stress fracture | Laura Kline – Multisport Athlete

As I’m patiently making way through this injury recovery what helps me is to approach it as I would a training block for a goal race. A healed bone and returning to running will be my “finish line”. I have to lay out my plan week by week. I need to listen to my body and make adjustments to the plan on the fly as needed. Most importantly, I need to prioritize rest, recovery and nutrition.

“Use Pain as Your Guide”
I despise this guideline. Pain is a 4 letter word. Using pain as a gauge is not very helpful and basically places me in a state of constant anxiety. Am I feeling pain or just discomfort? Is this feeling due to de-conditioning and then trying to use my right leg again? Is it just pulling and soreness from the muscles that had shut down and are now coming back to life? I don’t have a great track record when it comes to respecting pain. It’s very difficult to trust myself but I am trying…

I had a meltdown recently – the evening I first rode my bike outside. It felt great – no pain, not really any discomfort that I could tell. It left me feeling optimistic well beyond what I was expecting. Later that night as I got up to go to bed it hit me hard. I stood up and couldn’t walk properly – there was a lot of pain – it took me right back to where I was in May. I was lying in bed feeling stabbing pain and crying – not from the pain – from the feeling that I just fucked things up and would need to start all over. No. Freaking. Way. I told myself that in the morning I would get back on the crutches full time and figure out what to do next. Luckily when I awoke the next morning the pain was gone. I cautiously stepped out of bed and things felt back to “normal.” Phew. I really wanted to ride my bike again that day – the previous evening was the best I’ve felt mentally in 2 months. Instead I honored my recovery and erred on the side of yet another rest day. It shouldn’t be this hard, I know. I wish it were easier.

Progression
√ 90% crutches – non-weight bearing
√ crutch & touch – to slowly introduce minimal impact
√ upper body strength work while seated/core work
√ crutches outside of the house only
√ riding (w/o “pain”)
√ yoga without balance poses (w/o “pain”)
_ walking without crutches!!!
_ RUNNING!!!!! 🙂

I’m getting so close!!! My next MRI has been scheduled on August 14^th and will be reviewed that day. Wish me luck…

Results
I had the following tested:
· CBC w/ auto differential
· Ferritin
· Comprehensive metabolic panel
· Magnesium
· Parathyroid hormone, intact with calcium
· TSH
· Alkaline phosphatase, bone specific
· Inorganic phosphorus
· Vitamin D – 25 hydroxy

The only level I was concerned about was Vitamin D as it was on the low side the last time I had fractures. Although there is always room for improvement (you will see how I’m achieving that below) it was at a safe level. I felt confident that everything else would be great but it’s always good to take a look. As expected, all of my levels were where they needed to be! (I’m not going to post everything but if anyone wants to see any of my results please let me know)

Next up was the bone density test. Although my T-Score puts me in the lower end of the normal range, I am still within that range and the Dr. is not concerned. The more important score is the Z-Score which compares my results to a person of the same gender and age as myself, and she was happy with this score.

With the results of these tests my physician confirmed that my fracture is most likely due to a combination of the following:
1) biomechanical issues (*I am fully to blame for slacking off in this area.)
2) long term damage from prolonged use of Depo Provera (*I have been off this, and all birth control for almost 9 years. Please DO NOT EVER use Depo.)
3) exercise/nutrition imbalance (*this is a big one that deserves way more attention but I will touch on it briefly.)

Nutrition
The first order of business was to add some weight. This is standard protocol when you have a stress fracture as your body needs to heal, and the best way to facilitate that is by providing it with abundance. Any hint of deprivation is stealing resources that your body can use to mend itself. I learned the importance of this after my last set of fractures 9 years ago and now anytime I am taking a break (or off-season) I make sure to put on a few pounds. It’s a healthy practice that everyone should incorporate.

Time for honesty – it’s not easy. I don’t feel comfortable putting on weight so while I am always willing to do so for my health I’m also anxious to take it back off (safely). When my physician said we couldn’t rule out “female athlete triad” my initial reaction was to defend myself and dismiss it because she doesn’t really know me. However I am seeing her for this exact reason – real talk and an understanding of female athletes. So I am not taking it lightly. My plan was to initially put on some weight while I heal, then slowly start to take it back off so that when I’m cleared to run again I will be back to my “comfortable” weight. My physician informed me this week that I need to continue focusing on weight. So I will.

I am achieving this by following the same nutrition guidelines I follow during training, just with slightly smaller portions. Since 2009 I have been following a “5 servings of healthy fat per day” rule and I continue to do that even though I am not training. Healthy fats are always my number 1 focus – avocado, nut butter, hemp hearts, seeds, nuts, coconut oil – are among my daily servings. Equally important for recovery is protein, as protein is called upon to rebuild bone. Again I’m eating the same things I would eat if I were training – tempeh, beans, lentils, pea protein powder – I am not cutting out any protein during my time off from training. The biggest change has come in allowing treats, because who doesn’t need some vegan ice cream when you’re feeling down? 🙂

Supplements
I am in great hands when it comes to receiving direction on what supplements I should take to ensure proper healing and am extremely grateful that Unived provides a lot of what I need to stay on top of my recovery. A company dedicated to athletes, run by athletes who devote so much time to researching and obtaining the highest quality ingredients. I consider myself very lucky to be a part of their family.

Morning
Blood Builder – I’ve been taking MegaFood’s Blood Builder since 2010. It’s my source of B12 while also providing a hefty dose of iron and folate.

Mid-Morning

Unived D-veg – each serving has 2500 I.U. of pure vitamin D3 derived from Lichen. D3 is a fat soluble vitamin, so it is mixed with coconut oil which aids in fast transport to the bloodstream and maximum absorption.

