Pubic stress fracture?

Evening all,

Just wondered if anyone has any experience with pubic stress fractures?

I was diagnosed in October (after an 01:25 PB in Dublin half-marathon :p ) and it's driving me crazy!

I haven't run for five months and stopped cycling as well as that seemed to aggravate it. Instead, I've been desperately trying to maintain my fitness with low impact activities like aqua jogging, swimming, elliptical cross trainer and hiking.

The thing is, it still feels sore after exercise. I had an X-ray yesterday and the doctor tells me the bone is healing but he doesn't seem to know a whole lot about it (apparently it's the first one he's seen in 30 years).

So I don't know whether to ignore the soreness and keep going with the low impact exercises or just rest? I mean, I don't want to delay my recovery by exercising but I don't want to unnecessarily lose base fitness either - I've already gained 4 kilos since I stopped running  :'(

I'd appreciate any advice on this, especially from anyone whose been through the same thing and come out the other side.

Thanks! 

Answers

  • Rare for a male to suffer a pubic stress fracture.  Nearly all the cases I have seen have been women.
    Have you seen the xray, do you know where the stress fracture is? It is usually the inferior pubic ramus where the adductors tug.

    Successful treatment is usually nonoperative - however, in persistent cases a small screw can be inserted to aid healing.

    Soreness shouldn't necessarily mean cessation of exercise.  Pain definitely should.  I would certainly drop the aqua jogging, elliptical and hiking.  Concentrate on swimming until the soreness has gone and the fracture has healed.


  • Hi, thanks for replying. Yes, I think it's on the inferior pubic ramus. If not, it's definitely around that area on the X-ray.

    I crashed my road bike in May (wheels got caught in tram tracks in Zurich :o ) and I hit my hip quite hard on the ground so Doctor thinks that might have contributed in some way. But I'm not so sure as I did a lot of cycling and running over the spring and summer and I thought stress fractures were solely from repetitive forces?

    'Pain' might not be the right word though. It's hard to articulate exactly how it feels - an unpleasant, weird kind of tight soreness in my groin/hamstring/glute that feels worse when I'm sat down. Like sitting on a marble maybe! But it doesn't feel at all like the kind of muscle soreness you get from a hard workout, more like a strain.

    How long did the stress fractures that you've seen take to heal? 
  • PewpewpewPewpewpew ✭✭✭
    edited February 2017
    Yes - sitting is nearly always more unpleasant due to the location of the injury.  That's why the bike is usually ruled out.

    Typically, recovery can take anywhere between 4 months and a year depending how disciplined you are and what your day to day life consists of .  A period of complete rest is critical after diagnosis to speed up recovery. If you have jumped into alternative forms of exercise too quickly this will delay the healing process.

    Has your vit D / calcium been checked?
  • Hi, yes. They found I was deficient in vitamin D so I started taking a supplement but I'm guessing that's just weather related!

    I tried going to gym, just working upper body (light weights/high reps) and core but still experience some pain/soreness afterwards. Is this is normally ruled out as well due to compression stress on the body? 
  • PewpewpewPewpewpew ✭✭✭
    edited March 2017
    Did they give you a big loading dose of vitD along with supplement for x amount of months before a recheck?
    Although it can be seasonal related it can take several months to increase levels to an optimum level.

    Depends which exercises you are doing?  Three months of complete rest (no exercise, no unnecessary activity, sedentary lifestyle) followed by three months of gentle swimming has produced the best outcomes in my patients. Scan again and reevaluate from there.
  • Hi, no, they didn't say anything about having a large dose of vitamin D but I know there's a shortage! 

    Did any of your patients ever try swimming with a pool buoy during their 3 months of rest?
  • PewpewpewPewpewpew ✭✭✭
    No, first three months is strictly no exercise, complete rest.  Evidence suggests these patients recover a lot quicker than patients who attempted alternative forms of exercise during this period.
  • I stress-fractured my pelvis last April - both pubic rami (inferior and superior) on the same side. I spent a week on crutches initially and I rested - no running, no cycling, minimal walking. I DID swim with a pull buoy, as that wasn't using the legs at all (I had been told by the orthopaedic surgeon that I could swim if it didn't hurt, but it did hurt, while swimming arms-only didn't. I see no reason why swimming with a pull-buoy should aggravate your injury. At five weeks I was able to walk a parkrun, slowly, on level ground. Six and a half weeks I was cleared by the orthopaedic surgeon to restart running, but I waited until nearly eight weeks to do my first short jog (barefoot, on grass, about 200 metres). I've built back up since then; I ran a marathon a week ago and I'm in training for a 54-mile ultra.

  • Hi, thanks for sharing. Good to hear it does get better (eventually!)

    Was that eight months between your first short jog and marathon?
  • About 10 months, but it would have been less without a foot problem (cuboid syndrome, initially mis-diagnosed) towards the end of last year. I was back up to a 18-mile long run by about three months after re-starting running.
  • Debra BourneDebra Bourne ✭✭✭
    edited March 2017
    Note: everything I've read/heard about indicates that resting for the first 6-8 weeks, or longer if it's not healed yet, is really, really important. It's the people who keep cross-training with swimming or whatever during that time who seem to have ongoing problems.
  • Hi, it's been a month now since I last did any exercise. Been trying to be as sedentary as possible but I haven't noticed much, if any, improvement. Still feels pretty sore.

    Just wondered, is that to be expected?
  • MacMac ✭✭✭
    I was going to advise not running in public but then I re-read your thread..... ;)
  • PewpewpewPewpewpew ✭✭✭
    In many cases yes.  Keep activity at a minimum for another 6 weeks, and report back.  It should start to improve.  Keep that vitamin D / calcium up.
  • Finally some good news :)

    I went for an MRI yesterday. Got the results today and it shows an improvement since December and been told I can start up with a really easy 16 day walk/run program (Day 1 is 20 minute fast walk; building up to 10 minute fast walk, 20 minute slow jog, 10 minute fast walk, 20 minute slow jog by Day 16).

    After 6 months of no running at all, I'm thrilled!

    One slight hitch though. My groin/glute/hamstring etc. still feels uncomfortable, especially when sitting. The MRI showed bone consolidation and no damage to tissue but I've been told what I'm feeling might be a result of damage to muscles/tendons in the area and shockwave therapy/blood injections were mentioned :o

    What I'm wondering is whether it is normal to still have this kind of discomfort at this stage due to the stress fracture healing or whether it could be some kind of muscle/tendon damage as suggested?
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  • Hello!

    Anyone still reading here?
    I‘m so glad I found this post. There isn‘t much on the internet about pubic ramus stress fractures.

    I had to stop intervals on the track due to pain in my pelvis. I felt like I was breaking apart. That was 3 months ago.
    It got better but I was still cross training a lot (biking, swimming, elliptical).
    I finally got an MRI which showed the stress fracture.
    After 3 months!!! 

    I don‘t really know what to do now though. I feel terrible.
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