MRI showing the fracture on the left. Middle & Right show healed bone.

Returning to Running

A while ago, I posted these images of my lower right leg. In May, I found out I had a stress fracture on my right fibula. It sidelined me for more than six weeks. I walked with crutches and in a boot. I could take part in zero-impact sports only. Not being able to run because of a preventable injury made me generally grumpy. In September, I gave myself the all-clear to return to running.

I wanted to write about my experience. Maybe someone will find it useful.

The Fracture & Diagnosis

Broken Glass
Photo by Jilbert Ebrahimi

I had some pain I thought was just peroneal muscle soreness that just wouldn’t go away. I went to my chiropractor because I was already going once a week at the time. He suggested that I keep running because it was only muscle pain. So I ran once more.

That last run was a bad idea. Afterward, the pain was so bad that I went to urgent care to have it looked at. The x-ray showed nothing. Not surprising since stress fractures don’t show on x-rays until they’re a complete fracture. On the weekend, urgent care is the only option other than the ER. That week, I had an appointment with a sports medicine doctor. He said that without a doubt, it was a stress fracture. After consulting with him, I decided not to get an MRI. Instead, I started treatment for a stress fracture right away.

I still feel like foregoing the MRI was the right decision. You might be asking, “but Tom, how did you get the MRI images?” After four weeks in the boot, I started going bootless. I was still having a lot of pain, so I went bad to the doctor. He suggested the MRI to confirms his diagnosis and to see if there is healing in the bone.

The MRI confirmed the fracture and the healing. The doctor told me to spend more time in the boot and work out of it little-by-little.

I took more time to heal because I did not want to push back into running again and end up re-injuring my fibula. I waited two full weeks without any sort of pain before I started running again. I was cycling, walking, and swimming during those weeks.

The two weeks passed and I started running again in September.

Ramping Up to a 10k

A runner training.
Photo by Clem Onojeghuo

Before I even started running again, I made sure I had a complete plan to get back up to running distance again. My plan was not based on distance but instead was time-based. It looked like this:

  • Week 1
    • Run twice a week.
    • 40 minutes of Run:Walk intervals of 3:7 minutes.
  • Week 2
    • Run twice a week.
    • 60 minutes of Run:Walk intervals of 4:6 minutes.
  • Week 3
    • Run three times a week.
    • First two days: 60 minutes of Run:Walk intervals of 5:5 minutes.
    • Third day: 70 minutes of Run:Walk intervals of 5:5 minutes.
  • Week 4
    • Run three times a week.
    • First two days: 60 minutes of Run:Walk intervals of 6:4 minutes.
    • Third day: 70 minutes of Run:Walk intervals of 6:4 minutes.
  • Week 5
    • Run three times a week.
    • First day: 60 minutes of Run:Walk intervals of 7:3 minutes.
    • Second day: 70 minutes of Run:Walk intervals of 7:3 minutes.
    • Third day: 80 minutes of Run:Walk intervals of 7:3 minutes.
  • Week 6
    • Run three times a week.
    • First day: 60 minutes of Run:Walk intervals of 8:2 minutes.
    • Second day: 70 minutes of Run:Walk intervals of 8:2 minutes.
    • Third day: 80 minutes of Run:Walk intervals of 8:2 minutes.
  • Week 7
    • Run twice a week
    • Zombies, Run! Fall 2016 Virtual Race (10k)
    • Third day: 70 minutes of Run:Walk intervals of 9:1 minutes.

It was a slow return to running distances I enjoy running, but it worked. I wouldn’t have been able to stick to the times if I hadn’t recently switched from a Jawbone UP3 to a Garmin Vivosmart HR+. Switching fitness trackers, while not the focus of this post, was a great idea for me.

After week 1, I went back to my sports doctor because I was having some of the same pain I had with my stress fracture. There were more x-rays and more hop-tests. The x-ray showed that the bone is healing and that there was new bone growth. The pain was only present when palpating the muscle, not the bone. Conclusion: No restrictions whatsoever on my activities!  

Great news! So I kept running.

S.T.O.P.

Stop Light
Photo by Tim Gouw

During my ramp-up, I was running in my Vibram Spyridon MR trail running shoes. I was running at the IU cross-country course to keep on a soft surface. I started having some nerve pain behind the second toe on my left foot, but that is nothing new for me. I also switched to some Altra Lone Peak 3 shoes during the 5th week. I enjoy running in the Altras and the nerve pain has gone away.

  • S-Stop
  • T-Take a breath or two
  • O-Observe
  • P-Proceed

The week after the 10k, I started noticing stiffness that didn’t go away. It persisted regardless of how often I stretched. This was a signal to me to take it easy and to re-evaluate my fitness schedule.

I am currently on a self-imposed 2-week break from running. I’ve made a new workout schedule.  It contains varied activities, including swimming, cycling, weight training, and a lot of yoga!

And I am not going to push myself too hard when I start running again.

I’m in a good place, I think and I’m excited to start running again, again!

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