Frequent Stress Fractures...?
maureenseel1984
Posts: 395 Member
First a little background:
I have type 1 diabetes (which means later in life you're more prone to getting weak bones)
I have a history of an eating disorder...basically recovered now but was on and off for a few years since 2015.
I haven't had Celiac disease ruled out yet...dreading that test-if it's positive I'd have to give up so many of my favorite foods.
I started training for a full marathon back in 2017-2018. Granted-I was definitely not eating enough to support the amount of running/mileage I was doing. I also ignored my body's signals...when I was in pain, I started taking aspirin before my long runs because I'd start having mostly hip pain, but some pain in my shins. Well after one of my last long training runs (20 miles), I had horrible pain in my shins that wouldn't go away. I had an MRI and that was the first time I was diagnosed with stress fractures. After that it was just..on and off...fractures. I'd be told to rest, I'd rest...I did PT..then when I'd return to running the fractures came right back. I am now in the middle of a 6 month rest period-can't run again until September.
I saw a metabolic bone specialist who is trying to rule out the root cause of the issue. I already had a Dexa scan and it came back normal, but I am wondering...anybody else have issues with chronic fractures? I'm getting so discouraged-I love running and I miss it terribly...and now I'm afraid I'll never be able to get back to it.
I have type 1 diabetes (which means later in life you're more prone to getting weak bones)
I have a history of an eating disorder...basically recovered now but was on and off for a few years since 2015.
I haven't had Celiac disease ruled out yet...dreading that test-if it's positive I'd have to give up so many of my favorite foods.
I started training for a full marathon back in 2017-2018. Granted-I was definitely not eating enough to support the amount of running/mileage I was doing. I also ignored my body's signals...when I was in pain, I started taking aspirin before my long runs because I'd start having mostly hip pain, but some pain in my shins. Well after one of my last long training runs (20 miles), I had horrible pain in my shins that wouldn't go away. I had an MRI and that was the first time I was diagnosed with stress fractures. After that it was just..on and off...fractures. I'd be told to rest, I'd rest...I did PT..then when I'd return to running the fractures came right back. I am now in the middle of a 6 month rest period-can't run again until September.
I saw a metabolic bone specialist who is trying to rule out the root cause of the issue. I already had a Dexa scan and it came back normal, but I am wondering...anybody else have issues with chronic fractures? I'm getting so discouraged-I love running and I miss it terribly...and now I'm afraid I'll never be able to get back to it.
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My son had this issue in high school when he was on the cross country team. He basically had to give up running for most of the year and then when he returned to running, had to ramp up to long distances at a MUCH slower pace than what they were doing on the team. He does okay now but it was a combination of poor running stride, and pushing too hard too fast. Some bodies aren't meant for a fast immersion into running and your overall lifetime fitness plays a part in that.4
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My son had this issue in high school when he was on the cross country team. He basically had to give up running for most of the year and then when he returned to running, had to ramp up to long distances as a MUCH slower pace than what they were doing on the team. He does okay now but it was a combination of poor running stride, and pushing too hard too fast. Some bodies aren't meant for a fast immersion into running and your overall lifetime fitness plays a part in that.
I'm sure...yeah. I think part of what has me so frustrated is that I did do PT and followed their instructions for running...and it STILL happened.
I know when I do (if I do) get back to running, I'll go much slower. I think it really didn't help that I wasn't nourishing my body properly when I was doing my marathon training.
But I'd rather hear that than that I have Celiac disease. It is very possible I do since I have type 1 and the two diagnoses go hand in hand quite often...but...oh god, please don't take away my pasta!3 -
Just chiming in about celiac disease - a member of my family was diagnosed finally several years ago. Over time, she has become used to a new way of eating and even though she, too, loved pasta, she was able to satisfy her appetite after finding some gluten free products that she really liked. It has become easier for her to manage over time, and since finally getting a correct diagnosis and making the needed dietary adjustments, she feels 150% better overall. Courage, my friend
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You need muscle to support those bones. Yes, enough nutrition. And maybe strength exercises, no impact.
My daughter was prone to stress fractures and she uses a combination of shoe prosthetics and modified stride to keep running.
