The man in uniform kept asking me if I could walk. That’s my first memory from after I collapsed while running the 2016 Boston Marathon.
I was around mile 10 and somehow wound up on the sidelines, gravel embedded in my knees, in the arms of a National Guardsman. “Can you walk over there?” He pointed, and placed me on my feet. And then the world went black. I remember crying out in such raw, visceral pain that he immediately scooped me back up, carrying me while I clung to his arms.
Later, when I was strapped into the ambulance stretcher, I looked down at my hands to see prints from the buttons on his uniform embedded into my palms.
I would eventually be diagnosed with a compression-side fracture in the femoral neck of my left hip, a smaller, secondary fracture further down the bone (a “reaction fracture,” wrought by the trauma in the hip joint), and torn ligaments and muscles surrounding the break. If you’d told me this four years ago, I would probably have most been surprised by the news that I’d turned into a runner.
Driven by tragedy, motivated by love.
Growing up, my mom frequently joked that I was allergic to exercise. I wasn’t the kid that was interested in sports, choosing instead to take long, dreamy walks around my neighborhood.
But after I graduated from college, losing the mental stimulus of being in a classroom, I wanted to push myself in different ways. Earlier that spring, my mother had run the 2013 Boston Marathon, her first. While I wasn’t able to head to Boston for the race, my father and brother were waiting for her at the finish line. When the bombs went off, they were mere feet from the first explosion.
Miraculously, they were physically unharmed. To this day, I have trouble watching or reading coverage of the Marathon attack. It reminds me of how close I came to losing two people I love most in this world.
But as the shock of the day subsided, I was left with an intense, burning motivation to become a runner. Wouldn’t it be cool if I could run with my mom? I started to wonder, and, quietly, thought maybe the way to fight hate and fear was to turn the attack into private motivation. I bought a pair of sneakers and signed up for a 5K. I hated every minute of training until the moment I crossed the finish line. With that rush of energy, I was hooked.
That was in 2014. I continued to run and it turned into therapy. I loved how strong I felt when I was running and I craved the challenge of pushing myself to go further and faster. When I began to increase my mileage, I decided it was time to honor my family and their journey of recovery after the attack. I was going to run the Boston Marathon. Unsure I would be able to qualify, I entered as a charity racer, working all winter to fundraise for a nonprofit that aids trauma victims.
My body tried to warn me not to run, but I didn’t listen.
A week before Boston, a small, throbbing pain began in my left thigh. I wasn’t very concerned at first, but I did stop running. With some rest, I thought, the pain would eventually disappear. Except—it didn’t.
I didn’t want to mess with my body, especially when all of that grueling training was about to pay off. So I visited a sports physical therapist, who examined me, pronounced it a “muscle pull,” and told me it would be fine to run the marathon, though I would likely be “uncomfortable” the entire time.
While it wasn’t two thumbs up, it wasn’t a hard “don’t do this,” and there was no way I was going to skip this race. It was too deep an emotional pull. And when I thought about what my family had lived through in 2013, I convinced myself I was overreacting to my leg pain. People had accomplished more through worse injury, I told myself.
So on Marathon Monday, the common term in the Boston area for race day, limping, I headed to the start line. Other than a wave of nausea around mile five, which I thought was because of dehydration, I remember virtually nothing from the entire two hours I was on the course, slowly making my way to eventual collapse.
It wasn’t, of course, a muscle pull. Though it’s hard to know exactly how severe the injury was when I began the race, it’s evident that a stress fracture existed before I headed to Hopkinton that day.
“Stress fractures are really well named,” says Rajeev Pandarinath, M.D., board-certified orthopedic surgeon, and assistant professor at The George Washington University School of Medicine and Health Sciences, where he also serves as the senior sports medicine surgeon.
“It really is related to how much stress you’re putting on your bone. By stress, we mean the mechanical loading of bone-impact exercises. Running is a perfect example, because you’re constantly pounding on your lower extremities,” explains Pandarinath.
Hip stress fractures are fairly common in all runners, he adds, but they’re more frequently seen in female athletes due to a variety of factors commonly referred to as the “female athlete triad”: under-nourishment or disordered eating, overtraining, and not having a regular period. “When those three go together, you’re a higher risk for stress fractures.”
