The Slow (oh, so slow) Return to Running

Soon my lovelies, soon!  When runners are injured they often go one of two ways: 1) They can’t run, so therefore they try to put running totally out of their mind. They do other stuff, see some non-running friends, and generally just try to pretend they aren’t totally devastated by not being able to participate in their favorite sport. Or 2) Despite their best efforts, their brains can only seem to think about running. So they read everything they can about running, they plot their return-to-running schedule out with military precision, they live vicariously through others who are racing their fall marathons, and they may or may not purchase a few (okay, more than a few) pieces of running attire to cheer themselves up and ensure they are properly outfitted when they FINALLY get back on the roads.


Lots of fun stuff to read!

I’ve been both of those injured runners before, but I’ll give you one guess as to which camp I fell into this time.   While I am SLOWLY, SLOWLY returning to running, I can’t seem to stop the urge to remain immersed in the running culture while I’m forced to take a break.   From watching the live broadcast of the Chicago marathon to stalking some of my favorite bloggers for training updates and race recaps (Shout out to RunnerUnderPressureMsFitRunnerKrisLawrence, and JenChosesJoy!), I’ve definitely found myself with running on the brain.

This week I’m in the run/walk phase of my comeback - and I’m only running a total of 30-35 minutes at a time. It’s slow going and while my heart, legs and lungs are burning with the desire to just RUN already, I’m trying hard to be smart and ease back into it safely.   Here’s what the last week looked like:

Monday: 30 minutes of 3 min run, 1 min walk + Core class

Tuesday: Body Pump + Spin class – I was in charge of teaching the little spin “class” with my parents this week. It was so fun!

Wednesday: 30 minutes of 5 min run, 1 min walk + Core class

Thursday: Body Pump

Friday: 30 minutes of 7 min run, 1 min walk + Spin class

Saturday: 35 minutes of 7 min run, 1 min walk + elliptical

Sunday: Body Pump

The leg is feeling…okay.   A day after I posted about my awesome bone stimulator it started malfunctioning – so now it’s just me and my hopes and prayers that the leg is healed.   I was hoping to have the bone stimulator as insurance – I’d planned to use it once a day or so for a few more weeks for an extra boost of healing power. But alas, it wasn’t meant to be. I’m hoping that it’s a sign from above that this thing is healed and that I won’t need a bone stimulator again.   Let’s just go with that theory, shall we?

The running has been GREAT, but also a bit anxiety-filled. With each step I’m hyper-aware of the leg and every little twinge has me wondering, “Is it okay? Is that just the soft tissue adjusting? Should I stop? Keep running?”   I know that with stress fractures you can have phantom pains as the soft tissue and area around the fracture adjusts, but MAN, it is tough not to panic at each twinge.   Other than that, I’m feeling good, but SLOW.   I know it’ll take me a while to build back my pace and endurance.  With all of the marathons this weekend I’m been chomping at the bit to get back out there. I’ve seen some super fast times thrown down by some speedy ladies and I’m so anxious to get back into training so that I can put in the work towards a goal of my own. It’s been so inspiring to see everyone run so well, but as an injured runner I can feel a bit disheartened at times when I think about how far I have to go to claw my way back to where I was. But I am just so happy to be back on the comeback road! I know it will take quite a while to rebuild my fitness, but I’m grateful to be able to get back to something I love.   I know I’ll get there. I just have to be patient and trust in the journey.

For now I’ll just focus on enjoying the beautiful fall weather and be thankful for each pain-free step that I’m able to run!

How was your week? Which camp of injured runner do you fall into? 

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Stress Fracture Rehab – A Bone Stimulator + Cross Training

Our music choices for spin class make it impossible not to smile!  It’s been three weeks since the bone scan where I found out that I had a stress fracture in my tibia. Thankfully we caught the fracture early enough that I wasn’t put in a boot. I’ve been able to walk around pain-free from the very start and I’ve been spending these last few weeks doing some cross training and strength training to keep my body strong and (more importantly) to keep my sanity.

To not be running each morning (especially on these perfect fall weather days) feels so alien to me. I miss my morning routine of getting up and greeting the sunrise while out on the roads, then having a few moments to myself post-run to stretch and make my post-run smoothie before my little ones wake up to start the craziness of the day.   But since I haven’t been able to run, I’ve had to find other ways to keep sane while not putting too much pressure on my leg. Here’s what I’ve been up to for the past few weeks:

Monday – I’ll hop on the elliptical for 30-40 minutes and then take my core work class. My parents live in town, so I've talked them into meeting me at the gym for the core class.  It’s been so fun to have them in class with me!

Tuesday – Body Pump and spin class. Since I haven’t been taxing my leg muscles with running, I’ve been going heavier with my weights in Body Pump for the squat and lunge tracks. It’s not running, but at least my legs feel sufficiently fatigued afterwards!   Later in the afternoon my parents meet me at the gym where we take turns “teaching” our own spin class! Since the room at the gym isn’t in use, they let us use it for our workout. It’s a blast and we have a good time trying to one-up each other with our crazy music choices!

