Just recently I received an email from a woman who has recovered from a hip stress fracture, but said she doesn’t trust her hips like she once did. I have been teaching a woman in the same boat who has just started running again. This is what I can say, I have doubts about my hips too --- maybe less frequently then in the months proceeding my come back, but there are still doubts. Anytime I get a weird ache even close to my hip or groin, I think I’ve broken again. Luckily, I get either Rudy or Megan (as mentioned in my last blog) to work out kinks and reassure me that is just in fact tight muscles.
For those that are dealing with this injury or recovering, it’s difficult. It is hard to trust your body and worrying about its return is natural. But, I’d like to offer what I’ve learned in the two years post stress fracture.
- Find a body worker that you trust, ideally a massage therapist and someone that practices A.R.T (active release therapy). Getting regular work has made a huge difference in balancing out my stride, increasing my recovery, and it’s helped me with being a smoother and faster runner.
- Don’t be nut. I learned the hard way. I ran high mileage, high intensity, and I hadn’t changed my shoes in several months. If I hadn’t gotten a stress fracture it would have been odd. Patience is a hard one to learn, but the body has to get used to demands, you cannot demand too much all at once. This is why I highly recommend a running log. I was able to look back at the months before August 2010 to see my many mistakes.
- Yoga --- I would be careful with high intensity stretching. As a yoga instructor I know there is a balance between strength and flexibility. I highly recommend stretching, ideally active stretching and foam rolling as a day-to-day routine. I am a big fan of leg swings, both front and back and side to side. Foam rolling can be done on glutes, IT bands, hammies, adductors, quads, and calves. Yoga can be incorporated, but one should be cautious about doing long runs and high intensity yoga classes on the same day. Yoga is very intense on the hips and this can put extra strain on an area that is already very strained from running. This being said, I recommend doing yoga on an easy day or day off of running. It can be incorporated as long as you pay close attention to fatigue, over-stretching, and keeping certain muscles engaged while stretching (so that you’re not relying on bones, ligaments, and tendons to get a stretch).
- Pilates --- Strengthening your core is a huge help in preventing injuries and running faster. On a daily basis, I see what a huge difference this makes in people dealing with all sorts of injuries, aches, and pains. On a personal note, this keeps me balanced and strong in the areas that running fails to strengthen. Working on a reformer is the best, but there are certain exercises that can be done without the reformer. My favorites for keeping the area around the hips strong and flexible involve the gluteus muscles, specifically gluteus medius, illiopsoas, hamstrings, abductors/adductors, quadratus lumborum, obliques, and low abdominals/pelvic floor. I am also a big fan of doing single leg exercise, which work on stability and coordination. Samples of good exercises that could be done at home are the pilates five or the side-leg series. I also recommend a thera-band exercise. You will need a partner and a strong thera-band. Come into a yoga lunge with the back heel lifted. Your partner will loop the theraband around your front ankle and pull to one side of your body (you will switch after the first set and pull to the opposite side). As they pull, keep your balance and bend and straighten the back leg. Make sure to keep your front knee straight ahead and your hips in alignment. 10 bends and straightens are sufficient. And, there are a slew of other beneficial exercises. I’ll try to work on getting video of some of them when I find some time!
- Take deep breaths and relax when the nerves or worry increase. Stress doesn’t help with recovery and may actually prevent it from occurring. So take some Epsom salt baths, practice deep breathing, and get good sleep!
- Get blood work done if you haven’t --- you may need some extra calcium and vitamin d. I did!
So those are some of my tips. Hope they help! And, try to trust those hips, our bodies are strong and resilient. We just ask a great deal of them!