Whether a weekend warrior or a professional athlete, an injury can be devastating. Of course, there is the pain associated with injury, but then there are the emotional factors. The frustration and disappointment associated with the time to heal and being limited in what you are able to do. Most concerning can often be the fear, the questions, and doubts. Will I be able to return to my sport, and if so, at the same level? How will I cope with being stuck on the sideline, unable to participate? Will I simply injure myself again when I do return? What if there is something else wrong? No matter your age, level of participation or competition, these are all the questions that plague the injured.

Managing any injury requires the correct diagnosis and utilization of the best treatment practices to promote healing and a safe return to one’s sport. In addition, trust and knowledge are essential components to optimizing the best results. For the injured person, gaining knowledge as well as trusting their health care provider and their body is essential for the fullest recovery.

I believe Shalane Flanagan had it all!

On Sunday, November the 5th, Shalane Flanagan crossed the finish line of the New York City Marathon in first place. She is the first American to win this marathon since 1977. Earlier this year she was supposed to run the Boston Marathon but withdrew her entry due to a stress fracture in her iliac crest.

A stress fracture is a kind of bone break due to over-use and stress of the bone. The break-down of the bone happens at a rate that the bone cannot remodel and heal quickly enough. The iliac crest is part of the pelvis, the long curved upper border. A very unusual bone to break, it is believed that Flanagan’s training on snow covered roads and treadmill running caused the injury. Stress fractures in runners tend to occur when a runner increases mileage or training intensity too quickly. Additional factors contributing to the risk include poor running technique, incorrect footwear or foot problems, underlying strength and flexibility limitations, eating disorders and weakened bones. Typical symptoms of any stress fracture include bony tenderness, swelling and increased pain with activity. As the injury worsens there may also be pain at rest and at night.

Unfortunately, the most important component to treatment of a stress fracture is rest. The bone needs to remodel and heal. Next is determining why the fracture occurred and addressing these reasons. Obviously, Shalane Flanagan has a team of professionals working with her, to diagnose and treat any injury. But Flanagan had more. The trust and knowledge she had of herself and her team ensured that she was able to be patient and allow the fracture to heal. Her knowledge and trust in the actual marathon training process and her own body’s capabilities allowed for optimal training throughout every step of her journey. Flanagan set a goal and through hard work, determination, knowledge and trust she succeeded.

Injuries can be devastating for any athlete. But with the right mindset goals can be met.

Shalane Flanagan - 2012 Olympic Womens Marathon
By Tom Page from London, UK (IMG_2851 Uploaded by Kafuffle) [CC BY-SA 2.0 (], via Wikimedia Commons