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Femoral Neck Stress Fracture

Femoral Neck Stress Fracture
I had a lady in this week who’s been training diligently for the City to Surf. She has a long running history, consistently running at least three times a week for a number of years. For the last 6 weeks she has increased the training volume to 5, longer, faster runs a week on top of some strength and plyometric work in the gym, all with a personal trainer.

For the last 4 weeks she’s had “hip flexor” and “groin” pain when starting to run, which disappears as she warms up. The last week the pain has returned when she cools down and been sore in the mornings after running. She admits she’s been ignoring the pain and it’s now getting worse.

Her pain is aggravated with impact loading – run / hop / skip / jump, and is reproduced with hip quadrant testing, particularly internal rotation.

Suspicion of a femoral neck stress fracture comes from the history of an increase in training volumes. The diagnosis was confirmed with MRI.

Stress fractures are a reasonably common overuse injury in the leg resulting from increased training volumes. Femoral neck stress fractures are relatively uncommon though, making up less than 5% of stress fractures.

It was a good pick-up because they can potentially progress to a full fracture that requires serious surgery.

Management includes decreasing the load by using crutches for 3-6 weeks and then a very gradual return to jogging when pain free.

I’m sorry to say the City to Surf is out for this year.

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