As the majority of you probably know (I mean, I haven’t exactly kept this quiet), I’ve been injured with a stress fracture since January 2017, almost a year ago now. I often receive messages from fellow runners with problems like mine asking about recovery, how long it takes, and everything in-between; and so I’ve decided to try and create a week by week ‘diary’ of how things went. In the first months I kept a training schedule of each day, but of course that slipped after a while so I apologise for the increasing vagueness as the weeks go by.
Sunday 22nd January 2017
The day before I had placed fourth in the Kent Schools to qualify for English Schools, and at the end of my recovery run, about one kilometre from home, my right foot suddenly really started hurting. I couldn’t put any weight down on it at all. At first I thought it was just a cramp so tried to bend my foot to sort it out but nothing seemed to work. In the end I just ended up running (well, hobbling) on because I had no other option but to get home somehow.
Once home I tried having a hot bath to warm it up, but I still couldn’t walk without it being really, really painful. I managed to convince my dad to take me to the out of hours doctors where I was told that it was probably just a bruise or something similar to do with my tendons. By this point there was bruising around the area and it was mildly swollen.
23rd January to 6th February
During this time I was hobbling around school in my trainers and there didn’t seem to be any improvement so mum took me to A & E to see if we could get an X-ray. Unfortunately they refused to look at my foot as it wasn’t a serious incident so I booked in to see a physio who fortunately had a spot the next day. He thought it was most likely a tendon issue.
Anyway, by February I finally managed to get a doctor’s appointment and was referred to the hospital for an X-ray. Admittedly, the doctor did initially send me to a hospital without the facilities to X-ray 16 year olds, so we then trekked over to the Conquest in Hastings where my foot was finally scanned. Luckily, a slot opened up in the fracture clinic whilst I was there so I was able to receive the results immediately. The consultant explained that I had a stress fracture of the second metatarsal of my right foot, but that I should be back soon. Because I was young and athletic I should take the boot off at 3 weeks, and after that I should be back in the pool and on the bike for another 3 weeks before starting running again. He never really thought about the reasons why I might have obtained this fracture from just running on a flat road, and told me not to use crutches.
Funnily enough I was quite happy at this point. The longest I would be off running would be 8 weeks and I could cross train in between so that was all fine!
Weeks 1 to 4: 6th February- 5th March
No one really gave me any advice so I devised a schedule that would hopefully keep me as fit as possible for when I returned to training. Mum ordered some calcium tablets and then I would go to the gym on most days after school. I would alternate a 30 to 50 minute pull (just arms with my feet propped up with float) and core work out; with an upper body and core work in the gym. My foot was still swollen and bruised; and it hurt to lift up in the air.
At the end of this time I took off the boot, despite my foot still hurting to walk. I was following the consultant’s advice even though I could sort of tell that maybe I needed it for longer. In hindsight I should have completely rested at this stage, but I didn’t know this at the time and wanted to keep as fit as possible. At the end of this period I went for my check up X-ray. The results showed some swelling of the bone still, but the consultant thought I would be fine to swim and bike. He thought I would be running soon.
Week 5: 6th- 12th March
I was really pleased that the consultant had said I could cross train properly so I was quick to add in an easy spin and aquajog to the schedule. I also included some light leg work such as squats because I had asked at the appointment and was told that this would be fine. However it didn’t end too well because by the end of the week my foot has swollen up slightly again and it still hurt a little.
Weeks 6 and 7: 13th- 26th March
I did continue with the training because I thought my foot might just be getting used to things. It wasn’t getting worse but it wasn’t getting better. I was getting quite worried though because I knew that I was meant to be running at 8 weeks and was still quite a long way away from attempting even one minute of jogging. Looking back at this week, I was probably doing too much exercise to promote proper healing.
Weeks 8 and 9: 29th March- 9th April
Our Easter holiday to Spain saw me come down with a virus that left me in bed for a couple of days. Seeing as our villa was in the hills I ended up taking both these weeks off, occasionally doing some core and going for walks. Walking was just about okay but in the heat I was limited as my foot kept slightly swelling up if I went for longer than 30 minutes.
Weeks 10 and 11: 10th- 23rd April
Having had the two weeks off I found that my foot was in a much better place. I stepped up the training which I really appreciated, especially since I had loads of time since I was still enjoying the Easter holidays. Looking back at this now it does look like quite a lot: I was still in the mindset that I would be returning to running in the near future, so wanted to come back vaguely fit. I should have been taking more time to rest and only doing workouts here and there at this stage.
