Femoral Stress Reaction.

I have a stress reaction in my leg. The femur. For those not familiar with stress-related bone injuries, a stress reaction is the precursor to a fracture. Meaning–the bone is almost broken. But not yet. Wikipedia tells me the femur is not only the longest bone in the body (And I’m 5’9″. So we’re talking long.), but also one of the strongest. From what I understand, it’s an uncommon stress injury but one that’s mostly found in runners. So uncommon but kinda common. Mindblowing, really.

To say I’m upset is an understatement. I’m panicking. I’m disappointed. I’m dumbfounded as to how this happened. I’m pretty much freaking out. I’ve been told to do nothing for 4 weeks. No biking. No swimming. No yoga. No planking. Nothing. I can walk to get from point A to point B. I am not allowed to walk for exercise. I’m also getting a second opinion because I think this is an EXTREMELY conservative approach, and if I’m not allowed to do any sort of physical activity for the next 4 weeks, you might as well lock me in a padded room and watch me self-destruct.

I felt a tiny TINY niggle in my quad the week before Boston, so my second week of taper. Tiny. I’m talking, like, I felt it two steps into my run and it was gone. And then I didn’t feel it after my run at all. Had I known it was something in my bone, I would’ve canned Boston entirely. I was a little nervous about the pain, especially since it almost felt like my leg was giving out when I’d first step on it, but I chalked it up to a phantom taper pain. I’m experienced and cautious enough (like uber cautious. ESPECIALLY after last year’s 6-month injury cycle) that I really didn’t think I had anything to worry about.

The morning of Boston, my quad felt like it had been feeling all along–I had a few steps of light pain when I started the marathon, but it subsided quickly. I didn’t have any concerns. This Boston was, however, my most painful marathon to date. I started to have a lot of hip pain (which I assumed was from my torn labrum) around mile 22/23, and now I realize I was just likely doing major damage to my bone. I was fighting tooth and nail for my time in this race, and I think my leg just couldn’t take it, especially with the pounding downhills of the Boston course.

After the race, both of my quads were EXTREMELY sore, but I remember being super sore last year, so again, I wasn’t concerned. And just like last year, 98% of my soreness subsided within a couple of days…all except that distinct quad pain in my left leg. “That’s so weird,” I thought to myself. It was painful to walk and to go up/down stairs. I figured I had probably pulled my quad in the marathon. All those downhills, right??

All my friends told me to chill. “You just need to recover,” they said. “It hasn’t even been a week since Boston.” But I had this gut feeling that something was wrong. I couldn’t pinpoint the pain in my leg, nor could I feel it if I stretched my quad. The only stretch I would KIND OF feel it with was if I did the piriformis stretch where you cross one leg over the other, like the number 4. And when I did this stretch, instead of feeling it in my piriformis, I felt pain radiating down the front of my leg.

I also got a massage that did jack diddly. The massage therapist told me that my quad and adductor on the one side was super duper tight. Groundbreaking.

It wasn’t until the Saturday after Boston that I really started getting nervous. I had gone to the track with my friend Stephanie to do some strides, lunges, core, and we just wanted to enjoy the beautiful day. When I told Steph about my quad pain, the first thing she said was, “well, be careful. You don’t want to have a femoral stress fracture.” Stephanie is an MD and resident at Yale. She also ran track in college. So she knows a thing or two about running and the human body. She suggested I just be careful, and to maybe get it checked out.

[youtube https://www.youtube.com/watch?v=wTBKubE1EwA] (We also might have played with the steeple barriers. Maybe not my best decision.)

Wait, WHAT???? I didn’t even know that was a thing. A stress fracture in your femur. I mean, obviously it’s a bone and so, duh, it could be fractured. But I really hadn’t considered it, especially since I had been so cautious about taking care of myself this training cycle. I spent the weekend freaking out and contacted my ART, who knows me pretty well at this point, as we’ve worked together the entire time leading up to Boston. He, too, told me I just need more recovery time, and to contact him again if I was still experiencing pain 10 days post-Boston.

