MY truths about running and stress fractures

It's been a while since I've posted...all the way back to the IWK 5K In Memory of Jessica, which was a HUGE success thanks to everyone who supported it.  I reached all of my goals for that day, except the running in my own event, because it was the year of the stress fracture.  (actually 2 years, but last year I didn't know better and ran anyways).  

My understanding of my body, running and stress fractures has increased the hard way.  Yesturday I was outside running on a beautiful crisp morning, on a flat open trail...my first real run in what feels like forever, a fantastic 8K, and I got thinking....

I thought I'd share with you, from this one run what I was thinking about. 

1.  Running is hard.  Period.  Don't let any long term runner try to tell you how easy it is to start up, and get going, because until you make that commitment yourself, you will struggle with it in the beginning.  I started a lot of friends into running, and because it felt easy to me, I thought it should feel easy to them.  After being off for so long, I realize I was SO wrong.  I'm heavier then I used to be, my endurance kind of sucks, and muscles are all achy.  But I'm sticking with it to get back to where I was

2.  Running really is a natural laxative, sometimes just thinking about running makes me run to the bathroom.  Yesturday I was all excited to get outside, had a normal breakfast, had some water, drove to the trail...then realized I was not near a washroom, so had to walk an extra km or so to find one before I could run.  And this is normal for me.  When I was in a good running schedule, no bowel issues, I've noticed in the past year, I always feel bloated, constipated and feeling crummy, so a great reason to get running!!

3.  Running is great for weight loss (although it sucks for weight gain, if this is your main exercise and you get injured).  You burn a lot of calories with running, especially long distance running.  I remember looking at my Garmin after 30 K runs and seeing thousands of calories being burned up, whole day's worth of food.  But remember just because you run, doesn't mean you can eat everything you want!!  Well maybe you can after 42.2K, but not after a 5K or 10K run, eat healthy and you will run better, and lose weight.  Treats are fine in moderation, like everything else.  Decide what you are running for, is it health? to lose weight?, to feel good? or to eat more?

4.  I am not meant to run short distances.  I know I'm just starting up again, but even after yesturday's 8K, it was not until I reached at least 4K that I felt good, I mean really good!  I was breathing better, running faster, and had that feeling like I could have ran forever.  It's been so long since I've been running, I forgot that I am meant for endurance, not sprints.  We are all built differently, it's just a matter of finding what works for you. 

5.  There is such thing as a Runner's High.  And when you feel it, you feel like you are on top of the world.  My best Runner's high was my first marathon, but I also feel it after a long Sunday morning run.  For me, nothing feels better then a really early morning run with friends, followed by coffee...an epsom salt bath and then knowing the whole day is still ahead of me with my family.  Here is a little info from Wikipedia about endorphins and high's if you didn't believe me.
"A publicized effect of endorphin production is the so-called "runner's high", which is said to occur when strenuous exercise takes a person over a threshold that activates endorphin production. Endorphins are released during long, continuous workouts, when the level of intensity is between moderate and high, and breathing is difficult... During a release of endorphins, the person may be exposed to bodily harm from strenuous bodily functions after going past his or her body's physical limit. This means that runners can keep running despite pain  (this is where most runner's get into trouble, myself included), continuously surpassing what they otherwise would consider to be their limit. Runner's high has also been known to create feelings of euphoria and happiness....."  I thought it was interesting that it was suggested that the runner's high helped with survival of early humans for hunting and gathering their food over long distances.  "This could have caused them to develop conditions such as shin splints and stress fractures in their shin and feet bones. Without runner's high to negate the pain caused by running on bones with these conditions, early humans theoretically would not have been able to repeatedly cover these vast distances in search of their food and thus would have starved."  Interesting:)  Which leads me into number five.

6.  LISTEN TO YOUR BODY, do not ignore pain.  We don't need to hunt and gather our food anymore, we can go to the grocery store.  So unless you are being chased by a coyote or Pitbulls, (see Garritson story, crazy, I read it in Runner's World a months ago... http://www.cbs8.com/story/16139936/members-of-running-family-attacked-by-pack-of-pit-bulls?clienttype=printable)
stop running when you think something is wrong.  Get over your pride of needing to finish or get your personal best.  There is always another run if you look after yourself.   My biggest mistake this year was running the Bluenose half marathon with little training, and an unhealed stress fracture (I didn't know that at the time).  I felt relatively good for the first 11K, discomfort in my tibia that I ignored because I've had it forever)...running a good pace, and then I felt something BAD.  I knew right then I should have stopped.  But my pride of finishing the race and knowing that everyone looks up your time (don't say you don't, because we all do) took over, and I ran, walked, limped another 10K on a stress fracture that never healed from January.  If I would have listened to my body, I would have been running alot sooner, but instead had to defer the NYCM which has been my dream for 4 years (although if you pay attention to the news, it was cancelled anyways because of Hurricane Sandy), and had to take off 6 months of running.  


7.  Yoga is good for runners, it will help you stay injury free.   I don't do it, but I know I should.  Running injuries are caused from so many things, improper footwear, repetition, poor training, etc....but muscle imbalances are huge.   I am usually on a time restraint myself, running is my main exercise, and when I am done, I am done.   But when you run, your muscles get tight.  You need to stretch the muscles you use after each run, and strengthen other muscles that are not being directly used while you are running, but help support the running muscles.  For example, many runners have a lot of weakness in their glutes causing knee pain, so get out your green tubing that your physiotherapist gave you, or Denise, and start doing your duck walking (it really works).  And go back to old school and start doing some clams...get the hips stronger so that your knee and ankle joint doesn't take all the stress.  And yes you really do need to work that core to run better too.  I read alot about yoga, I have a friend that instructs yoga, I just need to get there.   It will strengthen your core and limber you up.

