INPUT: 15 yr old daughter hoping to recover from fracture in her foot

Coach Patrick

From Rebecca Holmes: 

"Need advice for 15 yr old daughter hoping to recover from fracture in her foot in time to try out for cross country team in early August. Her coach is doubtful she has enough time to bulid up the milage without injury, so I’m helping create a plan...

Plan so far: return to running plan from doctor, getting enough calcium, cross training, dynamic warm up, foam rolling etc. I’d love any / all recovery thoughts y’all can share. Any favorite ice packs that are big & work well while watching TV? Compression suggestions of some sort? Would love to hear your ideas!"

RHolmes

Thanks for moving it for me! I really appreciate the help. She loved cross country and is really discouraged at the idea of not being able to try out in August.

Coach Patrick

More details first:

1 - where is stress fracture?
2 - has she been on the team / been a competitive runner before?
3 - what is current prognosis timeline for return to being active?

RHolmes

Very small stress fracture in her 3rd metatarsal. Dx by MRI bc didn't show up on X-ray. Late February. She is finally out of the orthopedic boot and able to wear tennis shoes all day long comfortably.

She ran CC in 8th and 9th...and is going into 10th next year. She was in the top 1/2 of freshman on her team in the fall and is a hard worker and wants to improve.

The doctor's plan is a 6 week plan to walk / jog / run 5 times a week for about 2 miles each day with the focus slowly moving from walk / jog ...to jog / run. This should end about the first week of June, which is when the CC training calendar begins to prepare for early Aug. tryouts.

Robin Rodriguez

Rebecca, I've been in that place with a stress fracture as well. Here is a couple things that worked well for me.

After I got out of the boot, the doctor gave me a foot/ankle compression sleeve to wear (I wore it during running as well) like this one on amazon, http://amzn.com/B00N9L7M4E it was long enough that t covered/compressed my metatarsals somewhat was well.

Pete Pfitzinger has a 9 week water running plan here that you could consult as well http://kemibe.com/distancecoach/labreports/water.shtml

I had my stress fracture when I lived in Chicago and was able to go see a running specific doctors group, does such a thing exist in Dallas? Might be worse a second option on it.

Best of luck!

Keith Wick

First of all, who is this coach and what's his/her problem? Why would he/she ever try to discourage a young, high school athlete who is still growing, maturing and developing as a runner? The coach should be saying, take the doctor's advice and work your way back. If she's not back by tryouts, then we'll work her in to the season & training when she's ready to help her prepare to be a late season jump to our team. If not then she'll be ready when she's an 11th grader.....ok, rant over.

In addition to the water running, would it help her to do some of her initial runs on softer surfaces (like sand, crushed stone trails, etc.) in order to soften the impact and avoid a re-injury? She can also do other types of exercises to help build endurance and stamina--ellipticals, biking, swimming, etc. I've been able to run the marathon of an ironman with no run training except in the last 2 weeks because of injury. My endurance was still good because of other non-running training. If your daughter has good overall fitness, then her return to running will be easier.

RHolmes

Thanks Keith! I agree...and will hold that argument in reserve if needed. She is actually a great coach, and I'm surprised at her suggestion to possibly sit out a season that is months away. Who knows...maybe she's saying that to emphasize to my daughter that she needs to be disciplined & work hard if it's all going to come together in time. I'll give her the benefit of the doubt.

I appreciate your suggestions...esp about the softer surfaces. She has the ok from the doctor for swimming laps, riding a stationary bike with no resistance (sounds strange) and using an "Alter G" antigravity treadmill. So, she has some good cross training options to help her regain fitness.

Brian Quarton [OLD]

Your daughters situation sounds pretty encouraging. When you see the dreaded black line on X-ray it can be a really prolonged recovery. So it was caught early and she seems to be recovering great. I can sympathize. I have three running daughters. I would just try to encourage your daughter to cross train all she can. Most cross coaches have no idea how powerful this can be. "They can't measure what's between the shoulders" either. Consider a vitamin D level. You would like to see it above 30. Also might as well get a ferritin level and a CBC while they are at it, just to investigate the female athlete triad a bit further. You want to see the ferritin above 30 as well, indicating adequate iron stores. I wouldn't necessarily get another opinion. The key is to get this right. If she progresses too quickly and this is aggravated that will be a big setback. (My daughter got several stress fractures. I bought an ultrasound bone stimulator on Ebay for $65. I think it was a Smith-Nephew Exogen. That was an advanced maneuver.) The biggest thing is to encourage her that there is time and she can make the team, but she has to be smart and work hard. For the record I am a family doc. I was team physician for the local D3 college for many years. All good advise here. Let us know how it goes.

RHolmes

If I were a doctor, I'm sure I'd try an advanced maneuver too! As it is, I'm doing all I can to help her plan next steps. Thanks for the encouragement and the advice to stay patient...not easy for either of us.

I did learn that there is an "Alter G" antigravity treadmill at a place in our neighborhood. Anyone have any thoughts about the benefit of running on that? I think it takes away a significant portion of your weight but still allows you to "run," stay in shape, etc.

I'll check with her pediatrician about the labs you mentioned.

Thanks again.

Brian Quarton [OLD]

The AlterG is great. I bet they have a return to running protocol that will get her back to full weight bearing while running. Caution her not to try and run through any pain. I read about collegiate guys running through their cross season with stress fractures but that doesn't end well. That's about all I got.