Body awareness, body respect.3 -
Just chiming in about celiac disease - a member of my family was diagnosed finally several years ago. Over time, she has become used to a new way of eating and even though she, too, loved pasta, she was able to satisfy her appetite after finding some gluten free products that she really liked. It has become easier for her to manage over time, and since finally getting a correct diagnosis and making the needed dietary adjustments, she feels 150% better overall. Courage, my friend
Yeah. I mean I'm a dietitian and have had type 1 diabetes for nearly 20 years now. I'm used to gluten free diets in theory-understand what it entails. And honestly GF products have gotten SO much better over the years. It also is worrisome because I don't want it to become a gateway for the "ED" to sneak back in.3 -
maureenseel1984 wrote: »Just chiming in about celiac disease - a member of my family was diagnosed finally several years ago. Over time, she has become used to a new way of eating and even though she, too, loved pasta, she was able to satisfy her appetite after finding some gluten free products that she really liked. It has become easier for her to manage over time, and since finally getting a correct diagnosis and making the needed dietary adjustments, she feels 150% better overall. Courage, my friend
Yeah. I mean I'm a dietitian and have had type 1 diabetes for nearly 20 years now. I'm used to gluten free diets in theory-understand what it entails. And honestly GF products have gotten SO much better over the years. It also is worrisome because I don't want it to become a gateway for the "ED" to sneak back in.
I totally get your concern. I wonder about strategies to find ways to alleviate your anxiety without over-controlling/restricting with food. (thanks, Cap. Obvious? lol) There might be some practices that were really helpful with this when you were in your recovery journey that might be helpful now
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Yeah. I still work with a dietitian...and honestly I'm the most recovered that I have been since I was inpatient...I'm feeling good about my health and my body image despite being the heaviest I've been my entire adult life...so I think that's good. I'm coming from a much healthier mindset than I had before.6
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You seem similar to me -- I'm type 1, with an eating disorder/working on recovery, hypothyroid and celiac. And osteopenia -- I've had a couple of outright breaks, and had a stress fracture in 2017 that took eight weeks to fully heal. I'm also a distance runner.
Have you had a followup Dexa to see where things now? It's recommended that you get those repeated every 2-5 years (my PCP says 2 for outright osteoporosis, 5 for osteopenia).
Also -- What kind of orthopedist are you working with? I work almost exclusively with a sports medicine ortho for anything involving those fractures or overuse injuries.
Keep in mind that the reality is that if your bone loss is worsening, you may not be able to go back to running -- it sucks, but it's the reality (and it sucks that it's a consequence of past actions, but there we have it). PT can help, but it won't bring your bone mass back.
I would push for celiac testing. If you're not absorbing nutrients, it's never going to get better. I know it sucks to give things up, but it's amazing the difference you'll see in how you feel. And, you might also find that your blood sugar levels out more and is more predictable -- I was shocked at how much less I swung once my body actually started absorbing food as it should, rather than when it was able to.
Keep working with your dietitian, too. Make sure that you're eating to fuel *all* of your workouts -- that's just going to make things worse if you aren't.6 -
The only person I know who has that issue was anorexic for years. She did manage to continue running, despite intervals of broken bones. She does a lot of running on an Alter-G or pool to reduce stress on the bones. She does marathons and is very competitive at shorter distances.
I had one sfx (pelvis) and it took a while to heal and for me to be able to run without getting reinjured. I had a brief period when I was young where I was too depressed to eat normally, but I don't know if that was why I developed osteopoenia. Fortunately, AFAIK, that was the only sfx and in the 7 years since I have been able to run 5 marathons.0 -
collectingblues wrote: »You seem similar to me -- I'm type 1, with an eating disorder/working on recovery, hypothyroid and celiac. And osteopenia -- I've had a couple of outright breaks, and had a stress fracture in 2017 that took eight weeks to fully heal. I'm also a distance runner.
Have you had a followup Dexa to see where things now? It's recommended that you get those repeated every 2-5 years (my PCP says 2 for outright osteoporosis, 5 for osteopenia).
Also -- What kind of orthopedist are you working with? I work almost exclusively with a sports medicine ortho for anything involving those fractures or overuse injuries.
Keep in mind that the reality is that if your bone loss is worsening, you may not be able to go back to running -- it sucks, but it's the reality (and it sucks that it's a consequence of past actions, but there we have it). PT can help, but it won't bring your bone mass back.
I would push for celiac testing. If you're not absorbing nutrients, it's never going to get better. I know it sucks to give things up, but it's amazing the difference you'll see in how you feel. And, you might also find that your blood sugar levels out more and is more predictable -- I was shocked at how much less I swung once my body actually started absorbing food as it should, rather than when it was able to.
Keep working with your dietitian, too. Make sure that you're eating to fuel *all* of your workouts -- that's just going to make things worse if you aren't.
I work with a sports ortho...he's been following me for like a year and a half...and I did running clinic/physical therapy.
