Hip, hurt and hobbled
January 9, 2017 10:12 AM   Subscribe

After appropriately training for a couple of months, I ran a 4-miler on September 16th this past year. After hobbling across the finish line, and somehow making it back to my car and home, I was unable to put any weight on my right leg, and after X-rays and MRIs discovered that I had a stress fracture on the compression side of my femoral neck. I was able to spare myself surgery, and did everything on the appropriate timeline, but I am still not done.

After 6 weeks of being on crutches, I was granted freedom to walk about as I pleased. I used a cane for assistance for a few weeks more, and then started physical therapy. After weeks of PT, I had significant improvement in my range of motion, and strength, but I found that my pain levels were still largely the same. My follow up, 3 months from my date of injury, showed the same. My ortho reported that my X-rays show no fracture, but is still showing a lot of activity in that area, and my doctor was not able to clear me for regular activities yet. He said we are still in caution mode, and said that even he did not expect this to take as long as it has. I am now two weeks away from my 6 week follow up, with no improvement in pain, so I'm assuming my X-rays will not have changed much.

Has anyone else had experience with an injury like this? Why am I not healing all the way? This past year I was diagnosed with hypothyroidism and a vitamin d deficiency, both of which I take daily medications for and seem to be controlled well. I do not have any other health issues that I know of, and am only 33. For a young person he seemed surprised I haven't recovered. I have read forum after forum on femoral neck stress fractures like mine, and it seems like most people are pain free, for the most part, after about the 2 month mark. I find this really distressing. Has anyone else had an injury like this take a long time to heal. I wasn't expecting to just bounce back, but also wasn't expecting to have daily pain still when I am nearly 4 months out from date of injury.
posted by Quincy to Health & Fitness (6 answers total)
Three months from injury and six weeks of PT, is that right?

Goodness yes this is normal. I broke my wrist – both bones, in a few different places (it was basically exploded) – start of October 2015. Cast off at the start of December. Three days a week of physical therapy until April 2016!

The pain only really started to go away in March, six months after the injury. It's been more than a year now and it's still occasionally achy, although mobility and strength are nearly normal (I still work on it daily, it's slowly improving).

What does your PT say? Sometimes (often, according to my PT) doctors are a lot more optimistic than warranted. Keep listening to your body, everyone's different too, and not every injury is the same even when they're similar on paper.
posted by fraula at 10:53 AM on January 9, 2017 [3 favorites]

That is odd that its still remodeling after all this time, if you really stayed off it. Having said that stress fractures can be slow healing beasts, as any runner can tell you. Still, I think it might be time for a second opinion and or discussion with whoever is treating you for the Vitamin D deficiency. Are you still deficient? How is your diet? It takes a lot of calories to heal bones.
posted by fshgrl at 11:05 AM on January 9, 2017 [1 favorite]

I am going to my PCP for my follow up on my thyroid and plan to have them double check my vitamin d, and possibly order a bone density scan. My diet has been pretty horrible since my injury. Instead of eating less calories because I can't work out, I have been stress eating horribly.
posted by Quincy at 11:47 AM on January 9, 2017

Have you been taking any NSAID pain relievers? The consensus now is that many of them may impede certain mechanisms involved in bone healing, although the details are still hazy. You may want to specifically discuss with your PCP the possible role any medications you take regularly or periodically may be playing.

Otherwise, give your body time. It's entirely within the range of normality that your healing process may be happening at a normal rate that is nevertheless an outlier at the population level.

(I'm a toxicologist who long ago was involved in bone healing research)
posted by late afternoon dreaming hotel at 11:55 AM on January 9, 2017 [2 favorites]

Came here primarily to mention what late afternoon dreaming hotel said about nsaids and any other drugs you might be on. Older knowledge was to take nsaids for stress fractures, so you might have been recommended to take them for pain management.

Additionally since you mention the vit D deficiency, how are the rest of your nutrients for bone healing? First google result here? Zn, and Cu specifically might be low as my memory when I was healing from a stress reaction was my diet was low before I through in a nut mix with sunflower seeds. Zn still seems to be hard for me to get (no measured blood levels, just based upon looking up info on what I commonly eat). With a bone injury, I'd want my vit D levels to be on the high side of the spectrum rather than perhaps just reaching baseline (I'm not sure where you are but your "seem to be controlled" reads to me like low-normal).

Not all stress fractures are equal, you might just have had a severely bad one.

As long as the x-rays are showing increased activity in the area I wouldn't be too concerned about there still being pain.
posted by nobeagle at 12:46 PM on January 9, 2017 [2 favorites]

Sorry you're still hurting! I think it's pretty clear that yours was on the far extreme end of being not "just" a stress fracture, and probably worse than most you're reading about.

I have foot that has had several injuries. Each time, I had 6-8 weeks of non-weightbearing, so total complete rest, then a gradual return (boot, one crutch, sneakers, etc.) to bearing weight. And for those, at 4 months, still pain? Yes. Daily, yes. Less in the morning, then by evening, had to lay down.

I'd imagine that yours is a similar thing to a break, especially in that, well, you can't ever stop totally bearing weight on your hip.

So I don't think it's that surprising that at 4 months you're still in pain, and frankly I would expect it to continue. You're keeping a good watch with your doc, which is about all you can do right now, along with PT. Maybe ask the doc at what time mark would continued pain raise alarm bells, and spur further action.
posted by Dashy at 1:22 PM on January 9, 2017 [2 favorites]

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