Wednesday, December 14, 2011

Stress Fracture Re-hab Program

Pictured above is me, the shortest girl on the right hand side, celebrating my first win of the year. It was special to me because I had trained the 3 other runners, Renae, Mia and Lesley to complete their first Ultra, 50km Coastrek March 2011. I was also celebrating because I was able to run 50km pain free, and I had recovered from my stress fracture injuries.

In August 2010, I suffered stress fractures after running on concrete in shoes without enough cushioning in them. I broke both of my feet running 14km, the City2Surf in racing flats. It was a rookie error, and I paid for it badly. I did not seek advice, kept the injury to myself. I then ran Oxfam TW 2 weeks later, knowing that at least one of my metatarsals was broken. When I finished my first ever 100km event, I took myself off to the emergency ward to be x-rayed and to obtain crutches. This was the start of my healing process.
I'd suffered stress fractured in both of my 2nd Metatarsals as well as my 3rd, 5th Metatarsal in my left foot.
I almost shattered my heal on my right foot, and I was really lucky not to have totally crippled myself.

This is what I did to heal my fractured feet

Rest, I was on crutches for 8 weeks. I was given a boot as my left foot was the more injured out of the 2 feet, however both of my feet were broken, so I had to stay off both of them. I also found that my foot was more inflamed after wearing the boot. I later discovered that I had another stress fracture in my 5th metatarsal, the boot hurt that section of my foot . I also found it better to stay symmetrical on my body. I had the worse lower back pain from wearing the boot, as the height of the sole put un necessary stress on my disc in my lower spine. So I stayed on crutches for 8 weeks.

Ice. I would fill a container with about 2 inches of cold water, then empty 1-2 ice trays in to the container.
I would ice my feet regularly throughout the day like this for 20-30min at a time.  I iced my feet as soon as I got in my house, and before I went out on my feet. I would sit down on the computer and work, eat my breakfast, lunch and dinner with my foot in a container of ice and water. This made a huge difference. I continued to ice my foot regularly for up to 6 months after I had my initial injury. When ever my foot was inflamed it went into a container of ice and water.

Ultra Sound. I discovered the Stress Fracture Clinic in St Leonards. I became part of a free test trial of the Ultra Sound device. I used an Ultra Sound on all my stress fractures, or hot spots on my feet, for 4 weeks. I received free MRI's as part of the study and I was assigned a specialist to look after me for free as part of the study. Here is the link to their website. 

Pain Threshold. With any of the exercises that I am suggesting, you must work within your pain threshold. So if it hurts your injury, stop and change what you are doing, find something that you can do that does not give you pain. You will only extent the healing process if you work through your pain. This is what worked for me, it may not work for you, but it will give you an idea of how to rehab your injury.

Deep Water Running.
After a week of immobility, I was in so much pain in my lower back. 
So to get me moving again safely I jumped in the pool and started deep water running.
The deep water running helped to keep me fit, but also helped with the swelling in my feet, and relieve any pain that I was starting to suffer from being unbalanced.
My left foot was so bad, that I had to run in Deep Water for 4 weeks. I found shallow water running painful right through the rehab stage, so I stuck to deep water running. Usually you would be able to shallow water run, but my 2nd metatarsals were really bad.

After about 4 weeks of deep water running, I was able to move to a bike, with low resistance. I slowly built the resistance up as I could take more weight on my feet. I also worked out techniques to push with my legs and not with the balls of my feet, so I did not inflame my injuries. I still got a great work out but I did not use my injured area.

Stair Machine
At 8 weeks mark I was able to hop on a stair machine. I had to be careful at first as my 2nd Metatarsal was still inflamed at times.  I started on a low resistance and slowly built it up. I would swop from the bike to the stairs, to the bike, rowing machine and back again. Again when I felt any pain I would just stop and get back on the bike and wait a few days, or a week then try the stair machine again.

Rowing Machine
At about the 8 week mark I was able to row. This was great, again I had to watch the amount to pressure I put through my 2nd Metatarsal, but I was building my cardio and strength back up again, and I was starting to be able to build up my time in the gym also.

My team mates were out on the track completing 3-4 hour sessions. I tried my hardest to spend the same amount of time in the gym, as they were spending on the track, it was boring there is nothing like being out on a trail, but I had to do it. So I would complete 1 hour on the bike with a hard resistance on random with my RPM at 100. Then jump on the stair machine for 30 minutes to an hour, then hop on the rowing machine, the repeat.
I found that with my injury, I could not use the cross trainer, as it hurt my injuries. I stuck to the machines that did not hurt.

I started running again, after 8 weeks, and it was too soon. I am a personal trainer, so I was running around with clients before I was fully healed. I ended up re-injuring my 5th Metatarsal again. My job, that was mainly on concrete, was injuring me. I then had to stop running for 4 weeks, jump back on the bike, stair and rowing machine and wait for my feet to fully heal. 
I completed my first long run in Mid- January, Explorers Tree to Cox's River return 30km on a trail. 
I then ran the Megalong Mega 36km on a trail. I found that if I stuck to soft ground I could run without pain.
I then won Coastrek 50km Trail Team Event March 6th, and the week later I managed a PB of 8 minutes in the 6 Foot Track 45km Trail Run, nabbing a top 10 position of 9th. 
I found that every time I tried to run fast on the road, it inflamed my injuries. 
So I did all my speed work, which was very little I completed on an oval. I found that when ever I ran  intervals I inflamed my injury, so to get me through the races with PB's I had to use my new found climbing skills that I had built in the gym on the stair, rowing and bike machine.
I found that I could run 50km, 100km on the trail and not aggravate my stress fractures. So I was able to complete my first solo 100km The North Face 100km, in a time of 12 hours 50 Minutes and manage a 6th place.
It took me almost a full year to be able to run on the road again at full pace. 
I have been able to complete a full calendar of running, starting with Coastrek 50km 1st March, then 6 Foot Track 9th March, TNF 100 6th May, The Great Nosh 15km 1st June, Woodford to Glenbrook 4th 25km July, City2Surf 14km(with the flu only just making under the 60min) August, Oxfam TW  100km 8th August, Coastal Classic 29km September, Fitzroy Falls Marathon 2nd October, GNW100km 1st November. 
I am about to run the Glenbrook Marathon. I am fully healed, and I have not even been running fully for a year. I have achieved so much, especially with my injuries in mind. My hamstrings hurt, my feet don't.


  1. The back pain you had while wearing the fracture boot is common. An Evenup shoelift would have prevented it. Sorry its too late to help you but maybe this information will help someone else.

  2. Thanks for your inspiration. I have my first stress fracture; the proximal end of the 2nd MT. I'm 7 weeks down the road and the healing process is not going as well as hoped. I've found an exogen though and I've started using that daily. I desparately want to get back to running and move into ultra running so you're website has really helped me in times of doubt as to whether I'm ever going to be able to run again. Thank you. It will be a long road but I don't care....I'l get there

  3. Thank you for the great information. I am hoping to heal a 5th metatarsal stress fracture in time to run a 100 miler in 6 weeks. The problem is I am still needed to build fitness. I will be biking and pool running but I really enjoy lap swimming. I have not seen anything for or against that and wondering if you also swam laps or if that is to much for stress fractures? Thanks

  4. And congrats on coming back from multiple injuries and winning races! That is inspiring.

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