Thursday, April 3, 2014

All good things...

Locked down no more.

I was supposed to see my sports med doctor for a follow-up appointment yesterday. He wanted to review the results from the MRI that he ordered just in case. Unfortunately, my doctor called in sick and had to reschedule me (for April 16!!!). This would normally have been an unacceptable delay, but it really didn't matter on this occasion. I completely quit running last Saturday.

When you get an MRI, a generic radiologist reads the images and sends a report back to your doctor. My doctor likes to read his own MRI scan following the full examination to support his diagnosis. After he diagnosed me a couple weeks ago with osteitis pubis and recommended no major changes in my training, I had planned to wait until I saw him again to decide how to approach my future training and recovery. Then last Friday, while I was working in Paris, I received the generic MRI report via email. It stated that my MRI findings were consistent with a non-displaced stress fracture on the left side of my pubic symphysis.

Stress fracture. As much as it sounds like bad news, at some level I was actually relieved. It was also frustrating because I've struggled with an injury for almost 9 months that did not match any of the symptoms of a stress fracture. It never was tender to the touch at the location of the fracture and it never hurt during high impact activities like jumping. It always felt like a muscular injury. Granted, it's very clear that groin injuries are notoriously hard to diagnose. But back to relieved ... I was relieved that there was now a clear issue that I could focus on fixing.

Even so, I admit that part of my mind tried to rationalize that I could keep running until I saw my doctor again. Who knows, maybe he would disagree and say it wasn't really a stress fracture. But, why? Just to keep my daily running streak alive and so I could say I had a streak? If you're going to have an addiction, I guess running is a good one to have, but even this addict knows too much of a good thing is just that.

I spent all day Saturday walking around Paris and riding a boat up and down the Seine, but I'm proud to say that I never ran -- my first day off in over seven years. I will say, if you're going to pick a place not to run, Paris in the spring is a great place to be.  It was an absolutely gorgeous day.

When my doctor cancelled on me yesterday, I was so happy that I'd already made the decision to quit running. It would have been absolute torture deciding what to do for the next two weeks while I waited for my appointment if I had kept running.  But now I'm free.

Where do I go from here? I don't exactly know. But it will be at least a month before you see me running again.

...must come to an end.


  1. Sorry to hear about the continued struggles, David. At least you have a good diagnosis now. Heal quickly, and we look forward to hearing about future exploits.

  2. I have a good friend who had a similar situation a few years ago. Same injury, misdiagnosed for months, kept trying to run through it. Eventually, got the pubis stress fracture diagnosis, took about 3 months off completely - no exercise whatsoever. (note here that many docs will say 6-8 weeks for recovery from a stress fracture. But that's for normal "walking around" folks, not for ultra runners. Don't be surprised if it takes 10-12.) Completely recharged him mentally, he took a couple of months to get back in shape and hasn't looked back. You'll be back, better than ever! But it's gonna take some patience in the short term.

  3. I definitely agree with the commenter above! I believe that you'll come out of this health problem hale and ready to do the best running of your life! I hope you're well cared for; having good medical support versus the average can do wonders to the healing process. Stay strong and don't ever lose hope!

