The Stages of Injury

Getting injured leads to a rollercoaster of emotions, from depression to grief to hope to worry to disappointment to relief. If you ever get injured, you can expect to experience some form of The 8 Stages of Injury outlined below.

Bewilderment: What do I have?
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  • Incessant Googling of symptoms
  • Describing your symptoms repeatedly to your husband
  • Twisting and turning, poking and prodding your body to see what really hurts

Recognition: Could I have that?
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  • Google search terms become more specific
  • Discovery of “tests” you can do at home to see what it is
  • Trying those tests and hurting yourself
  • Weighing the cost of medical care against the chances of successful self-diagnosis and self-treatment

Denial: There’s no way I have that.
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  • Reading further into the Google search results in hopes of finding someone with your symptoms who doesn’t have the injury you think you have
  • Trying to run one more time and failing miserably
  • Taking pain medication and pretending nothing hurts
  • Telling your husband about how rare the injury is and hoping that means you don’t have it

Anger: Thanks Obama.
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  • Crying
  • Swear words
  • Throwing things
  • Angry phone dialing to make an appointment with the doctor
  • Blaming your shoes, the cats, your chair at work, and your upbringing
  • Giving your husband the silent treatment for going to the gym without you

Bargaining: Please, let it be anything but that.
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  • Promises to run less, rest more, stretch more, and lift more weights if your body lets you run again
  • Telling your injured body part how nice and pretty it is and if it will just feel better you’ll take it out for a nice jog or swim or cycle or whatever it wants

Depression: That is the worst thing that could ever happen.
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  • Shopping for motorized scooters online for when they amputate your leg because you’ll never get better
  • Crying
  • Ice cream
  • Making your husband watch chick flicks with you

Diagnosis: That’s what it is.
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  • Saying, “I told you so,” to all the skeptics who doubted your self-diagnosis
  • Cool bone pictures
  • Dusting off the crutches from when you broke your ankle in 10th grade
  • A crush on your cute doctor

Acceptance: That will heal. Eventually.
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  • “Will you take the trash out?”
  • “Will you hold the door for me?”
  • “Will you get me a beer?”
  • “Will you cook dinner?”
  • “Will you go to the grocery store?”
  • “Will you get up early and drop me off at the train station?”
  • “Do I have to wait till you’re done with all the chores before I watch Game of Thrones?”
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So You Have a Pelvic Stress Fracture

groin pain standing one leg
groin pain running
high hamstring pain
adductor pain
pelvic stress fracture symptoms
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pubic ramus stress fracture
what’s an inferior pubic ramus

These are just some of the terms I searched when trying to figure out my injury. One of my hopes for this blog is that it will find its way into the Google search results for other women who are experiencing these symptoms and don’t know what’s going on. From the stories I read on the Runner’s World, Let’s Run, Cool Running forums, and other blogs, this injury is misdiagnosed fairly frequently, and being informed before you even see a sports medicine physician can help ensure you receive the proper diagnosis, which can completely change your prognosis for healing.

What is a stress fracture?

“Stress fractures are tiny cracks in a bone. Stress fractures are caused by the repetitive application of force, often by overuse — such as repeatedly jumping up and down or running long distances. Stress fractures can also arise from normal use of a bone that’s been weakened by a condition such as osteoporosis.

Stress fractures are most common in the weight-bearing bones of the lower leg and foot. Track and field athletes are particularly susceptible to stress fractures, but anyone can experience a stress fracture. If you’re starting a new exercise program, for example, you may be at risk if you do too much too soon.” (from Mayo Clinic)

What is a pelvic stress fracture?

Pelvic stress fractures are not common and occur almost exclusively in females, primarily in runners and women who are training in the army. From what I read, pelvic stress fractures account for about 3% of all stress fractures. Although, for all you know, I made that number up.

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There are several locations in the pelvic bone that are susceptible to stress fractures. Most commonly, they seem to occur in the pubic rami. Mine is almost exactly where the fracture is shown in the lower (“inferior”) pubic ramus below.

pelvic stress fracture

How do you get a pelvic stress fracture?