Weeks 12 to 15: 24th April- 21st May
At week 12 I reached out to Jess Coulson which was the best thing I have done since getting the fracture. She quickly identified that I wasn’t eating enough and was training too much. We went through everything on the phone and since then Jess has been setting me training each week, and this has been absolutely brilliant.
I started off with short aquajogging sessions mixed in with pull sessions, and then gradually built in barefoot drills. I felt great because I had so much energy from extra things like protein shakes and bars, and even though my foot would range from a 3/10 to 0.5/10 on the pain scale depending on the day, I genuinely thought that I would be running again soon!
Just a quick note, 0/10 = no pain at all.
Weeks 16 to 18: 22nd May- 11th June
I was halfway through the GCSE exam season, and enjoying the summer heat whilst on study leave. I had started to introduce five minutes of dynamic drills in the garden every other day: it felt so weird to be almost running! A typical week would be as follows. Note that I had started a food diary to keep track of things. The red numbers are the pain out of ten!
Having had a very little negative response from the drills, I went for my first run on the 10th of June. The 5 x 1 minute jogs felt really strange but to be honest I was just so pleased to actually be running. It felt completely ‘right’ because I had spent so many weeks building up to it.
Weeks 19 to 21 : 12th June- 2nd July
The runs were going well. In the first week I stuck to 5 x 1 minutes, and in the second week 2 x 3 minutes. I would do three runs a week with cross training on the other days and then one rest day (always a Friday!). I iced my feet straight after each run which reduced any slight swelling due to the heat. However in the third week another part of my foot started to hurt and despite massaging it and resting it, it wasn’t really letting up. So the runs stopped and were exchanged for cross training again. I visited a physio who thought that the bone might not have fully healed and that the pain was being transferred to other parts of my foot.
Week 22: 3rd- 9th July
Same as normal: cross training 6 days a week (all sessions under an hour to make sure no energy was diverted away from healing my bones), with the foot feeling anywhere between 0 and 2 out of 10. Running completely stopped for a while.
Weeks 23 and 24: 10th- 23rd July
I went on holiday to Crete for two weeks and took a lovely and relaxing rest from all training. From what I can recall my foot felt really good for most of the holiday. I think it was definitely helped by the fact that I spent the large majority of the time on a sun lounger or swimming in the sea which had a cooling effect.
I know that from an outsider’s point of view, it’s easy to see that when I rested the foot it improved. But the thing is, I would always rest it for one or two weeks, and then it would feel fine so I would go out and start doing a bit of cross training or something similar which would sometimes slightly irritate it. It was fine to take some time off but I couldn’t just then completely stop doing everything forever. Even though the cross training schedule might sound quite intense to some of you, I would stop if my foot ever really hurt, and all of the methods were always very low impact. I always felt full of energy and if I ever did feel really tired I would just give that day’s session a miss.
Week 25: 24th- 30th July
Continued with training. The skipping drills were introduced again without any response so things were looking up.
Week 26: 31st July- 6th August
Back in April I gained a scholarship to the Full Potential running camp. Of course, at that point I thought I would be there to run, however it quickly came around and I found myself travelling to a running camp but with no intentions of running. Despite this I had a lovely time and still had the opportunity to get my own training in. I was very pleased because my foot rarely went above a 0.5/10, even though some of the evening activities involved a little jogging from time to time.
Weeks 27 and 28: 7th- 20th August
Things carried on as normal until my appointment to see Dr Noel Pollock in London came around. Noel used to be head of the GB medical team and he really was amazing. During the appointment we went through absolutely everything and he was first to suggest that low bone density could potentially be a problem due to hormone levels, previous overtraining and low weight. He took a look at the MRI which I had been given on the NHS at the start of August and confirmed that there was still a small bit of healing of the bone going on. I was referred for blood tests and a DXA (bone density) scan to get to the bottom of the issue.
Of course, I was also put on the waiting list for an NHS orthopaedic consultant but even today we are still waiting for that appointment to come through, so going private really was the only option, despite the costs involved. The care was incredible, and even the contact with receptionists was brilliant because it meant that things were processed ten times faster and more efficiently.