    Alan @ ProClinix

  4. I've been googling symptoms of pelvic fractures during recovery, and I came across your blog. Your experiences are identical to mine. I am an ultra-runner and trail runner, way older and much slower than you, but similarly addicted. In December 2013, after a summer of 70-100 mile weeks and a very successful Leadville, I developed deep groin pain that hurt only when I ran, sneezed, sat up or rolled over. I went to a top sports doc in my town who put his finger right on my pubic symphysis - it hurt - and diagnosed me with OP. I immediately jumped into PT (Jane Fonda stuff), got a shot of cortisone and tried to resume running - again focused on a summer of ultra trail races. Because of the cortisone, no pain when sneezing, etc. but the more I ran the pain spread to my abs and adductors. Massage would give me a few days reprieve - and I'd run. In April, I did a sub 9 hour R2R2R in the Grand Canyon, and after switched to cycling. In June, I sneezed - and the pain was back. I got an MRI and the sfx on my ramus just to the right of my PS was plain as day. I was thrilled - because I knew it would heal. It's 2.5 months after the sfx diagnosis and I'm feeling much improved. The pain when I sneeze is diminished somewhat, as is the pain when I sit up. I haven't run - I'm afraid to and was planning on one more month of cycling and swimming. I went to the same doc who diagnoses me with OP today to get a script' for PT and he basically blew off the stress fracture and is sticking with his OP - and now maybe sports hernia - diagnosis - mainly because it's been 10 weeks since the MRI and he thinks the sfx shouldn't be an issue. I think he's trying to reconcile his original diagnosis. Anyway - I'm not looking for a diagnosis or medical advice, I am hoping your share with me what your recovery FELT like - and also how you're doing these days. I haven't found anyone with a diagnosed pelvic sfx who had pain while sneezing, coughing, etc. As you know - this injury plays with your head. I want it to be a sfx, but it feels like what I read about OP or sports hernia/pubalgia. Sorry the long post - I am inspired by folks who keep fighting, stay optimistic and get through injury. RB

  5. Your symptoms are eerily similar to mine. The groin pain, especially when sneezing, rolling over in bed, and running ... spreading to the abs and adductors. I was diagnosed with osteitis pubis after my first x-ray, but my Dr. changed his diagnosis after seeing the MRI. I was just starting to feel improvement 2 months after stopping running, and now I'm closing in on 6 months and still can't run 3 trail miles without irritation (I started cycling a couple months ago to stay active and that doesn't hurt at all). I did PT for a few months, but it didn't seem to help much and would often just irritate my injury. So your Dr. thinks its not a stress fracture because that would heal in 10 weeks??? Well, all of my research said that OP and a sfx in this area typically takes months to heal. I didn't believe it at first, but now I do. This bone gets very little blood flow relatively to other parts of the body, so it takes an extremely long time to heal. So, to answer your question, my recovery has been very slow. All your symptoms match, and I am convinced that I have a sfx (and OP inflammation caused by the sfx). I ran through my injury for ~9 months, my Dr said I almost broke all the was through the bone, and I had vitamin D/blood calcium issues that may have slowed my recovery further. In the end, I don't think it matters exactly what my diagnosis is. The fact is that as long as it hurts, something isn't right and my plan is to let it heal completely. All of my research says that groin injuries are difficult to diagnosis and slow to heal. That's my experience, and I think I still need more time. Hopefully you don't need as much time as me, but I would encourage you to be patient and cautious. Good luck and keep me posted.

  6. If I had a blog, it'd tell the exact same story as yours. My doc missed the SFX 10 months ago, diagnosed me with OP. I don't blame him - as you know, it's a tough one, and even MRI doesn't always make the call. When I got the MRI 7 months later (3 months ago) his position was the same - I have OP. Even though I did have a SFX at some point, right now - I have OP. He's right, I suppose. He's not too interested in whether and to what extent the misdiagnosis at the outset and the subsequent mismanagement contributed to the extent of the current inflamation and other issues I'm dealing with at this point. And he's right there too. As you pointed out - it doesn't matter. I haven't run since late June, I don't plan to run in the forseable future. I'm afraid to! I've been cycling in the mountains, learning to swim and just started a deep water pool running program. I am in the camp of folks who say that if it doesn't hurt and it doesn't aggravate the injury further, it's OK to cycle, swim, pool run, whatever. So, I am. I haven't tried ellyptical since early spring. I was also directed to take a daily dose of Vitamin D and glucosomine. It took me a while to accept that it was OK to stop running, that the goal is to get back to a lifetime of running. I had a whole season of trail ultras paid for, and tons of bragging rights at stake - including the UTMB - but I know if I behave, I'll get back to all of them someday. Hopefully next summer. Yeah, keep me posted. If I find the miracle cure, I'll let you know. This is a tough one, there are a lot of tough stories out there - most of them end with full recovery and reloaded strength. We'll get there.