The Stress Fracture Diary: A Return to Running?

Yesterday marked one full month since I've been out of the boot and off the scooter. It went by wickedly fast and thankfully, the memories of being non-weight bearing are fading.

So now the question remains; when can I start running again?

The answer isn't easy to determine. There is no "one size fits all" treatment to stress fractures. Depending on the location and severity of the fracture, healing could take six weeks or six months or even a year or more. That doesn't mean that you can't run during that time, but it does mean that precautions have to be taken and mileage can only be built up very, very slowly.

When I visited my orthopedic doctor last month, he told me I could start running as soon as two weeks ago. He said to take it easy, continue with my low-impact workouts, and start to incorporate running into my walks. Anytime I had pain in my foot I was to back off and take a rest day. His instructions were a little ambiguous and I was eager to have a more concrete plan as I didn't want to re-injure the fracture and have to go back in the boot or have surgery.

So I scheduled a visit with my PT two weeks ago. He suggested that I start walking three times a week, starting with a half hour, and then increasing by a few minutes each time. When I asked when I could run again, he said two things needed to happen:

- Walk two pain-free miles
- Walk pain-free on back to back days

In the last month, I've been following all my doctor's orders to the letter. Walking slowly, backing off when I feel pain, taking rest days when my foot hurts. I even called the orthopedic doctor a week after the boot came off because I was having pain at the site of the fracture. He assured me that this was normal and that I'd continue to have pain for quite a while as the bone heals.

Pain is a funny thing- it's hard to judge what's "normal" healing pain and what could be re-injury pain. A quick google search of "stress fracture recovery pain" will give you all sorts of timelines about when it should hurt, where it should hurt, and for how long it will hurt. But pain is subjective and it's difficult to measure- especially when you've never had pain like this before.

I know I'm being overly cautious with this injury and that I could have started running earlier. But the risk of re-injury with a stress fracture is high. And if I were to injure this foot again, the options would be crappy: surgery, more time in the boot/scooter/crutches, or never running again. I'd like to avoid all of those if possible, thank you very much.

But here's the good news. Last week I tried back to back walking days for the first time- and both workouts were 95% pain-free! I'm fairly confident that I will try to run a little this weekend- maybe only for 3-5 minutes. But I think I'm ready. I'm still terrified that I will re-injure the fracture or incur some other injury, but I know I have to get back out there and try. Running is a large part of who I am so no matter how scary it will be, I will get back out on the road.