"Technically Healed" so this is my FINAL post!

Here is my very final blog post. Today is 1st September 2009. The reason for the final post today is because I got this pelvic stress fracture injury in September 2008 and have therefore completed almost 1 year. This injury had literally consumed and drained me this past year as you can see from the previous post.

I got another MRI scan at the end of July (10-months post injury). The results: pubic ramus bone is no longer fractured and is now consolidated. This was wonderful news but still confusing as to why the pain/discomfort clearly remains, particularly increasing the longer I am sitting. As a result I still cannot cycle or take any impact (e.g.: jogging etc). The most frustrating thing is the long sitting periods in work and college. I need to shift and move about often to relieve the pressure. I can go for long walks since June without any time limits but the muscle burn in the groin intensifies the longer I go. It starts as a mild sensation on the surface, only feeling muscular, but as time progresses it moves the longer I’m moving. The radiologist, physio and doctor cannot explain. All they can see is the new MRI scan results which show a fully healed bone and no more extensive muscular oedema or avulsion tears. Therefore the severely stress-fractured pelvic bone has finally healed!

Despite improvement, being much more agile and able to finally walk pain-free and wear heels again after such a long difficult time, the groin burn continues and especially noticeable with certain sudden movements and as mentioned - sitting is the worse. So I dug into further investigation with fellow pelvic sfx sufferers on our group blog about it. I setup this community blog last year and it has been very active since and growing in members. One of the best pieces of advice I have received recently on the blog is from a female radiologist who suffered this same injury due to long distance running. She explained to me that despite the MRI showing stress fracture bone to be finally healed & consolidated, Micro-fractures on the bone will remain for some time after which take longer to heal and still require much rest in order to heal. Therefore I am at a very vulnerable stage and cannot increase exercise attempts beyond walking for now as this would cause the muscle in the area to pull on the pelvic bones thus straining it. Despite the fractured bone healed, it’s not 100% there yet and as the pelvis is attached to many ligaments and tendons these are constantly pulling on and moving pelvis. Therefore these micro-fractures will take more time.

Until then I have more than enough to keep me busy and don’t miss running etc. Being without any real exercise or gym for so long now I have gotten use to it and really enjoy and appreciate long walks with friends. However since August my priorities have changed since starting Masters in college. There is not much time for exercise or much other these days while juggling fulltime job and priority of Masters Course. It's a very interesting and enjoyable challenge but time consuming with constant assignments, study and job to keep me very busy indeed! The increased challenges and distractions for my mind helps ensure continued physical rest also. But I will join the gym again in a few weeks when the short & darker winter days approach. I should then be able to do some gentle cross-trainer and swimming as more of a relief and escape from work and study than anything else!

Overall I am happy with this progress update 1 year later but running and pre-injury state is still a long way off yet. I will continue to share updates on our group blog. Thank you to everyone for your comments throughout my blog, your support and emails through this very tough year+
Things are finally good again and I will work hard on making it continue and maintaining positivity! Any further updates on our group blog only, here:
Group Blog Link

This is the final post until healed

Today (May day!) marks 7 months since I got this infuriating & very confusing pubic ramus stress fracture. But I have learned & am still learning so much. I have decided that this will be the last post on my personal blog until healed. The next & final post will be one of delight when fully recovered. I was told by various people (doctor, physio's, orthopaedic & professor of sports anatomy etc) that it will take at least a year…

But since this, I had a long conversation with noted physiotherapist Gerard Hartmann (physio for athletes such as Paula Radcliffe, Sonia O’Sullivan, Eamonn Coughlin, Karl Lewis....). He explained the complexity of my pelvic fracture, which can easily take 18 months – 2 years in my case before recovered. SO, until then, here is a wrap up summary of the blog to date. I really look forward to writing the final post when healed, no matter how long more that will take!

Sept: Ran Berlin marathon 28th September for cancer. Wonderful & exhilarating experience. Trained very hard mixed with various races in the months leading up to Berlin.

Oct: Still limping since marathon with much groin pain. Doctor said it sounded like groin/muscle strain & prescribed anti-inflammatory tablets. They barely worked, still pain. Then I go physiotherapist…
End Oct: MRI scan diagnosis severe “stress fracture to the left inferior pubic ramus” with muscle avulsion tears etc.

Nov: Continue attempts of cycling & swimming only. Getting through this limited activity until the pain is too much then taking difene for relief. Still unaware of the severity & long-term nature of this injury.

Mid-Nov: Cellulitis infection in right foot. This is unrelated and separate to the fracture injury. Serious swelling, pain & inflammation in foot & up leg. Total 6-weeks with this. Bed/house bound with leg elevated & on crutches for 4 weeks before can return to work on crutches. Therefore this an enforced rest for fracture also…

Christmas Eve: Ease off the crutches & start walking slowly with only mild pain in foot (cellulites) but the pain from pelvic fracture clearly continues. Cycling 2-3 hours/day over Christmas holidays after 6-weeks of immobility & inactive. Pain still there but not as bad. Outdoors & air much needed after being housebound so long.