I'm having a repeat Dexa next week as well as the Celiac workup and looking at kidney function/if I'm losing calcium through urine.
It's surprising I never had Celiac workup given that I've had Type 1 since I was 15/for 20 years now. I think I could live with Gluten Free but...if I don't have to...LoL2 -
spiriteagle99 wrote: »The only person I know who has that issue was anorexic for years. She did manage to continue running, despite intervals of broken bones. She does a lot of running on an Alter-G or pool to reduce stress on the bones. She does marathons and is very competitive at shorter distances.
I had one sfx (pelvis) and it took a while to heal and for me to be able to run without getting reinjured. I had a brief period when I was young where I was too depressed to eat normally, but I don't know if that was why I developed osteopoenia. Fortunately, AFAIK, that was the only sfx and in the 7 years since I have been able to run 5 marathons.
5 marathons?! That's amazing! Three of my four sisters have run marathons and it has been on my bucket list for a long time-all 4 of my sisters also suffered from eating disorders. I've done many half marathons and honestly had no problems up until my anorexia really got bad and then I trained for the marathon-that's when all the problems started. 1 -
maureenseel1984 wrote: »First a little background:
I have type 1 diabetes (which means later in life you're more prone to getting weak bones)
I have a history of an eating disorder...basically recovered now but was on and off for a few years since 2015.
I haven't had Celiac disease ruled out yet...dreading that test-if it's positive I'd have to give up so many of my favorite foods.
I started training for a full marathon back in 2017-2018. Granted-I was definitely not eating enough to support the amount of running/mileage I was doing. I also ignored my body's signals...when I was in pain, I started taking aspirin before my long runs because I'd start having mostly hip pain, but some pain in my shins. Well after one of my last long training runs (20 miles), I had horrible pain in my shins that wouldn't go away. I had an MRI and that was the first time I was diagnosed with stress fractures. After that it was just..on and off...fractures. I'd be told to rest, I'd rest...I did PT..then when I'd return to running the fractures came right back. I am now in the middle of a 6 month rest period-can't run again until September.
I saw a metabolic bone specialist who is trying to rule out the root cause of the issue. I already had a Dexa scan and it came back normal, but I am wondering...anybody else have issues with chronic fractures? I'm getting so discouraged-I love running and I miss it terribly...and now I'm afraid I'll never be able to get back to it.
To be honest, I’ve not got much knowledge about female hormone levels. I have a little experience working with 2 men with Low T, which in turn causes low estrogen, causing issues with bone health. One of them had VERY similar issues and experiences as you and turned out to have low T.
I’m not sure the symptoms of low E in women but I do know one of them is having bone density problems and longer term osteoporosis... worth a check IMO and working with an Endo or a clinic if levels come back out of range1 -
To be honest, I’ve not got much knowledge about female hormone levels. I have a little experience working with 2 men with Low T, which in turn causes low estrogen, causing issues with bone health. One of them had VERY similar issues and experiences as you and turned out to have low T.
I’m not sure the symptoms of low E in women but I do know one of them is having bone density problems and longer term osteoporosis... worth a check IMO and working with an Endo or a clinic if levels come back out of range
So fortunately the doc I saw in the metabolic bone center (actually a former colleague) is an endocrinologist. She thinks that could very well be a problem, but it is hard to figure that out, as I'm on an IUD that can mess with hormone levels.
I do think she's looking into that as well as calcium and vitamin D intake and absorption.
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maureenseel1984 wrote: »To be honest, I’ve not got much knowledge about female hormone levels. I have a little experience working with 2 men with Low T, which in turn causes low estrogen, causing issues with bone health. One of them had VERY similar issues and experiences as you and turned out to have low T.
I’m not sure the symptoms of low E in women but I do know one of them is having bone density problems and longer term osteoporosis... worth a check IMO and working with an Endo or a clinic if levels come back out of range
So fortunately the doc I saw in the metabolic bone center (actually a former colleague) is an endocrinologist. She thinks that could very well be a problem, but it is hard to figure that out, as I'm on an IUD that can mess with hormone levels.
I do think she's looking into that as well as calcium and vitamin D intake and absorption.
I would just stay confident and keep trying to work with your Endo to figure it out. It’s weirdly similar to the guy I mentioned above which is why I even posted.
Just don’t get discouraged and don’t get down. You’ll find the solution, it may just take some time, but once you get your hormones “dialed in” the changes are massive and they begin to come fairly quickly.
Outside of that I would just take it slow when you are increasing mileage. not sure if you swim, but maybe learn to swim well and use that. Take a few days off a month of your running schedule and use them to keep your aerobic work, but less impact on your bones for the time being.