Wednesday – Core class and either walking on the treadmill or elliptical

Thursday – Body Pump

Friday – Spin class

Saturday – Spin class and walking

Sunday – Body Pump

I’ve also been making sure I’m getting calcium and vitamin D each day – through both my diet and a supplement – and prioritizing good sleep and nutrition in an effort to give my body everything it needs to heal my leg.

My bone stimulator.  (Don't mind the bright pink compression sock)

After doing some research and reading this great post, I opted to purchase a bone stimulator off of Ebay. I’ve been using that on my leg twice a day for the last few weeks and I’m hoping that it’s giving my bone a little boost to heal more quickly.   It’s a painless treatment of 20 minutes at a time, and according to research can heal the bone 33% faster. For an injury like mine with a healing time measured in weeks, that can cut a significant amount of time off!

I head back to the sports doc next Friday (10/17) and hopefully my follow up will show that the bone is healing nicely. For now, I’ve been cleared to start adding in a tiny bit of walk/running (intervals of 3 min running, 1 min walking for 30 minutes). I got to do my first “run” back on Saturday and the 30 minutes flew by! I was so happy to be running again. I’m being extra cautious and won’t try a consecutive run until a week or two from now. Even though I know I have a long way to go to build up my mileage to anywhere near where it was, it’s a step in the right direction.   Here’s hoping the comeback will continue to proceed smoothly!

Stress Fractures 101 and a Root Cause Analysis

Week #2 of rest for my tibial stress fracture has found me with slightly more time on my hands since I’m not running, and a slightly cranky attitude from missing the glorious fall running days. I’ll talk about what I’ve been doing for cross training in the next post, but today I wanted to write about my answer to a question that was posed recently by a member of my running group: “What caused the stress fracture?” To try and answer this, I first had go into a bit of detail on what exactly constitutes a stress fracture.   Dr. Wikipedia defines a stress fracture as “a fatigue-induced fracture of the bone caused by repeated stress over time. Instead of resulting from a single severe impact, stress fractures are the result of accumulated trauma from repeated submaximal loading, such as running or jumping. Stress fractures can be described as a very small sliver or crack in the bone.”

Our bones are in a constant state of remodeling, with osteoblasts responsible for repairing the bone in response to stress. In sports where extraordinary stress is applied to the bone on a frequent basis (i.e. long distance running), these osteoblasts have to work hard to keep pace with our activity. Over time, if enough stress is placed on the bone that it exhausts the capacity for the bone to repair itself, a weakened area (or stress fracture) can appear.   We’ve overwhelmed the osteoblasts and they are unable to rebuild the bone fast enough to “keep up” with the repeated stress we are placing on our bones.

Muscle fatigue can also place a role in stress fractures. Both muscle and bone act as shock absorbers to the large forces placed on our bodies with each stride we take.   If the muscles fatigue enough (say, at the end of a long run, or during a particulary intense effort), they start to force the bones of the body to absorb more of the shock. And as the bones experience more of the stress, the risk of stress fracture increases.

So. Now that we know what stress fracture are (tiny cracks in the bone from repeated trauma), we can try to answer the real question: Why did this happen?

So let’s take a closer look at a few factors in my case:



  • Nutrition/Female Athletic Triad: This one didn’t even make the root cause analysis because honestly this is an area where I feel I’m doing okay. My nutrition isn’t perfect, but I work hard to eat well, and eat enough to support my high activity level. I have a healthy BMI, and I get my period each month. (so no Female Athletic Triad for me)
  • Size of calf muscles – I’m putting this on here because there have been studies that link the size of your calves to the likelihood of stress fractures. The bigger the calf muscles, the lower your risk. I’ve got very strong (and large) calf muscles so I don’t think this was a contributing factor.
  • Shoes – I pay close attention to the mileage on my shoes and rotate several pairs. I don’t think the choice of shoes was a factor.