  • Wrong shoes
  • Hard running surface
  • Hills
  • Being a recovering couch potato
  • Too much running
  • Too little rest
  • Not enough cross-training
  • Not enough strength
  • Not enough flexibility
  • Lady parts
  • Osteoporosis or osteopenia
  • Calcium and/or vitamin D deficiency
  • Swallowing your gum or not eating your broccoli as a kid (just guessing)

I did not have any idea that I was overtraining. If I could run it, I did. And going from running 3 miles at a time to running 6 miles at a time did not seem like a huge leap. But going from running 0 miles in January to 28 miles in February to 68 miles in March to 85 miles in April to 98 miles in May was too much too fast.

What are the symptoms of a pelvic stress fracture?

The symptoms vary for each person. If there were symptoms that developed slowly over time, I missed them. Here’s what I experienced:

  • Tight hamstrings (unusual)
  • Sensation like I was developing a UTI (not a UTI)
  • Pain in groin and adductors
  • Pain in fold of glute/top of leg
  • Couldn’t stand on one leg to put pants on, wash foot, or get in and out of shower
  • Pain when walking
  • Pain when sitting
  • Pain in groin/back of leg when lifting and carrying a laundry basket
  • Pain subsided with rest but never went away
  • Very clearly pain in bone, not muscle
  • I have not been able to find a painful spot on palpating the area

I walked on my injury for three weeks, during which my body compensated by changing my gait which resulted in pain in my gluteal muscles and tfl (outside of my hip).

For those following along at home, the symptom that clued me into the fact that I might have a stress fracture was not being able to stand on the leg of the injured side when putting pants on. The other common test is the hop test. If you can’t painlessly hop on the injured leg, you might have a stress fracture.

stress fracture

Here’s the biggest takeaway I learned: Go to the doctor. If you’re informed, you’ll know what symptoms to emphasize, what questions to ask, and what kinds of tests to ask for. And if they give you an ice pack and some ibuprofen and tell you to RICE without doing any tests, find a different doctor.

So what happens now?

Rest. If you need me, I’ll be on the couch catching up on Orange Is the New Black.

Will Run for Food

I am lazy. I love TV. I love food. I love beer. But I also love comfortably fitting into my clothes and being able to walk uphill without having an asthma attack.

So last summer, I bribed myself to go on a run with the promise of ice cream afterward. And it stuck. Running allowed me to enjoy beer, pizza, and ice cream with much less guilt. It also made me feel strong, happy, and productive. But when winter hit and we moved from Rochester to Minneapolis and couldn’t afford a new gym membership, I took up being a couch potato again. In Minnesota, it’s a good idea to pudge up over the winter, anyway, right? Then, in February, when I had to jump to get into my pants and lie down to button them, I decided it was time to clean the cat toys out of my running shoes and hit the pavement. I did 1-minute run, 2-minute walk intervals on day 1 and went 3 miles. My lungs hurt. My legs hurt. I was drenched in sweat. And it felt amazing.

I bragged about documented this moment by sending this selfie to my husband, who was traveling at the time. (This was a big deal. I don’t normally take selfies.)

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Over the next 3 months, I went from run-walking 3 miles 3 times a week to running 20+ miles over 4 or 5 days each week. My longest run was just over 8.5 miles and was one of the few times I actually experienced a “runner’s high” and felt like I could keep going forever.

But it had only been a few months, and I still didn’t feel like I deserved to say those magical words: “I am a runner.”

Then, something happened.  I had a run that felt off. Then another. Then I ran one block, limped home, and took a few days off. After a forced 4-mile run/walk/limp/hobble/stumble, I knew there was something seriously wrong. I saw a family practice doctor, who referred me to a sports medicine physician. On June 20, I received a diagnosis: stress fracture of the inferior pubic ramus, an injury that affects almost uniquely female runners. More on the journey from injury to recognition (to denial to anger to bargaining to depression to acceptance) to diagnosis later.

I never felt worthy to say, “I am a runner.” But I can now say with confidence, “I was a runner.” And I will be again! Eventually.