Based off your picture you seem pretty strong so I’d assume you do some weight training? Either way I’d focus on working heavy loaded compound exercises to help improve potential bone density issues
You’ll find the solution, just keep at it.
All the best.3 -
I would just stay confident and keep trying to work with your Endo to figure it out. It’s weirdly similar to the guy I mentioned above which is why I even posted.
Just don’t get discouraged and don’t get down. You’ll find the solution, it may just take some time, but once you get your hormones “dialed in” the changes are massive and they begin to come fairly quickly.
Outside of that I would just take it slow when you are increasing mileage. not sure if you swim, but maybe learn to swim well and use that. Take a few days off a month of your running schedule and use them to keep your aerobic work, but less impact on your bones for the time being.
Based off your picture you seem pretty strong so I’d assume you do some weight training? Either way I’d focus on working heavy loaded compound exercises to help improve potential bone density issues
You’ll find the solution, just keep at it.
All the best.
Thanks so much for the words of encouragement. I did do aqua-jogging for a while. My strength training is yoga (as seen in the picture ) Which has been good for body, mind and spirit. 0 -
I’m sorry you’re going through this. Are you open to trying other activities like cycling, swimming, walking, rowing, weight lifting, racket sports, etc. Maybe you’ll find other things you enjoy ircleatn to enjoy “almost” as much as running.0
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I’m sorry you’re going through this. Are you open to trying other activities like cycling, swimming, walking, rowing, weight lifting, racket sports, etc. Maybe you’ll find other things you enjoy ircleatn to enjoy “almost” as much as running.
OH yeah I mean...when I'm on rest from running I do yoga...I walk my dogs when it's not hot as b@lls outside. I did swim, but my membership got too expensive. I don't have a bike anymore but my husband and I have talked about getting me a road bike.0 -
maureenseel1984 wrote: »To be honest, I’ve not got much knowledge about female hormone levels. I have a little experience working with 2 men with Low T, which in turn causes low estrogen, causing issues with bone health. One of them had VERY similar issues and experiences as you and turned out to have low T.
I’m not sure the symptoms of low E in women but I do know one of them is having bone density problems and longer term osteoporosis... worth a check IMO and working with an Endo or a clinic if levels come back out of range
So fortunately the doc I saw in the metabolic bone center (actually a former colleague) is an endocrinologist. She thinks that could very well be a problem, but it is hard to figure that out, as I'm on an IUD that can mess with hormone levels.
I do think she's looking into that as well as calcium and vitamin D intake and absorption.
As far as I'm concerned, vasectomy blows all other forms of birth control out of the water
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kshama2001 wrote: »maureenseel1984 wrote: »To be honest, I’ve not got much knowledge about female hormone levels. I have a little experience working with 2 men with Low T, which in turn causes low estrogen, causing issues with bone health. One of them had VERY similar issues and experiences as you and turned out to have low T.
I’m not sure the symptoms of low E in women but I do know one of them is having bone density problems and longer term osteoporosis... worth a check IMO and working with an Endo or a clinic if levels come back out of range
So fortunately the doc I saw in the metabolic bone center (actually a former colleague) is an endocrinologist. She thinks that could very well be a problem, but it is hard to figure that out, as I'm on an IUD that can mess with hormone levels.
I do think she's looking into that as well as calcium and vitamin D intake and absorption.
As far as I'm concerned, vasectomy blows all other forms of birth control out of the water
Haha! Yes well...hubby did go that route...I have the IUD for other reasons (horrific periods)1 -
I highly recommend biking. It is worth the investment to buy a good bike - a used one maybe? If you want to replace running, you should get a street bike. I have a hybrid trek, which I LOVE, but I stay between 12 and 15 MPH. If you want to start biking competitively, you may want to stay with a street bike. I hope you are able to find out what is wrong and fix it.0
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I got stress fractures over and over again in a three year period. What finally corrected it for me was slowly switching to a different running form. I was a heel striker wearing oversupportive shoes. I slowly transitioned to a barefoot shoe(over 2 years slowly reducing the support in my shoe purchases until I was wearing vibram toes shoes. The distance in each shoe started very gradually to ramp up as well each time I “graduated” to a new shoe. Within those two years I started running half marathon distances regularly, and my pace got faster. I will never be FAST, but I had improvement. The most notable, my lower legs, which were always skinny no matter my weight, gained 1.5” in diameter. So, I am not saying transition to barefoot style(even though it rocks!), but do look at your gait, your shoes, and for sure the muscle mass in your lower body.1
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Curious... you aren’t on any meds for heartburn are you? I was on PPIs for a little over a year for ulcer/GERD. I kept getting stress fractures. Apparently you don’t absorb as much minerals and it gets pulled out of your bones. Just a thought2
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youngmomtaz wrote: »I got stress fractures over and over again in a three year period. What finally corrected it for me was slowly switching to a different running form. I was a heel striker wearing oversupportive shoes. I slowly transitioned to a barefoot shoe(over 2 years slowly reducing the support in my shoe purchases until I was wearing vibram toes shoes. The distance in each shoe started very gradually to ramp up as well each time I “graduated” to a new shoe. Within those two years I started running half marathon distances regularly, and my pace got faster. I will never be FAST, but I had improvement. The most notable, my lower legs, which were always skinny no matter my weight, gained 1.5” in diameter. So, I am not saying transition to barefoot style(even though it rocks!), but do look at your gait, your shoes, and for sure the muscle mass in your lower body.
