In the late spring of 2006, I posted this entry to my blog after sustaining a stress fracture of my left pubic ramus in the process of marathon training. I am posting a follow-up entry now because I have been amazed at the number of emails I have received from some of you out there about this topic. I don’t mean I’ve gotten hundreds or anything, but probably about a dozen or so since I wrote about my own experience.
As you may have read in subsequent posts, I had a baby in July 2007, a little over one year after the fracture. I became pregnant about five months after the injury, and about one month after feeling that it had recovered. I had initially wondered if the pain from the fracture would return as the pregnancy progressed, but it never did. Even at the end of the third trimester, I never would have known the fracture existed - it was a non-issue.
Another question I receive with some frequency is what I did to get better. The answer: I removed myself from all exercise for three months. It was irritating, because at the time I was quite fit from training, but every time I would attempt to do anything even as low impact as using the Elliptical trainer, the pain was back within minutes. Riding a stationary bicycle doesn’t help, because it requires sitting on the affected area. I finally had to use crutches for several weeks to keep weight off of the left side because it just was not healing.
This does not seem to be as uncommon of an injury as I initially thought - now that I’m aware of it, I have met many people who have friends or acquaintances who have had the same injury. I have not yet met a man with the injury - it really seems to hit women.
I have not run a marathon since the injury, but this is more for reasons of time and motivation than anything. I think I will wait until after I am finished having children and they are all done breastfeeding before attempting another one. 
I think that’s all I have to write for now about this. Please feel free to email me if you have further questions.
Sorry-just had to leave a comment. Injured myself running 5 months ago…and after 10 weeks of physio for an “adductor strain” I had an MRI which showed a healing inferior pubic ramus fracture. Just about starting back to running and was googling return to running and found your site. Just found it funny when I was flicking through and found references to radiology. I’m a radiology registrar (resident) in Ireland! Newly identified risk factor perhaps?!?
Gráinne
Comment by Gráinne — March 5, 2008 @ 2:59 pm
hey i got a stress fracture in october 2007, but my doctor said it was just overuse. I continued gymnastics on it until december and then finally got a boot on my right foot. I got the boot off in February 2008, all i did for that month was upper body strength at my gym. I started working back out in february very slowly, and then competing again in the middle of march. During my competitions i did very basic skills not what i used to do. Now its April 2008 and i have been experiencing some pain in my foot again. I went back to the doctor and he put the boot back on for this month. I’m competing in my state meet on May 3rd 2008 and the doctor said after that i have to take a break so it can heal, my only worries are that its gonna get worse while i’m working out for this month. Whats possible of happening to it?
Comment by jessica — April 4, 2008 @ 9:31 am
I am a cross country runner and in my last season of competition I got a pubic ramus stress fracture and was having problems with the left side of that whole region. I competed in two more meets (extreme pain) and then took 4 months to let it heal. When all pain was gone I began running again and it felt great for about two months. Then slowly I felt some similiar pain in the right side. After continuing to run about one more week, I started feeling more of the same symptoms as I had on the left side. I am extremly dissappointed to be back in the same position! I have once again reverted to no exercise, but I was wondering if you had any suggestions to stay in shape? I am a competitive collegiate runner and hate to think what kind of shape I will be in after this. I was also wondering if you had any suggestions as to why the injury proceeded from the left to right side, after prolonged rest and then returning to running?
Comment by Bailey — May 28, 2008 @ 12:13 pm
Dear Jodi,
I am a physiotherapist and my area of speciality is lower limb overuse injuries. I am currently researching pubis ramus stress fractures.
