After I had processed the report findings while sitting in radiology at Mt Sinai, I got in a taxi to pick up my x-ray records from the urgent care center on the west side. While I waited I texted a couple of friends with the news and felt a little on the verge of tears, I think I choked up a bit when one friend called me right away to see how I was doing. Even though I had tried to prepare myself for this diagnosis over the last few days, it still came as a blow. Crutches, no running, no walking even. I love to walk, so that last one really hurts.
After this first of the brief pity parties, I got home and digested the rest of the report: Oh, torn labrum too. Maybe that was what added to the terrible initial pain? This was the full list of goodies in my right hip:
- Femoral neck stress fracture: compression side
- Labral tear
- Low-grade muscle strain in the gluteus maximus
- Moderate hamstring tendonitis
- Inflammation in the area where the pubic bones join
But only the first two are worrisome. The upside: No mention of arthritis, which another friend points out is really good news. And there was nothing to indicate the need for a hip replacement either, which was one of the worst-case scenarios mentioned by others. And if a lot of the pain I experienced was coming from the tear, that might have actually saved me- with a fracture alone I may well have insisted on running until the bone broke in two. It’s not that I listened to my body and decided to drop, my body stopped listening to me, and I had no choice.
On Wednesday I was pretty excited to finally see a specialist. I think I lucked out with Dr. Bharam. He is one of the top hip doctors in town, and it also turns out he’s the one who operated on my friend Sara’s torn labrum a few years ago. What a small world. However, I was a little worried that, with him being the man to see for labral surgery, he would want to get me under the knife stat.
Again, no need for concern yet. He said it would be best to put off even thinking about labral surgery while my stress fracture heals. The femoral neck stress fracture is very serious, as there’s limited blood flow to the area, and additional stress to the can result in a full break, requiring pin surgery, or a hip replacement, and maybe no more running ever. As a result, the initial course treatment for very conservative (aka a whole lot of nothing)- I stay on crutches for another five weeks, with no cross-training at all, and then I’ll come back for a check-up and another MRI at the end of May. In the meantime I’ll have a bone density scan and see an endocrinologist for further blood work to look into potential underlying issues.
I try to maintain a positive (or at least neutral) attitude to this injury but it’s rough at times. I know, it could be much worse. Even over the last 10 days I’ve seen many positive changes: the scary pain is gone and the crutches are better than the wheelchair, just as the wheelchair was a huge improvement over no chair. I’m at home, I’m comfortable, I don’t have to go to an office or be on my feet for work, and I have a lot of love and support coming my way every day.
Still, I had no idea it was possible to develop a stress fracture in a matter of hours, and a torn labrum too. My previous understanding of fractures and labral tears was that they build up over time. Something starts bothering you, but just a little, so you run through it, and it gets progressively worse over the course of weeks or months until the body says enough and you go to the doctor and your worst fears are confirmed. So these assumptions were entirely wrong, as my doctor (and the internet) told me: people get stress fractures running 20-30 miles a week, people get stress fractures walking around and taking a wrong step. I’ll have to get over this eventually, but right now it scares the crap out of me to think that any time, on any run (especially during an ultra, when I’m geared to push through the pain) there could be another stress fracture lurking and waiting to get me: “Surprise! And FU too!”
I know I’ve been lucky to avoid major injuries so far, especially as I started becoming competitive over the last two years. In my first few years of running, I struggled with IT band issues that derailed a couple of marathons where I’d go out too fast and end up walk/running to the finish. After switching from heel striking to a mid-forefoot strike those problems seemed to go away and have never bothered me again. Everything else I’ve dealt with (hip bursitis, tight hamstrings and calf muscles, achey knees and buttocks) I’ve filed under “niggles” that have responded to treatment and adjustments in training, and my race-day performances have never been hampered by these issues.
Would it be any easier if I’d gone through a long injury process before and knew what to expect of the layoff and coming back? I don’t know, though over recent months I’ve felt a little uneasy about how important or central running was becoming to my life, because I know that I’m not young, and no matter how hard I might work at training for an planning the perfect race, what ultimately happens on race day has a lot of luck in the mix.
The next step is hard but necessary- withdrawing from all the major races on my calendar this year: Rock the Ridge, TGNY, Badwater, and Spartathlon. NYC Marathon? Still a possibility as it’s more than six months away, but I’m leaning hard towards rolling over my entry to 2016. Realistically (ie based on my research of online discussion forums), I shouldn’t expect to be running 60+ miles weeks before the end of the year. I’m setting my sights on Boston 2016 as my comeback race, and then gearing up to get back into ultras in late spring and summer. In the meantime, non-running adventures await.