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Saturday, December 16, 2017

Treatment plan

I can hardly believe that two weeks ago I ran a 19 miler with 15 tempo miles at 6:54 thrown in there like it was no big deal. And this was capping off a 72 mile week, the most I've ever run, and the week after a 4-week stretch that included four races (three of which were PRs).
Hm, I can't imaging why I'm injured! Really, that's a recipe for overuse injury, and I think that's exactly what I have.
I don't have an official diagnosis, but I am 100% sure this is a stress fracture. I have textbook symptoms, and my recent running history also points to the likelihood of this being a fracture. Maybe it's not a bad one - I definitely caught it early; I saw my doctor the day after it started to hurt, and no fracture was visible on the x-ray, so it was too early for any osseous changes to show. But I will probably never get an official diagnosis.

Why? Well, my doctor, who obstinately refuses to think this is a stress fracture, has asked me to get a confirmatory MRI. Totally understand that - you need proof before you can go willy-nilly prescribing walking boots, etc. But with my schedule, holidays and end of the year, the schedule of the imaging center, and the fact that I am changing insurance January first (and restarting a jumbo deductible!), I probably won't be able to get one until the first week of January. And at that point...well, I'd be four weeks out and probably out of the boot, anyway.
Walking boot, the perfect holiday accessory!

So I think I'm just going to go ahead and not get the MRI, and self-treat. Please, someone, when I lose use of my left foot, remind me that I wrote these words. But really, I think it's ok. One of my dear friends is lending me her walking boot (oh, runners!), and I don't intend to wear it long, anyway. I see the value in protecting the tender bone from impact until a callous starts to form, but then I need to start stimulating bone growth, and that happens with impact. I guess I'm thinking about a week or three in a boot, then three more bootless, then see how it feels? I know healing times vary hugely for stress fractures, so I'll have to play it by pain!


  1. This is kind of what happened to me with my second (tibia) stress fracture. Having had one before I knew--KNEW!--exactly what it felt like and I knew I was right. I didn't even bother going to the doctor or asking for a scan because to me it was so obvious & I was already pretty well versed in the treatment protocol from last time. Happy to report that I did NOT lose the use of my left leg but DID save a lot of money on medical expenses.

  2. I think you have the right idea personally. I would not get an MRI either, because essentially you're paying hundreds of dollars to confirm an injury where the treatment is rest. You may as well just rest for say, 4 weeks, then see how it feels if you need to rest longer. That's what I did earlier this year. Also, I really wish medical professionals were nicer about things like money and realizing that we are not made of it. I just dumped my PT because I was paying $90 to essentially have someone watch me do exercises I was already doing at home. I don't think she realized or knew what I was paying because most people's insurance helps them out with some of that. It wouldn't be a huge deal if my copay was say $20.

    Anyway, I really hate that this happened to you because you were having a super successful season! And I was jealous of all the awesome training runs you did. But, you'll get back there and you're still a kickass runner no matter what!

    1. My PT was invaluable to help me recover from my hip surgeries, and were a vital component in my return to running. But other than that, I almost always think PT sessions are a waste of money. Unless I'm there for Graston or dry needling, I can mostly replicate the process at home.

    2. I agree. Mine used a TENS unit on my injury, which I could also purchase on my own. She also massaged it a little, but I can get a full body massage for 2/3 of the cost of PT.

      And of course, I can do the exercises at home, without a babysitter. I don't need to pay for motivation to do the PT exercises, wanting to get back to running is motivation enough...

  3. I totally understand why you are opting not to get the MRI since your deductible is starting over and things like that are stupid expensive. I feel so bad for you, though. Just when you are feeling great and running in peak condition, this happens to you. :(

  4. MRIs are such a hassle. The scheduling, the time it takes to go, and then an entirely different appointment to get the results. But it does sound like a stress fracture, and it sounds like you are doing all the right things. I am so bummed for you. :-(