8.  Running is hard on the joints, especially road running.  Everyone should try to do some trail running once in a while to give your bones a break, and also include some cross training.  Your bones will thank you, and trail running is also a great change and a lot of fun!!  (just don't expect to have PB's running trails)

9.  Goals are important.  whether it is a distance, a time, or a race.  We all need motivation from time to time, and if you have a goal race in mind, and a schedule to follow, you are more likely to get out of your warm comfy bed and put your running clothes on.  My first fun race is the Resolution run, can't wait!!!  And always challenge yourself...if you get to the point that running is easy, then maybe you need to switch things up a bit.  Run some hills, do intervals, run a new distance...

10.  Stress fractures suck for a runner.  Number TEN is what I HAVE learned about tibial stress fractures.  I am not an expert and don't take everything I say as golden, this was just me and my experience.
Diagnoses early on is very important to determine if you need to take a prolong rest from running.  Xrays are usually unhelpful early on, especially the first 3-4 weeks until a callus formation is shown, a bone scan will show a dense area if there is a stress fracture.   Xrays WILL show the "dreaded black line", which you don't want!!  which is "a transverse fracture line across the entire anterior shaft of the tibia that most often occurs in dancers or athletes who participate in jumping sports"  Very poor prognosis.

Stress fractures are very localized on palpation.  If you have tenderness over your entire shin (which I have now) this is most likely shin splints and not as concerning, but treat them so they don't develop into a stress fracture.  If pressure is applied over the bone and you nearly jump off the bed, you probably have a fracture.

Do not take anti-inflammatories!!  They actually slow down the healing process of bone so if possible, try to avoid them.  Ice is good.

Off-loading boots are great initially.  they are expensive, a couple hundred dollars, but most insurance plans will cover them.  Wear it as soon as you know you have a stress fracture, and wear it frequently.

To keep up your cardio and to avoid getting really fat, the pool should be your friend.  Swimming laps, water running (best), and upper body workouts should be your main exercise for a while.  Do not use the elliptical, go for walks or spinning class!!!  I was recommended spinning class with my stress fracture, and I made it worse with all the drills standing on the bike and the resistence...all to much stress on the bone.

Take lots of Vitamin D, and calcium, wouldn't hurt to have your levels tested.  I was Vitamin D deficient and my orthopaedic surgeon recommended 3000IU daily, she also takes this as preventative, it won't hurt you, and it's good to have the extra Vitamin D. especially women.  Almost all of us are lacking in this vitamin, unless you live in Florida and are exposed to the sunshine daily, and those that are, usually cover up full in sunscreen.

There is no set time for when stress fractures are healed enough to run.  It depends on the location, the bone structure, and the individual.  8 weeks is generally rule of thumb for bone healing erring more on the side of caution...however in saying that a bone will not show fully healed on a bone scan for at least a year (maybe a bit longer).  So multiple bone scans are not necessary.  How you feel will mandate your return to running.  I had discomfort for a long time, not enough to stop me from my job, but I always felt something on my tibia with stairs, and walking....My first brief return to running in the summer I ignored the discomfort because I thought I could run through it, and it wasn't as severe as it initially was.  My running didn't last long then.  Now I have no pain walking or with stairs, I do feel a little something running, but the ortho surgeon said I will for a while.

A gradual return to running is very important.  My mistake in the spring, was jumping right back into a 10K once the 6-8 weeks was up.  I still had a good fitness level, I thought I was fine.   This time I started running ONLY on the treadmill, 2 mins run, 2 mins walk for several weeks, then I gradually added running time, and kept a minute walking until I got up to 10min run, 1 min walk.   This is where I am today,  running 8K on trail.  I'm sure I've left out some stuff, but this is what I could think of at the top of my head.  Which is another great reason for running!!

11.  Running helps you think.  I gather my thoughts together during my runs.  Most of my blog posts during our NICU stay I thought of on the car drive to and from the hospital watching runners on the bedford highway.  After the NICU stay, my runs are where I thought of my blog posts.  When I run, I plan my day, think of what meals to make, what errands need to be run, etc...Somehow I feel more organized after I run.  If only I could run all the time to keep my life organized!

12.  Runners love runners.  I have met very few unfriendly runners...everyone is so high with happiness that they are so wonderful to be around.  Runners love talking about running, they love to encourage and support fellow runners, and they love challenging each other.  I'm met some pretty wonderful people running, who I miss dearly!!  It is a great social sport...you may tell more to your running friend on a long 20K run then you do to your best friend.  When you spend that much time together, sometimes they are the ones who know you best...we all open up more when running, and let out a lot of steam (and gas;).  Fellow runners are the people who understand your training schedule, who understand why you didn't have that glass of wine Saturday night, who understand the excitement of race day!!  Someday, when you get a chance just go to a running event as a spectator, you will feel the love and excitement!! or volunteer...because the volunteers are so much appreciated!!

13.  In saying all of this, Running isn't for everyone.  I talk about running....alot.  So much that I try to convince almost everyone to run.  But now realize, not everyone wants to run.  Not everyone driving in their car to hockey with their kids, wishes they were out running with the large group of runners Sunday mornings.  As a runner, sometimes we are in our own little bubble...
I just want everyone to feel as good as I do when I run.  That's all. 

Happy Running!!!  If you want to get started and don't know how, send me an email, and I'll get you started, or if you live close, we will get out together!!