Don’t worry, I am not currently injured. I shouldn’t even type that for fear of cursing myself. Anyway.
I was reading a blog and came across a woman who recently discovered she had a stress fracture in her pubic ramus. If you know me, you know I immediately had to send her a note. Sister, I have been there. REALLY been there. It’s such a weird injury, I feel like I have to open up to someone else who has had it.
It’s just not like a stress fracture in your leg or foot, which you can rehab in a few weeks and then forget about. A stress fracture to your pubic ramus — or two, which I had — pretty much takes you down. Even now, a year and a half after my diagnosis, I am still paranoid about it and even still feel it sometimes.
A brief history, if you need it: I had my son in September 2008. I ran through almost my entire pregnancy, including half-marathons, and some much longer runs. I took 2 weeks off after his birth and started again slowly (I had been on bedrest the last 3 weeks of my pregnancy for low fluid issues).
In 2009, I ramped up mileage, and then PRed in every distance from 10K to marathon, including qualifying for Boston in May 2009. That summer, as I got ready for Twin Cities Marathon, I had some random pain. It would come and go, so I mostly ignored it, or took a day off here and there.
In August, I put in my highest mileage yet, with a 70-mile week. The next week, I stood up from my desk at work, walked 3 blocks to meet my husband for lunch, and then could hardly walk. The pain I had been feeling intermittently was THERE and wouldn’t let up. I made an appointment, got and MRI and found out I had a stress fracture in each pubic ramus.
You have to be fucking kidding me.
Everything I read said it happened to Army recruits (wtf?) and that it could take a year to heal. I believed it, since at that point, even a trip to Target was painful (and not just painful on my bank account, like it usually is). Everything hurt it. I took some time off — I think like 2 months, maybe more. Then tried to start running. It was a lot of stopping and starting. If I felt pain at ALL, I quit running. That meant a lot of canceled runs with friends, and a lot of starting only to get a mile from home and walking back. It was a long, slow road.
In January 2010, I was able to run pretty regularly, and built up to a 10 or 11-mile long run by March, I think. Then I found out I was pregnant again. I was able to run about 20-30 miles a week through the first half of the year, with some twinges here and there. It was all easy miles, since I had no base left anyway, and since I was pregnant again, and unwilling to pound out the miles on a healing pelvis.
I stopped running regularly in July 2010, after nearly blacking out at a ridiculously hot 5K (where I ran very, very slowly, yet still truly almost passed out from heat). I also started dealing with some other issues, including low fluid levels and preterm labor. It seemed like a good idea to just shut it down.
I did a lot of lifting and spinning — right up until the day I left a spinning class and then had so many contractions I had to go to the doctor and start taking medicine for it. Ugh. After that, mostly walking, and then maybe a run here or there. I forget now, and I quit keeping a log last year so I wouldn’t obsess (though started up again recently — let the obsessing begin!).
Anyway, my daughter was born at 36 weeks in October 2010. I took about a month off after she was born, then started with short runs, with some walking (mostly up the hills, I am a loser). I had some pubic ramus pain AGAIN, and my OB sent me for an MRI after my post-partum appointment. I was convinced I had stress fractures again. It was that painful. Again.
The MRI showed nothing. I was honestly shocked. I had been prepared to hear that I had somehow reinjured it during a super fast delivery. After a few weeks, everything settled down. I also had a bone density scan (normal) and a bunch of other tests to see why this crap kept happening (my sports doctor, who I adore, said, “You know, a lot of people run marathons and don’t have these problems.” So he was pretty thorough with the testing and couldn’t find any reason for why this kept happening. I guess it really was just overtraining?).
I got a little cocky and decided to run a spring marathon. About a week ago, I did my second 14-miler for that. I immediately had pain in those bones the next day. I don’t know if it’s the relaxin from breastfeeding and pregnancy, or if I ramped up too fast, or what. But I am again backing off. I plan to do a half this spring, and still plan to run Twin Cities in October.
The thing with a pubic ramus stress fracture is NOBODY understands unless they’ve had it. It sucks. It hurts like hell, yet kind of comes out of nowhere. There is no special thing you can do to rehab it, just rest. And it’s not like you can completely stay off your pelvis, you know? It just really blows.
And then I always wonder: When something hurts, even a tiny twinge, which, I admit, I am hyper aware of, is this just my new normal? Is this just a random twinge, or the return of the injury? It’s enough to drive me nuts.
A blogger I read regularly also recently talked about it here.
So, I don’t know. The point to all this is that I just wanted to share my experience. There’s no real reason it happened — normal bone density, etc. (and that scan was compared to one I had in 2006, so they had something of mine to compare it to, you know?). But man, like when I hear someone mention miscarriage and feel like I want to talk to them, I feel the same way about pubic ramus stress fractures.
So, good luck to Stefanie, rehabbing hers. And let’s hope mine stays far, far away.