That's what I don't get though. I wear really good shoes, have proper form and had no fractures up until that stretch of time I was training for my marathon. I did PT to analyze and correct any problems with my stride. I'd been doing long distances before but...who knows.0 -
maureenseel1984 wrote: »That's what I don't get though. I wear really good shoes, have proper form and had no fractures up until that stretch of time I was training for my marathon. I did PT to analyze and correct any problems with my stride. I'd been doing long distances before but...who knows.
But you already mentioned upthread that you did your marathon training under conditions of low energy availability. This reduces your body's ability to repair damage and increases the likelihood of stress fractures and overuse injuries...2 -
maureenseel1984 wrote: »That's what I don't get though. I wear really good shoes, have proper form and had no fractures up until that stretch of time I was training for my marathon. I did PT to analyze and correct any problems with my stride. I'd been doing long distances before but...who knows.
But you already mentioned upthread that you did your marathon training under conditions of low energy availability. This reduces your body's ability to repair damage and increases the likelihood of stress fractures and overuse injuries...
I just don't get why it continues to happen. It's been over a year at this point. 0 -
maureenseel1984 wrote: »maureenseel1984 wrote: »That's what I don't get though. I wear really good shoes, have proper form and had no fractures up until that stretch of time I was training for my marathon. I did PT to analyze and correct any problems with my stride. I'd been doing long distances before but...who knows.
But you already mentioned upthread that you did your marathon training under conditions of low energy availability. This reduces your body's ability to repair damage and increases the likelihood of stress fractures and overuse injuries...
I just don't get why it continues to happen. It's been over a year at this point.
While I didn't actually intend this pun, it could be that your body more or less reached its breaking point physically. You weren't doing yourself any favors, physiologically, when you trained for your previous marathon under less than ideal circumstances and you're likely seeing the results of this combined with damage that's been done previously. I wonder if the type 1 diabetes might have something to do with this as well with regards to your risk of fractures. Very very cursory research on my part says there is some correlation. I would discuss this explicitly with both your endo and your ortho.3 -
maureenseel1984 wrote: »I just don't get why it continues to happen. It's been over a year at this point.
But you're now operating on already compromised skeletal structures and if you're recovering from the equivalent of female athlete triad how long does it take for all hormones to come back to their "correct" levels to ensure a return to full strength?
Absent any other consideration, if I told you that I broke my <insert bone> twice in the past year, would you show any surprise if I told you that I fell the other day and broke my <insert bone> a third time? The structure may be somewhat compromised making it more susceptible
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maureenseel1984 wrote: »maureenseel1984 wrote: »That's what I don't get though. I wear really good shoes, have proper form and had no fractures up until that stretch of time I was training for my marathon. I did PT to analyze and correct any problems with my stride. I'd been doing long distances before but...who knows.
But you already mentioned upthread that you did your marathon training under conditions of low energy availability. This reduces your body's ability to repair damage and increases the likelihood of stress fractures and overuse injuries...
I just don't get why it continues to happen. It's been over a year at this point.
While I didn't actually intend this pun, it could be that your body more or less reached its breaking point physically. You weren't doing yourself any favors, physiologically, when you trained for your previous marathon under less than ideal circumstances and you're likely seeing the results of this combined with damage that's been done previously. I wonder if the type 1 diabetes might have something to do with this as well with regards to your risk of fractures. Very very cursory research on my part says there is some correlation. I would discuss this explicitly with both your endo and your ortho.
Yeah. The tests should give us more information as to what's going on and what we should do next.2
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