Mid-January: Pain too much from cycling & even walking form A-to-B. Referred to orthopaedic consultant. Isotope bone scans confirmed same severity of pubic fracture & no recovery. Instructed minimum 8-12 weeks of complete solid rest with 2-3 weeks of this on crutches. Not even swimming, walking or anything. Keep off feet as much as possible.

February, March - 1st April: Total & solid rest taken very seriously & aided by crutch(es). Minimal walking & not even able to stretch! During this time, my best friend of 25-years died of the same cancer that my Mum died of last year. At this point I reaLLy need my running & exercise passion to combat this. It’s my release outlet. But I’m on crutches! I’ll deal with it… and I did. It is impossible to describe the feelings (physically & mentally) of hitting rock bottom through this very tough period.

Start April: I say “right Lizanne we’re getting rid of this damn crutch now"..... Walking is much easier albeit very gently with mild limp & pain. A sudden movement or turn will send dagger into pubis. The pressure of sitting on the bone still remains. But I'm determined to only go upwards now & not allow this injury to take over everything.

Start Aqua-jogging group for injured athletes with Catherina McKiernan (Retired Irish Olympian runner) at out National Aquatic Centre. I last 2-3 aqua jog sessions of 45mins… the pain returns full force. Back to limp & total rest again after almost 2 weeks of showing improvement for the first time.

Mid-April: Catherina & fellow coaches advises me onto Professor of Anatomy & sports medicine and chairperson of The Irish Osteoporosis Society. The DEXA bone density scan showed no osteoporosis thankfully. Professor prescribed high calcium + Vit-D tablets, put on gluten-free & greatly fiber reduced diet to aid absorption of vits & minerals to aid bone repair.

Referred to a well-known Dublin physiotherapist. This is the latest update (May) after 2 physio sessions with him. Today I still have pain & continue to do stretching/strengthening core exercises only. Walking normally but it's minimal & slow. So I have now (1st May) reached 7-months no running or impact exercise. Walking gently A-to-B is OK but the pain more prominent after 20+ minutes on feet. I return to the Professor in a few weeks for more results of tests.

And my sanity?!? Absolutely fine. I have learned so much along my journey through this rocky section of my life. The way I see it is that these obstacles prove very challenging but by treating them as experiences to learn from, they can be put in the past & I know I will return to the good times eventually. Sticking to this philosophy. I setup a community group blog. The authors of this blog are people from all over who share the same experiences & frustrations with this pelvic fracture. The group blog provides the much needed understanding & support to each other. (Link below)

Next steps: A much needed holiday but not as active as I would like. Going on a 3-week South African camping safari tour soon. I will just have to take it easier than the rest of the group & be a spectator only for some of the activities! Starting my part-time Masters course in August at Smurfit Business College, UCD. I will continue working fulltime job through studies so until that kicks in, I want to take advantage of the free time by focusing on friends, family, work & life! This injury will no longer consume me as it has for too long now.

There are positives. I will get better because nothing lasts forever. This is just another experience (very difficult, upsetting & long experience admittedly) that will serve to make me a stronger person. It continues to put so many other things into perspective & provides valuable lessons. When I'm able to walk properly & get outdoors to enjoy any kind of exercise again I will be so grateful. It's amazing how much we normally take for granted!

Until my next post when healed, updates of progress will continue on our group blog. Click here: Group Blog

You can see the location of my pubic ramus fracture in this diagram and also see why it's sore when sitting - directly on the fractured bone!

New support group blog :-)

I have adopted a new support group of people who truly understand what has taken over my life - as it has done the same to them. We all share the same understandings, frustrations & support each other in our group blog below.
My pelvis is in knots. Also the groin pain is changing again. Apparently this is ‘normal’ though and all part of the veryy longgg process! My updates continue on our new group blog with others here: pelvicstressfractures.blogspot.com

And our wonderfully active support group on runnersworld here: Chats with those who are experiencing the same.

Hope is fading rapidly but I must and will hang in there for the long haul!

Its official: This is the most absolutely insane injury recovery process. Minimum of 1-year before walking and sitting pain free... and running probably never again. I have never, and will never, have my patience tested so much. It’s a small comfort to find these people experiencing exact same frustrations. It’s a very uncommon injury where only the few people who have it can really understand & relate. Have a quick look by clicking here:
People from Runners World with exact same.

Back to square 1: March 2009

Full set of crutches again due to zero improvement from 6-weeks of total rest so far. I emphasise the word TOTAL. The limp & pain persists. Following review he said there would be no improvement whatsoever until ALL weight bearing is removed completely by using full crutches constantly. Admittedly I was only using 1 crutch and didn't bring to work while only limping there. The grey stick just doesn’t match any of my clothes and looks rather pitiful. Despite never applying any normal walking pressure during all this time - the limping was still too much pressure on the pelvis.

Did you know that “The pelvis supports the entire weight of the body and all muscles”? Therefore your pelvis is the most serious and worse possible place to get a fracture - particularly the inferior pubic ramus bone (in my case). I have genuinely been taking this rest business v-seriously ensuring as little need to move as possible. Sacrifices galore have been made to ensure no unnecessary travel or movement. But this evidently was not enough. Yes I know…. should have been using both crutches all along.

