Word From the Doc - it's Likely a Stress Fracture

Not really knowing what was wrong with my hip, I was trying everything -acupuncture, physio, chiropractor, heat, ice, various anti-inflammatories, whatever, but today the physiotherapist repeated an idea that he had had at the last meeting - that it sounds like a stress fracture. Apparently the main clues to this are that it is common in runners (more on that in a second) and that eventhough it seems to be healing, I still have trouble standing on the injured leg. The clue that would have been clinched it would be if I was woken up in the night with pain, and although that hasn't happened yet, I did get up to pee in the middle of the night last night and could barely walk.

Ugh. 

So I've done some poking around the internet today and I have to say he's got something there. It does sound an awful lot like a stress fracture.

A stress fracture is a thin crack in the bone that develops over time, due to repeated impact.  It will worsen over time and is not detectable by X-ray, at least at first, and can only be seen with an MRI or bone scan.

Stress fractures are most common in runners, more than any other injury, and especially in long distance runners. And according to e-orthopod, apparently women are 10 times more likely than men to get them.

From the same site, a bit about how it happens:

"Doctors think that putting extreme stress on the bone over and over again causes stress fractures of the hip...Bones can usually adapt to repetitive stress, and any change in the function of a bone causes it to change the way it is built...The tendons pull on these areas, and the bone adapts by building up. This is normal. But extreme stress repeated too often can overwhelm the bone's ability to adapt. This is especially true when someone suddenly begins a new, strenuous, repetitive activity such as running."

The American College of Foot and Ankle Orthopedics and Medicine also has some good information on the cause: 

The more you work out, the more impact your muscles have to absorb in order to protect your bones.  After a certain amount of time, your muscles become fatigued, and the impact gets transferred to the bone.  Repeated stress to the bone eventually results in a small crack that can become bigger and bigger (and more and more painful) if it is ignored.

So what's the cure? Apparently I am already doing it. Rest, rest and more rest. No running, not too much walking or standing,  just sitting on my ass waiting for it to get better. And I'm told it will get better - actually it already has this week - but now it's just going to be a timing game to see how long I need to rest and how much cramming I can do before the marathon without injuring it again. 

The ACFAOM also gives a word of caution that was useful to me, since I found myself in the same situation just today:

It’s natural to want to get back to your normal activities as soon as possible. Stress fractures will begin to mend relatively quickly, as long as the patient is resting the injured area. As soon as the bone starts to knit, the pain will become noticeably less aggravating.  Many people, upon discovering that their pain isn’t as severe when they stand or walk, will immediately want to do just that. Remember that as long as you can feel pain - any pain at all - the bone is still fragile in that area, and is susceptible to a repeat of the same break, in the same place...You won’t heal a fracture by adding to the stress on the bone.  That was how it broke in the first place.

So I took a cab home today and skipped the yoga class I was going to attempt. On the one hand, I feel better knowing that I have a direction to go in, some kind of idea of what might be wrong (and why), but on the hand, it's just depressing news and I'm not pleased with the diagnosis.

But I am nothing if not an optimist and I faithfully sent off my marathon registration this week anyways. I may be doing it a lot slower than I originally thought, but I'm still doing it.