Will three weeks of bed rest heal a stress fracture? Well, that is a great question and that is what we’re talking about today on the Doc On The Run Podcast.
Today’s question comes from someone who watched the YouTube video on the Doc On The Run YouTube channel called “How long before I can run with a stress fracture.” The comment was, “Thank you so much for this video. I want to ask if resting for three weeks, complete bed rest and I can afford to do this because I am a student and it is summer holiday then I can walk to my college to do daily normal tasks. I do not do any physical training or running and my college is about a kilometer away.”
All right well this is a good question and one thing this person might enjoy is the book called Making the Most of Bed Rest: Tips, Tools, and Resources for a Rewarding Recovery from Any Health Challenge. I wrote the foreword to this book, and it was written by a multi-world champion triathlete named Barbara Peterson and Barbara has been on the podcast a couple of times. I wrote the foreword to this book, and she was on strict bed rest.
What this person is asking is three different questions. The first one is three weeks of strict bed rest enough to heal a stress fracture. Well, that depends on how severe the stress fracture is, and I don’t know that. Second question is can I walk two kilometers a day without making the stress fracture worse. Well, I don’t know because I don’t know how severe the injury is. The third question this person is asking me is can I do activities of daily living without making my stress fracture worse. Well, bed rest is difficult first of all but it is the most complete way of removing stress and strain from a stress fracture.
Barbara didn’t have a stress fracture. She fell and broke real fractures not just a stress fracture broke both heel bones. She was on strict bed rest. Strict bed rest is very difficult. A lot of triathletes, runners, marathon runners, ultra runners might wind up on bed rest not because of an injury but because of difficulty with a pregnancy and in that case there’s a reason they’re putting you on bed rest. It’s the lowest chances of dramatically increasing stress that could lead to a complication.
To heal any stress fracture you have to get the stress applied to that one injured bone and only that one injured bone down below the threshold at which it can actually have tissue repair happening without making the crack worse. It’s that simple. Bed rest is very very rarely required to heal a stress fracture. However, there is a broad range of the amount of time it takes to heal a stress fracture, and that broad range of time is broad because you have a different amount of stress applied to varying levels of stress fracture in athletes and if you do not get the stress low enough to get it to heal it will take longer.
If you have a stress fracture and you just stop running and just walk and you decrease the stress it will probably heal eventually. I recently did a series of coaching calls with someone who has a stress fracture for two years has an enormous bone callus around the bone that I believe still causes pain and difficulty. It would not have happened if he had decreased his activity sufficiently to get it to calm down.
If you have an event that you need to train for and you’re on strict bed rest well two things happen. Number one the stress fracture itself is probably going to heal very quickly but if you’re on strict bed rest lots of bad things happen. You lose all your running fitness. You lose your aerobic fitness. You get weaker. You get stiffer. You lose your neuromuscular connections and keep your running form tuned and decrease loading forces when you run and in addition to that being on bed rest causes osteopenia which is a mild form of osteoporosis. It’s decreased density in the bones so if you’re on bed rest, you’re going to get weaker bones.
Yes, the crack is probably going to heal but overall, the bones may decrease in their density and predispose you to other injuries later. You should always do whatever is the least restrictive intervention for the stress fracture that will get you to achieve your goal. So, I don’t know what this person’s goal is. In fact, he even says I’m not a runner, so I don’t know if he was a runner, and he just quit or if he really never ever did running. I don’t know, but everything that I do to help runners is based on what is your goal number one, number two how severe is the injury and then based on how severe the injury is how severe is the intervention we need to cast upon you to make sure that you’re healed.
Sometimes you need an actual cast. Sometimes you need a fracture walking boot. Sometimes you don’t need any of that, but you have to make sure that the severity of the injury is the thing that you’re monitoring and that the goal is the thing that your doctor is working toward.
If you want to learn more about this you should go to www.stressfracturesecrets.com and I’ll show you how to take advantage and not make the biggest mistake runners make when they have stress fractures.