  • Bone Density - I put this one on there because it’s kind of a question mark. I am fairly short (at 5’4”), fairly young(ish) at 33, and have been participating in weight bearing activities for years now (which are great for building bone density!), so I don’t think I have a problem with my bone density, but I don’t know for sure. I haven’t had it tested. My mother and grandmother are both much taller, but they do have bone density problems. So this one makes the list as something that MIGHT be a contributing factor and might warrant additional investigation if I were to suffer additional stress fractures.
  • Mileage – I have been VERY diligent about slowly increasing my mileage. I took a month off after my marathon in March and then slooowly built back up to my normal range of mileage. That being said, that “normal” range is in the 60s/70s and even though my body is used to handling it, it’s still a pretty big chunk of mileage.
  • Extra stress - The beach. I knew that taking 3 kids to Myrtle Beach wouldn’t exactly be a carefree vacation, but I didn’t anticipate how much the extra stress and activity would tax my body. I had a recovery week (mileage-wise) when I was there and only logged 37 miles – BUT I had the additional stress of the waves/sand, holding kids in the ocean, and up-and-down the steps to the condo multiple times a day while loaded with stuff. Couple that with some later nights and a few days of walking around all day pushing a stroller and it’s not a surprise that I came back more tired than I’d been (despite the lower mileage week).
  • Biomechanics - I’m hoping that this is a very limited contributing factor at best. I have been doing strength training and core work consistently for a while now in hopes to provide additional stability to all of the muscles in my body. However, I know there are two areas of weakness that may have contributed to this particular injury: very tight calf muscles and limited dorsiflexion of my ankles.     The calves have been tight forever. I do stretch them and foam roll them as well, but they are chronically tight. That could be placing more stress on my tibia as my calves aren’t able to stretch to their full extension with each stride.   The other biomechanical piece is the limited dorsiflexion of my ankles that may be placing additional stress on the tibia. I had been doing exercises a few months ago to improve ankle mobility, but have since stopped. Sounds like it may be time to reintroduce those!
  • General fatigue – The week after the beach I returned to my 70 mile week of running and was upset to find that I was still dragging. I told myself to just get through the week and I’d feel better, the legs would bounce back. But the fatigue lingered. This should have been my cue to maybe take a day or two off, but I was just flabbergasted by the fact that I SHOULD have been extra peppy – with only 37 miles the week before my legs should have felt great!   But what I didn’t count on was how much the different stress from the vacation would take its toll on me.
  • Intensity & Group Runs – For our group runs this year, I’m finding myself as one of the only gals in a group of speedier guys. This is great because it pushes me to get faster, but it’s also tough at times because in order to keep up with the group (and therefore have folks to run the long run with), I have to run faster than what my long run pace should be. (averaging 7:30s over the long run vs. a pace closer to 8:00 which is probably what my long run pace should be) Since I don’t want to run all by myself on those long runs, I’ve been keeping up with the group.   The downside of that is that Saturday long run turns into more of a workout and another day of intensity when you look at my overall schedule. So when we mix one tired Jen with a few weeks with hill repeats, some faster runs with the group, plus a half marathon, we get the start of the leg pain and most likely the emergence of the stress fracture.  Given that I was still feeling the fatigue from the beach, I should have changed something and backed off on the intensity. But I went ahead with the schedule as planned and that may have been my undoing. I don’t think that the hills (which were a new addition to my schedule this year) necessarily caused the issue, but that higher intensity workout on top of the faster group runs and the half marathon may have been too much.

The Bottom Line:

With so many factors that can contribute to stress fractures, it’s hard to really say for sure what caused mine. I feel like I was training in a very smart way this summer and built my mileage very, very slowly – and only to a level where I’d had lots of experience with before. (each of my marathon cycles for the past few seasons have had 12 weeks in the 70-85 mile per week range)

The biggest “red flag” for me came after talking to a good friend of mine (and 2012 Olympic Trials Qualifier) and she mentioned that some injuries are not necessarily the result of doing more volume, intensity, or running on a different surface, etc. – but how tired or how recovered we are when we do it.  She asked me if I could pinpoint being especially worn out and tired while trying to maintain a set training schedule – even though I’d done that cycle successfully in the past. She mentioned feeling “off” – like she was grinding or pounding more than normal when trying to hit a certain pace when she was tired.   Then that in turn would make her MORE tired, and she felt that if she went through that cycle without adequate rest, she felt prone to an injury cropping up.

This made a light bulb go off in my head. I had discounted the toll the beach had taken on me because, it was a VACATION, right?!?! I had reduced my mileage! Enjoyed the break! I should be so rested and rejuvenated…..shouldn’t I??   So when I jumped right back into my 70 mile weeks and added the hill repeats, I should have listened to my body when I felt like I was dragging that first week back. At the time, I didn’t want to take extra days because I was JUST STARTING my training cycle of 12 weeks. I was at the beginning! It wasn’t time for extra days off! I’d done weeks of higher mileage in the summer and felt fantastic! What was happening? When I convinced myself to keep going and that my legs would come around, I should have been telling myself it was okay to take a few days off to let my body get rid of some of the lingering fatigue.

So that’s the best I’ve got.   Not a clear-cut cause by any stretch, but maybe it was just enough to tip me over the line from “tired” to “injured”.   In any case, I now have more information about my body and how I might modify my training in the future if I run into a similar situation. A valuable piece of info, but just wish it didn’t come with a several-week-long forced break from running!

For more awesome information on stress fractures and great info on how to overcome them, check out Camille Herron’s blog post HERE.

Next post: Cross training and a bone stim machine?

Any advice from fellow runners out there who have dealt with stress fractures in the past? Agree with my analysis? See any other red flags? I’d love to read any and all comments!