I thought I would just mention that at this point I was doing quite a few foot drills every other day. These would start with barefoot exercises; followed by peroneal strengthening with a resistance band; then walking barefoot drills; and finally skipping drills like you would do for a usual warm up at the track. Since working with Jess, I’ve always done 10 minutes of glute work and core work on session days which really has built me a stable base to push off from.
Weeks 32 and 33: 21st August- 2nd September
Having chatted to Noel and Jess, it was decided that incorporating more healthy and unhealthy fats into my diet would improve my overall health, especially the hormones side of things. I started adding in half an avocado to most of my lunches, and made sure to eat oily fish multiple times a week. I also started having a pudding after every dinner which of course I was very pleased about actually being told to do!
At the end of the August I returned to London for my DXA scan and booked in an appointment with Noel to recieve the results.
Weeks 29 and 30: 3rd- 17th September
I managed to develop a little hip niggle so decided to take these two weeks off. I needed a rest from training anyway and sixth form was just beginning so Jess and I thought it would be a great time to recover.
Weeks 31 and 32: 18th September- 1st October
I resumed training as usual: monday pool, tuesday spin, wednesday core, thursday pool, saturday spin, sunday pool, with glutes, core and footwork included. By this point the foot pain had completely vanished and after months of putting up with it, I really noticed how great it felt to be pain free! This left me in very positive mindset when travelling to my appointment with Noel on the 29th of September (the day before my birthday!) to collect my DXA results. I was expecting an ‘all clear, you can begin running again’ because I knew that I looked much, much healthier than at the beginning of the journey, and also because I felt much, much healthier. I certainly didn’t think that I would be told I had T scores of -4 for my lumbar spine and -2.3 at my hips. See the picture below to see what this suggests.
But there was a positive: after examination Noel thought that aside from the bone density, my muscles and health were very, very good so he prescribed some strength work to be added to the schedule…and also said that I would be able to build up to three 25 minute runs a week! Of course, I was upset about the whole bone density thing, but even being able to run for a short while really made me happy. He suggested that I try training again at the start of the track season.
Since then I have also been on the pill for a couple of months to help with oestrogen levels which contribute to bone health.
Weeks 33 to 45: 2nd October to 31st December
Apologies for the 13 week jump, but basically, I’ve just been building up those runs. The first week of five minute runs went smoothly, the 10 minute runs were harder, and on the 15 minute runs: well I have to be honest I just felt awful and slow. But it’s all good, I really am enjoying it.
Unfortunately I am susceptible to a number of niggles: for example I was off swimming for 3 weeks with upper back pain (however I was able to run) , and then for the whole of December I’ve had to stop running because of hip pain. Before the latest niggle I was up to 20 minute runs with 5 minutes of walking on either side, and I now can’t wait to get back to it. All of these niggles are incredibly irritating, but I’m thankful that as of yet none of them have been too serious, and on the plus side, my foot doesn’t hurt!
A training week would normally look as follows:
Monday: glutes, leg session at gym, foot drills, walk/run/walk
Tuesday: glutes, core, swim session
Wednesday: foot drills, walk/run/walk, glutes + longer leg session
Thursday: glutes, core, aquajog
Saturday: foot drills, walk/run/walk, glutes + leg session, maybe core
Sunday: swim or spin session, glutes, core
And that takes us up to now. I would like to thanks absolutely everyone who has helped me throughout this journey from the followers who’ve helped me on social media, to Jess to all the doctors I’ve seen and of course to my parents. Hindsight really is an amazing thing and if I knew that by training so hard over the last few years and not fuelling correctly would have left me with a stress fracture and recovery time of just under a year I would definitely have done things differently. But still, things happen for a reason and I believe that everything I have learned throughout this journey will help me in the future.
Plans for the future
I’m in the process of being referred to a metabolic bone specialist and possibly a sports gynaecologist, however it’s tricky finding specialists who treat under 18s privately. Despite this, things are going well and I’m planning to book another DXA scan for Easter where I’m hoping to see some improvement that should allow me to get back training. Whether I’m competing in the late summer or just coming back for cross country I’m not sure.
And that’s it. From now on it’s just trying to get back to consistently running 3 times a week without injury and building strength in the gym.
Have a lovely week everyone and I hope all races went well this weekend, especially those of you at the county champs!