facilitate fracture healing, but was surprised to learn that the Exogen uses ultrasound. Ultrasound is basically a vibrational frequency, meaning that the healing effect in this case is thought to come from the mechanical stress induced by the shockwave created. When I learned this it kind of confirmed my decision not to use the boot. My thinking was that if daily ultrasound application (mechanical stress) helped bone healing, then immobilizing it in a boot would almost have the opposite effect. So long as I was putting some stress on the area by continuing to walk on it with shoes that allowed me to do so without pain, I thought I would be accomplishing relatively the same effect. The key I felt was really heeding the pain signal and resting and icing when it felt appropriate.

3. I started taking a calcium supplement (Metagenics Cal Apatite) right from the beginning. This is a higher grade form of calcium called MCHC. I remember seeing a study showing decreased healing fracture times with large doses of MCHC. Most calcium supplements consist of calcium carbonate (the same as TUMS) which don't absorb all that well. I've seen x-rays where calcium carbonate pills are floating through the intestines, undigested.

I don't know if these factors made a huge difference, but I can say that my particular fracture healed to where I could run again within 4-5 weeks, which seemed like a pretty quick turn-around time.