How to not miss a sacral stress fracture

Low back pain is a common problem in active populations, but I rarely see runners with back pain—and when I do, it’s often a bone stress injury (BSI).  When a runner reports a gradual onset of unilateral back pain, I’m immediately concerned about a potential sacral stress fracture (SSF). Although rare in the general public, these often occur in endurance …

Programming Exercise for Navicular Stress Fractures

Rehabbing a broken foot is no small task, and navicular stress fractures (NSFs) are particularly challenging. My last blog covered considerations of deciding on surgery or going the conservative route. Today, let’s focus on the critical elements of a successful rehab program.  Key Principle One: Absolute Rest NSFs require absolute rest whether you have surgery or not. Complete non-weight bearing in a …

When should I race after a stress fracture?

A runner begrudgingly crutches into their physician’s office with a stress fracture diagnosis and beautiful black boot. The million-dollar question of “When can I run again?” is proposed, and unemotional calculation occurs. The runner quickly circles the specific date on their calendar and heads to the gym to tread water and spin on a bike. Time slowly passes like a kid waiting for Christmas. As the sun rises on the morning of the circled date, the runner happily exits their front door and starts their return to run progression.