foot pain

Stress fractures are common in runners.  Typically stress fractures are seen in newer runners or in runners that increase their weekly mileage too quickly.  Recently I saw a patient that experienced a stress fracture in his lower left shin (tibia) after an extended break from running. This particular runner had 10 years of Ultramarathon running under their belt but had taken an extended period of rest from running. Because of his experience he did not think he was susceptible to stress fracture but had increased his mileage too quickly which resulted in excess stress on his bones.

It all started in October when his mother was diagnosed with terminal brain cancer.  The doctors told him she had 3 months to live.  He moved back to New York to spend those 3 months with her.  While he did bring some running clothes he was completely unprepared for the brutal winter that New York was about to experience as well as the emotional strain of watching his mother die.  These two variables combined to prohibit him from any significant running for three months.  It only takes two weeks of inactivity for bone to begin to deteriorate from lack of impact.  Bone requires repetitive stress to maintain its strength.  These three months of no running had weakened his bones essentially making him a “new” runner and he should have returned to lower weekly mileage gradually increasing the volume which would have allowed his bones to naturally strengthen to withstand the stress of high mileage running.  During the exam I asked him why he had stopped running for 3 months which resulted in the stress fracture.  The below is his personal story that he shared with me.

“I was getting ready to go back to New York to stay with my invalid father while my mother would be gone to Italy.  She was going with my cousins to visit relatives in Sicily and see some sights.  Two days before I was to leave my mother began to experience confusion so my sister brought her to the hospital.  It all happened so quickly.  The situation went from not knowing what was wrong to having a brain scan and seeing the tumor to my mother requiring emergency brain surgery.”

“When I arrived in New York two days later I went straight to the Intensive Care Unit.  To my surprise my mother was awake and alert!  Those first few days were spent going back and forth from my house to the hospital to spend as much time as possible with her.  One day when the doctor came to take the bandages from her head he spoke to me privately in the hall.  He explained how she had the most aggressive brain tumor there was and that she probably had three months to live at best.  During the surgery he had attempted to remove some of the tumor, the portion that was putting the most pressure on her brain.  Although mildly successful it l