How to Return to an Exercise Program After a Stress Fracture or Sports Injury

Sometimes a stress injury can seem to come on suddenly, even though it may have been building to a breaking point for weeks - or even years - slowly and quietly. That was the case with me when I suffered a sudden stress fracture in my foot. One moment I was walking briskly around a track with a friend and then, less than an hour later, I was barely hobbling off the track. It felt like someone had taken a hammer to my ankle and heel of my left foot .

At first, I assumed I was merely out of shape and had sore muscles, even though the pain was centered primarily in that one ankle area of my foot. But within a few days, I couldn't deny that something more serious than a mere muscle sprain might be happening. The pain lingered and worsened. Buying new athletic shoes didn't help. Neither did taking over the counter painkillers like Tylenol or Advil. Finally, I went to my doctor, got an x-ray and was shocked by the diagnosis. I had a stress fracture, a particular type of sports injury which can be associated with certain types of exercise. According to her, I actually had tiny tears and even a break in one of my bones. I was baffled. How could I possibly be walking on a broken bone?

In the next few weeks, I learned a great deal about stress injuries. My primary goal was maintaining my exercise routine. With that in mind, I was sent off to see a team of orthopedic doctors. I hoped they'd find a way to allow me to keep exercising - and they did.

Stress injuries and fractures - what are they?

Although I heard varying theories about what causes stress fractures, my doctors told me that a stressed bone can get a small crack or break in it. This was indeed the case with me and that break was located near my back heel area. Sometimes these types of tears or breaks are also known as repetitive stress injuries. They occur fairly often in athletes, particularly runners, according to information found at the Merck online medical library here:www.merck.com/mmpe/sec21/ch324/ch324m.html , and (as I experienced) can occur suddenly after a long workout. I discovered that I was lucky because some information indicated that it could take repeat x-rays to properly diagnose a stress injury. They don't always show up right away, a fact also confirmed by my local orthopedic specialists.

Other types of stress injuries can include tears in the Achilles tendon, shin splints, various sprains in other parts of the body, tendonitis - and more. Ironically, stress injuries can occur both in elite athletes who train too often or couch potato types who suddenly start an overly ambitious exercise routine. In short, they can happen to anyone.

Without knowing it, I'd been risking that stress fracture for years because I'd been running on a particularly hard surface. Even though I hadn't felt any warning signs, the repeated impact of my feet against that very hard track had put me at an increased risk for muscle damage and tiny breaks in my bones. That was indeed what happened. I was a classic textbook case for a stress fracture patient.

Stress fractures and injuries - how to get back to your exercise program as quickly as possible

At first, I felt very disheartened. If I had a break or stress fracture in my ankle, I thought I'd have to stop exercising. I'd worked long and intensely to lose weight, eat properly and make progress. Would I suddenly have to let all that slide? I was afraid all my hard work would be in vain. So I had a pretty glum face when I me with the orthopedic doctors.

Stress injuries - how I found an exercise routine that kept me fit but allowed my foot to heal

Happily, my doctors reassured me that I didn't have to stop exercising. They did recommend that I stay off the foot for a few weeks but noted that I could then find alternate exercises that would maintain my fitness level. Even before then, I could lift weights, although they preferred I do that while sitting in a chair or exercise machine. They also noted that I also needed to wear orthotics, special foot pads to help cushion my damaged foot as well as help prevent further damage. The doctor got an imprint of my foot in the office and ordered custom orthotics for both my feet, including the one that didn't (yet) have a stress fracture.

When it came to my exercise program, I met with a fitness trainer who also had a background in physical therapy. I worked out at a local Indianapolis fitness center which had personal trainers available, including the one I eventually used to help me start exercising again. Her encouragement was key to keeping my spirits high. She reminded me that proper warm-ups as well as longer cool down periods were vital and I'd feel pain if I skipped this step. At first, I stayed off my feet except for normal walking activities - perhaps to the mailbox or walking to and from the refrigerator and stove as I prepared meals.

Instead of my usual walking or running routine, I began to swim, an alternate form of exercise suggested by both my trainer and sports doctor because it minimizes pressure on one area of the foot, including my heel. I was told to drink plenty of water and to make sure to stop if I felt the slightest bit of pain in my foot. In order to play it safe, I'd switch to a different exercise after 30 minutes or so, perhaps working on a weight machine or using a core fitness ball for some stretching. It was actually helpful to learn some new ways to stay in shape without running or even walking briskly on a track.

Stress fractures - healing more quickly by supplementing exercise with proper diet and more

One thing that really surprised me was learning that I might have been doing several things that raised my risk of a stress injury. My diet was low in calcium and a nutritionist and personal trainer at my fitness center told me it was important to get calcium to keep my bones strong. I started taking between 1000 and 1500 mg of calcium a day. This information supported by information I found online, including the Merck site noted above as well as a sports injury site here: www.sportsinjurybulletin.com/archive/stress-fractures.html. To make things worse, I wasn't drinking enough water. I could have lowered my risk by cross training from the start, alternating running with swimming, bicycling and weight training.

There were also days when I did have to take some Advil or Tylenol to reduce inflammation in my foot. I tried to use these medications as infrequently as possible but they did make a huge difference when I needed them.

Stress injuries and fractures- starting to walk or run again

Even though cross training, eating well and drinking plenty of water were keeping me fit, I longed to integrate walking into my exercise routine again. Finally, I got the go ahead to do so, although I was cautioned to ease back into my walking program. Since I didn't want a repeat of the pain and inconvenience I'd experienced before, I was very cautious. At first, I'd walk only for 15 minutes at a stretch and I did this only every other day. Week by week, I added 5-10 minutes to my walking routine. Finally, I was able to walk an entire hour without pain of any kind. Of course, I also paid attention to the slightest indication that a stress fracture might be looming again - as well as the advice of professional fitness trainers and orthopedic specialists.

After I worked up to an hour of walking, I started to walk in areas that had some hills. I also spent some time walking on a thickly padded treadmill. By breaking up my workouts and spending a minimum of time on hard surfaces, I've been able to avoid a repeat of the stress fracture I had before.