Receiving blog comments & emails from fellow sufferers, which is reassuring knowing I'm not alone even though the severity of stress fracture varies. For me the pelvis is severely fractured, wehey. I'm starting to wonder how much longer I can maintain the positive outlook and brave face. My patience with this total sedentary life can only stretch so far. Hearing friends speak of brighter sunnier days for walks and jogs in the park only puts more salt into the wound despite their good intentions. That feeling of pure bliss is now a distant memory. Bring on 'life'… soon again please God? Any comments welcome. (but not if referring to the idea that perhaps I may be now starting to reach insanity)

Update!

My pelvic stress fracture continues. Up to 5-weeks so far of absolute total rest. Still a limp and using crutch as much as possible. The pain is frustratingly still the same with no improvement. But staying positive despite the rarity of success stories from few fellow sufferers around the world! Excellent forum here with comments from those also frustrated from lack of recovery. Click here: Stress Fracture of Pubic Ramus

February 2009:

I was referred to orthopaedic surgeon January 2009 as the stress fracture was now constantly painful even when sitting or standing. He said the MRI scans from October (near 4-months prior) displayed a very problematic injury. He sent me for Isotope nuclear bone scans. By this stage I was limping and had already cancelled gym membership and put bicycle in storage. Any form of exercise was impossible.

Results of scans arrived: “Lizanne, I cannot emphasise enough how problematic this is. The pubic ramus bone is detached from pelvis. You must take absolute rest for minimum of 3-months. This is the only way it will ever heal. This means avoid walking from A-to-B. For 2-months of this on crutches to alleviate any weight bearing". I couldn’t believe that 4-months later this was even worse - despite not ever running/jogging in all these months but only some low-impact gym classes.

The main challenge initially was adjusting the mind to accept this long-term plan of absolute rest! I now needed to plan alternative evening and weekend activities to keep constantly distracted in order to further deal with this now constant and absolute enforced ‘rest’ for at LEAST 3 months! These activities would need to ensure minimum movement of course! I have now revisited my old passion of playing piano. Thankfully I haven’t forgotten the basics. I am also learning Spanish for beginners. I don’t necessarily aim to become a fluent speaker but enough to engage in general conversation. It’s not only the most widely spoken language in our world but also a beautiful and generally ‘easy’ language to learn. My main priority is to spend every weekend with friends and family. I’m enjoying re-living earlier days again by getting the train to different parts of Ireland to spend weekends with family and friends. Over the past few years my evenings after work/college running consisted of running and/or gym before any ‘relaxation’ time. The weekends also needed to consist of at least 1-decent run before chilling out. Things have changed a lot….

This huge change has been a struggle initially but I’m surprised at how quick and easy I have adapted! It was very upsetting and frustrating to accept even more bad news considering the non-stop misfortunes of the previous 22-months. After a few weeks of a very slowed down self, I feel my mentality and attitude is completely changed for the better. I have become far more laid back and happy. I’m really enjoying all this new increased time catching up with friends and family and taking up previous hobbies including lots of reading. The pain continues however and I'm still limping and using crutch (I won’t bring it to work though!). I’m learning and adopting some very important things already. The main attitude shift is no longer (1) complaining about on-going issues (2) dwelling on past circumstances (3) any negativity… A shift to only positive thoughts and energies has made me feel ultimately content, at ease and in control again :-)

“When you think negative thoughts and feelings, you are simply separating yourself from the world and others by sending out negative energy signals. Therefore, only attracting like back to like so more negativity and misfortune!

Competition is an example of separation – coming from a lack of mentality as you are saying there is a limited supply. (I have always been very competitive in every aspect of life). By doing this, you are saying that there is not enough for everybody so we have to compete and fight to get things. When you compete you can never win, even when you think you have won. By the law of attraction, as you compete you will attract many people and circumstances to compete against you! This I now understand :-)

A person who sets their mind on the dark side of life, who lives over and over the misfortunes and disappointments of the past is essentially praying for similar misfortunes and disappointments in future. If you will see nothing but ill luck in the future, you are asking for such ill luck! If you go back over your life and focus on the difficulties from the past, you are just bringing more of this into your life. By deliberately focusing only on what we want, we begin to radiate good feelings.

This is why I have chosen to accept this new way of thinking and break free from my previous patterns, routine and ways of thinking. To do this I am maintaining an awareness of my present thoughts and feelings and adjusting when necessary. I have a reminder throughout the day o become aware of my thoughts and feelings and adjust these if they are negative thoughts. Every day I am now also acknowledging gratitude for what I do have and what I can and will have. I have never had the time to think of just how grateful I am for all the positive things! Our thoughts are constantly being emitted, returning and creating our future. This may sound like the typical “self-help” baloney or just a simple affirmation "positive thinking" process… but it's a lot deeper than that. The law of attraction really IS “The Secret" to life...