Fractured pubic rami in superfit sportwoman running 100 miles a week invites questions about diet and walk up routine.
4 months ago my 100 miles a week runs ended in crippling pain; I could barely WALK home. After many visits to Osteo, chiro, physio, acupuncture I finally had an X Ray which revealed the above stress fracture. The X-Ray also showed that it was almost healed.
What puzzles me is the changing nature of the pain. At first I had a marked limp; now I no longer have the limp but a deep aching stiffness (still very painful) in my pubic area. It feels as though it is actually getting worse rather than better. I am currently swimming (not breast stroke) in a futile bid to maintain my very high levels of fitness.
I am a 64 year female with exceptional bone mineral density.
Hello Deryl, Even top athletes have stress fractures if they over do it, and particularly don't go through a proper warm up routine before setting out. I would recommend sitting down with a biokineticist to figure just how a super fit woman with exceptional bone density finds herself disabled with a fracture of the pubic rami.
Incidentally, it's interesting that calcium density is not the only determinant of bone strength. Research on sheep for example that have been put in a feed lot on very high protein diets have fractured limbs despite high calcium density in the bones. Look to your diet too.
Meantime, though, there are a lot of muscles that attach to the pubic rami, both internally the deep pelvic muscles and the thigh muscles. Every step you make they are pulling on that healing fracture of the pubic rami; whenever you bear down on the toilet or sneeze.
What's need is deep tissue work on these tendons; you may be able to do it yourself. If you run your thumb from the iliac crest down through the groin towards the inner thigh is it extremely tender?
Then both the hip and sacroiliac joints need to be checked; I'll bet that one or both are complicit to the pain and disability you are experiencing.
Then, have any of the branches of the femoral nerve been affected?
A sports orientated chiropractor with a FICS qualification is trained to deal with injuries like this. Contact the local association.
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1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.
2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He's doing well.
3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost painfree.
Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.
4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.
He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he's well pleased; sixty five percent better after three treatments.
5. Mr T is a wise man; he's taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily walk has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift.
6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.
7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. Xrays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.
8. This 65 year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.
9. This 88 year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done.
10. Mr X is a 71 year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a year ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.
11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.
12. Mr D is a 38 old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he couldn't sleep on that shoulder.
13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback
since working above his head. Trapped nerve tests are negative but he
has advanced degenerative joints of Luschka; after just two treatments
he is 50 percent better. Can we reach 90?
And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.
Greetings, Dr B. You helped me quite some time back with a soothing and professional response which turned out to be exactly correct. I now consult a local chiropractor. You write a superb newsletter, too.
Knowing that up to 70% of the time the correct diagnosis is made with no examination, no special tests, no xrays, but just from the history, there's a fair chance I can add some insight to your unresolved problem. But at least 30% of the time, I may be quite wrong! Give plenty of detail if you want a sensible reply.
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