So I waited. The pain level hadn’t changed, which concerned me. I didn’t try much running, but the running I did was excruciating. That Saturday I was with Stephanie, I managed a few strides, a lap around the track, and a mile around my block, but that was it. There was a lot of limping involved. The next day, I cheered with my friends during the NJ Marathon, and it actually didn’t really bother me, so I thought I was in the clear. It wasn’t until I went on a slow 4-mile run a week later and it ached the entire time that I started getting really worried. At this point, it had been exactly a week and a half since Boston. I decided to shut it down, just to be super cautious.

Since over 10-days had elapsed since Boston, I also made that appointment to see my ART, who diagnosed a grade 2 quad strain. “Be patient, but you’ll be fine after another session of ART.” But I was still worried. The pain level just wasn’t changing or improving from day to day and it constantly hurt to walk and move around. So I called my doctor to make an appointment.

When I went back in to see my ART a week after my first appointment, I could tell by the look on his face that he was shocked that I still had quad pain. But he kept insisting that he didn’t think it was a bone injury, simply because they’re so freaking rare. “But, Mary, I think you should probablyyyy keep that doctor’s appointment. You know, just in case.”

So then I saw my doctor last Friday. And she didn’t think it was a bone injury either. But she ordered an MRI anyway. She didn’t even mandate an X-ray first. I enjoyed my weekend with the small sliver of hope that it was “probably just a quad strain,” –even though dancing at a family member’s wedding hurt, as did walking around. Still.

The MRI was Tuesday (yesterday) and my doctor called to talk to me personally about the results. “The bone has not cracked yet,” she said, “but there is swelling along your bone and in your bone marrow.” Then she pretty much told me not to move for 4 weeks. She wants me to have some blood testing, because two stress reactions in one year isn’t normal. It’s also a possibility that the tear in my labrum is finally just not able to support my body and rigorous training anymore, so other parts of “the leg chain” keep breaking. I’m hoping I will find some answers.

I’m thankful for a lot of things in this situation. I’m thankful that this is happening coming off of a peak race, where I’d need to be recovering anyway. At least this isn’t happening in August, you know? I’m thankful that I’ve already put the running on hold as soon as I felt that something was wrong, so I’m already into the healing phase. (To be honest, I’m actually shocked that the swelling even showed up so prominently on the MRI, since I haven’t even really run much at all since Boston. I guess that’s how bone injuries work.) I’m thankful for my friend Stephanie who even suggested that a femoral stress injury could be a possibility. Without her suggestion, I don’t think I would’ve made an appointment with my doctor as quick as I did. I’m thankful for friends and teammates who have listened to me bitch about this issue.

But I’m not thankful that this is happening. I just have so many questions and lack so much understanding about how this came to be. It all just seems so unfair that I could come back from one injury cycle and jump right back into another one. My training was smart. I ate right. I get my period (Sorry not sorry to mention this. Amenorrhea is a huge problem in athletic women and girls and it is very much a taboo topic, which I disagree with.) I slept 9-10 hours a night during training. I strength trained (though, I did let it slip when mileage got high). I didn’t think that my mileage jumps were too high (or were they?!). I take my vitamins. Hell, I even take a calcium supplement! In the next 4-6 weeks I hope to not only let my freaking femur get better…but I also want to figure out what’s going on and make sure I can avoid future bone stress injuries at all costs. Because having two in one year is just completely unbearable.

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hey, i’m mary

I’m a running coach, athlete, business owner and mama.

If you asked me on the starting line of the 1500 in high school (with my pink Nike Air Max shoes) if I’d become a private running coach, I would’ve given you a hard stare and laughed out loud. But through following my passion and through hours of research, education, and experience, I’ve turned what I love into something that is my career, and I could not be more grateful.

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