As with all overuse injuries the cause is multifactorial and the treatment needs to address and at best resolve/eliminate as many of these factors as possible. Such that when treating someone with a pubic stress fracture I resort to “micromanagement”. The process is very frustrating for all involved. Fractures do occur in males but it is much less common. The specific cause of the injury has not been identified but it is thought to due to how the adductor magnus pulls on the pelvis. I am pleased to hear that you have experienced a pregnancy and birth without any problems from the healed pubic fracture. I’d be happy to converse some more and offer you any assistance I can, however we are limited on the blog. The most helpful I could be at this stage is to recommend you have someone look at your running technique with particular reference to lumbopelvic stability, stride length and the vertical alignment of your leg as you land and take off.
regards,
Sarah
Comment by sarah — July 20, 2008 @ 3:51 pm
[...] - By the way, thank you for all of the comments about pubic ramus stress fractures. I still continue to receive emails from people (all of them have been women, I think) with either [...]
Pingback by Jodi’s Running Blog » And I’m back again — July 27, 2008 @ 10:14 am
Well, here’s your first male with a stress fracture of the superior pubic ramus. Starting in April, I ramped up my training for an 18 mile trail race with the help of a running coach. The onset of symptoms kicked in right after my first hill sprint day. (Aug.) I am supposed to use crutches for a month, then no running until January. My biggest concern is how to keep it from happening again….
Comment by Daniel — September 20, 2008 @ 5:49 am
hi, i would like to know more about what sara has to say…i had the famous left pubic ramus fracture,and, it was missed diagnosed as a groin tear…i am a p.s.w…that means i work with long term care seniors so i worked for 4 months lifting and walking to work thinking it was a groin tear…any help for my recovery would be appreciated..i’d like to take this info to take to my specialist who tells me im his “first”….thankx….D
Comment by diane richardson — September 20, 2008 @ 3:25 pm
P.S…i once read a small article on pronaters and suponaters….that people who are pronaters tend to have stress fracture more than suponaters…does any one know of this???
Comment by diane richardson — September 20, 2008 @ 3:30 pm
Jodi,
I am 55 and have been running for about a year and really enjoying it until I got two stress fractures of the public ramus. I was wondering what all you did for healing. I still have pain walking after 8 weeks. My orthopedic doctor did not suggest crutches and I do have to walk a lot being a teacher. Did you take anything particularly to help with your healing? I want to think I can run some again. I want to heal as quick as I can. Running was the first sport I really enjoyed and could do with my husband.
Comment by Debbie — October 2, 2008 @ 9:40 pm
I was diagnosed in early June 2008 with a left inferior pubic ramus stress fracture. I had pain on both right and left side several weeks after the MRI. I took 5 weeks off after the initial diagnosis and tried to swim and bike for 2 weeks, but the pain was too much. I’ve done NO exercise since 8.2.08. As of 10.26.08, I’m still dealing with it. My pain has gone away, but I still feel like I’ve got inflammation. Anyone else experience this or have any ideas?
Comment by Jason — October 26, 2008 @ 12:53 pm
I too suffered from a pubic ramus fracture two years ago, and after having my daughter four months ago, I’m again experiencing pain as I am trying to get back into running. It’s on both sides. I started taking Glucosamine DS, but wondered if anyone has heard if this is supposed to help. My knee dr. recommended trying it. (I’ve had five knee surgeries, but have running “in my blood.”)
Comment by Gina — November 2, 2008 @ 3:19 pm
Hello! I have been suffering from a strss injury on my left pubic ramus. The pain has been unbearable at times. I beleive it was from pregnancy/chilbirth, and then jogging did not help. I just got my MRI results today, so i am trying to lppk into the healing process. It seems rest and crutches is what helps? Thank you for sharing Jodi, i appreciate it. I am looking forward to getting this taken care of!
Comment by elicia — November 10, 2008 @ 2:32 pm
i believe my male friend has had a pubis ramus stress fracture that has also caused some nerve damage via nerve impingement. Muscle activation with right glute, right gastrocs and right hamstrings is minimal. bladder control is minimal. some numbness and tingling in left foot. Anyone have similar experience?
Comment by michaela — November 13, 2008 @ 11:43 pm