Afternoon
Unived Colox – Colox offers natural relief from joint pain and inflammation which is superior to and safer than OTC NSAIDs. It contains Boswellia serrata, Ashwagandha, and Curcuma longa extracts.
Curcumin – in addition to the Colox I am taking 500 mg of Curcumin C3 complex. Again this is a great anti-inflammatory which also helps increase the antioxidant capacity of the body and can even improve your mood! **Unived will be releasing its own highly bio-available Curcumin soon!
Cissus Quadrangularis – clinically proven to accelerate fracture healing and reduce the recovery time.

Evening
Unived CalDVeg – I’ve been taking this daily prior to the stress fracture but a supplement for enhancing bone health is definitely a priority. CalDVeg is sourced from algae and also contains Vitamin D3, Vitamin K2, and magnesium which will enhance calcium absorption and utilization.
Unived Colox – dose 2 for the day
Magnesium – I use a powdered magnesium fizz blend to assist with enhancing bone density through assimilating calcium absorption and activating Vitamin D. It’s also great for relieving anxiety and providing calm, which is why I like to drink it before bed.
Zinc – zinc supplementation aids in callus formation, enhances bone protein production, and thus stimulates fracture healing.
Curcumin – dose 2 for the day
Cissus – dose 2 for the day Overall I’m feeling very optimistic about my results and progress, so now it’s just a matter of giving my bones optimal time to fully heal so I can come back even stronger!

Beyond this my focus is on relaxing – the biggest challenge of all – but it’s a good opportunity to spend quality time with family and friends, reflect on the mentality that broke me, set positive future goals, and most importantly be thankful for everything I have.

I hope everyone is having a great season of training and racing – run some stunning trail miles for me! 🙂

Eight years ago I ran and ran and ran through pain. I ran until I could barely run. And then I ran some more. Until I could barely walk. After the long, grueling recovery from my fractures in 2010 I vowed I would never do this again. Those fractures wrecked me – not so much physically as mentally. And after taking 17 months off to fully heal I promised myself “never again.” Oops.

Towards the end of a disappointing 2017 season I ran through pain. I ran more than I should have but then I did the responsible thing – I stopped, saw the doc, took time off. I was so proud of myself – flaunting my responsible decision. Look at me – I’m a changed woman!

I started this year running with some pain (but seriously, have I ever run without pain since 2009? No.) I had it under control, so I thought. Typical me – I always have everything under control, even when I don’t. And so I kept running until suddenly the pain was drastically worse. I forced runs even though each step was painful. I could still “jog” and I was only walking with a slight limp. As long as I can mask the appearance of pain it doesn’t matter what’s going on under the surface. No one can see that I’m struggling. I had to run.

It got to the point where I had to physically lift my right leg with my hands from a seated position. Major red flag for me. So I spent more time at the gym instead of running to get those muscles firing again. It worked, so I was fine. Every day I made sure I could hold my weight on one leg, then I would do the hop test. I was ~~passing~~ able to get a little clearance off the ground with some focus and effort, so I was fine. I’ve learned to look for red flags but then I find ways to take them down. Great.

Next up was my spring training trip – the trip I dream about each year until it’s over, and then I start dreaming about it again. I took 4 days off from running leading up to the trip thinking that would do the trick. Then I ran 11 painful and awkward miles in the mountains. The whole time trying to not focus on what my body was struggling to tell me – simply enjoying the opportunity to be out on those trails doing what fulfills me. Later that day the pain was really settling in. Luckily I had spent the past week preparing myself mentally for this outcome. After consulting with a trusted friend and coach I pulled the plug on my running. The next day I made some calls.

Diagnosis

I have a stress fracture in my femoral neck. I’ve now had the 2 worst fractures for runners. If I fuck this up I could break my hip. Needless to say I am going to put all of my effort into not fucking this up. So if you see me doing something I shouldn’t – call me on it. Please. After 12 weeks of no running I will have imaging done again because the doc wants to make damn sure that there are zero signs of this fracture before I’m released to start running again. I will be able to start progressing with other activities over this time but for the next few weeks I have to shut it down entirely. Time to heal.

I’m clearing my race calendar and am hoping once I can slowly start to build again I can aim for some shorter late season racing. But I’m trying not to get too far ahead of myself and focus on what I need to do right now. This will not be a 17 month affair like it was in 2010…

Since I’ve been down this road before I have set some goals for myself. Here are the main ones:

Do not allow your injury to rob your sense of identity. This will be the toughest to tackle.
Acknowledge and respond to pain. Don’t ignore it. This isn’t a race.
Use the damn crutches. No matter how embarrassing or emotionally uncomfortable they make you feel .
If there’s ever any doubt that something you want to do may be stupid, ask someone you trust. Then actually listen to them.

During my previous injury I had to do a lot of hard work on myself. One of many helping me through it was able to break down just enough of my wall to sneak in something that has stuck with me. He told me that I am grasping my running too tightly. He used the visual of holding a small pebble in the palm of my hand and I was clenching my fist around it so hard so I wouldn’t lose it. I had to hold the pebble in an outstretched hand. If I kept such a tight hold my running would ruin me. It’s time to revisit this concept.

There are many things I say in hopes of convincing myself they are true. This rarely works. There is currently one thing I’m telling myself which I know to be true – I will come back stronger.

Thank you to Dr. Parker for always looking out for me and understanding me.
Thank you to Dr. Goolsby for providing me with a recovery plan with which I can get behind.
Thank you to Elizabeth Azze for helping me pull the plug before things got incredibly worse, and for being that trusted friend I need.
Thank you to Unived for supplying me with the supplements that will be an integral part of the healing process.
THANK YOU to all of my friends who are showing me love and keeping me busy. It’s going to be a bumpy road for sure. I’m going to try my best to keep it together.

See you on the trails soon I hope!