Estrogen is a protective agent for your bones; if your estrogen levels are low enough for you to miss your period, it means your bones aren’t being taken care of. And any sort of malnourishment puts your body’s entire level of function at risk, not to mention lowering your count of vitamin D and other nutrients necessary to feed your bones.
My fracture likely came from overtraining, the doctors think, a fairly common occurrence when one is ramping up their mileage too quickly. The severity of my injury—and the extended length of recovery I would later face—probably came from running 10 miles on an already fractured bone, something Pandarinath said he’s almost never heard of someone doing.
I had to recover physically and emotionally from this injury.
Luckily, my fracture was compression-side, meaning that each time I bore weight on my hip, the bones were being forced together instead of being pulled apart. The doctors at the hospital explained that this meant I didn’t immediately require surgery. Had the fracture been on the other side of my hip, they likely would have had to hold the joint together with pins.
Instead, I was instructed to be on virtual bed rest for two weeks, waiting for the pain and inflammation to subside. Then, while on crutches, I would have to have X-rays every few weeks to make sure the fracture was healing properly.
At the outset, any movements that jostled my leg would cause me to sob and dry-heave at the same time. Slowly, I began to get around on crutches, but I struggled with basic activity. Once, I sat on the edge of a chair, staring at my knee, willing my leg to lift up under its own power. I couldn’t do it.
I felt like an imposter in my own body. Essentially immobilized, it became frighteningly easy to fall into a cycle of self-pity. Every waking moment, I was met with pain. Pain so sharp when I tried to make it to the shower unassisted, I had to lean against a wall, bracing myself and catching my breath. I needed help going to the bathroom, bathing myself, and getting dressed.
Waiting for my pain to subside, and realizing each morning that it was the same as the day before made me feel like a failure. Collapsing on the course of my dream marathon did, too. By the time I was cleared to begin physical therapy, I doubted that I’d ever be able to run again.
I visited the therapist three times a week, an hour and a half each time. At first, we focused on muscle manipulation (think the most sadistic massage of your life), dry needling (a practice where needles are inserted through the skin into trigger points directly in your muscle), and stretching. As my strength grew—to my surprise—we mixed in mobility exercises including lunges, squats, and Bosu ball moves.
This multi-approach rehab plan is typical for fractures in the hip, says physical therapist Bryan Heiderscheit, Ph.D., a physical therapist at the University of Wisconsin Health Sports Rehab Clinic, who specializes in the diagnosis and treatment of running-related injuries.
Also key, Heiderscheit added, is patience in recovery. “A lot of stress fractures [symptoms] disappear in the first two or three weeks. If you push yourself too quickly, you can easily re-injure it,” he said.
I slowly began to mark off physical accomplishments. I went from struggling to stand the sensation of a hand on my left thigh to pulling my knee toward my chest. The day I held my first 30-second plank, the therapist high fived me so enthusiastically I staggered back a little.
But no matter how much I improved, I had one giant hurdle to leap: I was terrified to run, even after I was cleared in mid-August, four months after my injury. That apprehension is a common response to traumatic injuries like mine, Heiderscheit said.
“We work with patients to go through post-injury imaging to show the extent of recovery,” Heiderscheit said. “Then, you have the confidence [knowing] that the structure is there.”
Eventually, I found my footing and started to run again.
One morning in September, I decided it was time. It had been nearly five months since I collapsed at mile 10 my doctors said I was healed enough to test my limits. I took the first few steps the way you get into the ocean water early in the summer—slowly, wincing, expecting the cold to knock the breath out of you at any moment.
After checking with my physical therapist, at the end of September, I signed up for my first post-injury race, accompanied by my mom and some friends: the Tunnel to Towers 5K in New York City. In the past, a 5K was my warm-up; that day, I stood in the corral waiting to begin the run with gnawing anxiety in the pit of my stomach.
I was worried I would fall and worried my leg would give way. As the run began, I stuck close to my group, too nervous to venture far away from immediate help. But my rhythm returned, subconsciously. I felt my body leaning into the climbs, and I felt my strides lengthening as my confidence grew.
As I rounded the corner into the end, I saw the finish line, and a surge of adrenaline coursed through my body. I tucked my head down and just ran. At the finish line of my first race since shattering my hip, I was too breathless to cry. All I wanted to do was smile, anyway.
SELF – Fitness