Tibial Stress Fracture

[ashevillain]

I was just diagnosed with a tibial stress fracture yesterday. This was most likely caused by a combination worn out shoes and improper running technique during one of my 3(ish) mile runs that I was doing 3x per week. I was told no running, hiking or biking for at least 6 weeks (my next dr. visit).

I have been an fairly avid weekend day hiker over the past few years. I'm at the point where I know my limits better while hiking than I do while running (only been seriously running since January).

If anyone here has had the same injury I have a few questions. Were you able to return to hiking sooner than running? Or did you just stay away from it all for the given length of time? Did hiking on inclines/declines cause pain after it healed? Where any other alternate activities suggested? I wish I had access to a pool because that seems like it might be OK but I've even read reports of that causing pain to the fracture.

[ashevillain]

I'm surprised this has so many views yet no one has had any experience with this injury!

Anyway, just to update a bit. It's been almost 6 months since I originally injured my legs and I still have pain...too much pain to run, in fact. I had a follow up visit 6 weeks after the initial diagnosis and the Dr. told me I still wasn't healed enough to run but said I should get on the elliptical machine, so I've been doing that for anywhere between 3-6x per week since November. He also said that while he initially told me it was a 6-8 week healing time, it could take up to 12 weeks. Well, that time has come and gone and these fractures still aren't healed! I've tried to do some small run/walks (on anything but a concrete sidewalk...even asphalt is softer than concrete) and I've still felt pain...not to the point where I could not walk afterwards but pain nonetheless. I wish I could go back and see what the Dr. would say now but I got laid off a couple months ago and lost my insurance (can't afford COBRA).

I still haven't tested out what it would feel like to hike. I guess I'm somewhat nervous about what might happen if I get way back into the woods and then starting hurting...I don't want to have to crawl back down the trail. At some point in the near future I am going to test myself on just some short easy hikes (< 4mi or so).

[Pedaling Fool]

I've never had this injury, but my answer to the problem is same as with many other injuries regarding the skeletal system -- weightlifting and other weightbearing exercises, like jumping...

I wouldn't sit around and wait for it to recover; I believe the body recovers best by continually stressing it, albeit at a reduced level than with a healthy body. Good time to start weightlifing.

[burger]

I had a stress fracture (in my foot) and one or two stress reactions (like a precursor to a stress fracture). In each case, I was told that you should base your activities on being pain-free. So, if you have pain from walking, get crutches until you can walk without pain. Once you can walk pain-free, gradually amp up your exercises (elliptical and/or bike), but if you have pain from those, scale it back. I'm guessing you overdid it during your recovery and didn't give the bone a chance to heal properly.

Also, you might consider calcium supplements if you don't get a lot in your diet.

Another resource: check out the forums at runnersworld.com--lots of people who've had stress fractures post there.

[burger]

I should add that the above post from "John Gault" is totally wrong.

[Pedaling Fool]

I've never had this injury, but my answer to the problem is same as with many other injuries regarding the skeletal system -- weightlifting and other weightbearing exercises, like jumping...

I wouldn't sit around and wait for it to recover; I believe the body recovers best by continually stressing it, albeit at a reduced level than with a healthy body. Good time to start weightlifing.


I should add that the above post from "John Gault" is totally wrong.
Totally wrong? Do you deny that weightlifting increases bone density? Do you deny that exercises, such as jumping stresses one's skeletal system, thereby causing your body to build a tougher skeletal system? (And yes calcium is important, but not enough on its own). Do you think one should become a couch potato during the recovery period?

Please tell me how I'm "totally wrong"

[burger]

Like I said, I've had a stress fracture plus two stress reactions, and my doctor (a well-regarded sports medicine doctor who's written books about athletic injuries) told me very clearly to stay off the bone until it stopped hurting. You don't just jump back into weight-bearing exercises right away--you have to let the break heal, and that takes time. That's why I told the OP to gradually ramp up activity based on pain. Only once the bone is healed do you do exercises to increase bone density. So, sitting around and waiting for it to recover is exactly what the OP should do, contrary to your advice.

If that doesn't satisfy you, PM me and I'll give you the number of my sports medicine doc. You can make an appointment and hear it from the horse's mouth.

[Grampie]

On my first thru-hike attempt, I came off the trail with a tibial stress fracture. My doc said that I could probably hike again in 6 weeks. Like you in 6 weeks I still had a lot of pain. The pain finally went away after 6 months. After that I was able to hike and also ski. I started a thru the following spring. Made it to Katahdin with no further problems.
My experience may be different than yours because of our age difference. I was 65 years old.

[ashevillain]

@John Gault, you are wrong. Every time there is pain in a fracture that means that it is opening back up. Nothing good can come from further stressing the already overstressed area. My orthopedic Dr. is a marathon runner and well experienced with running injuries. I trust what he said to be true. And, ummm....there is a happy medium somewhere between jumping (causing further injury) and being a couch potato!

@ burger - I definitely did not overdo anything for the 1st 5 months. During the 1st 6 weeks I did absolutely nothing (which drove me crazy but that's what I was told to do). After that re-check from the Dr. he told me to get on the elliptical or recumbent bike a 4-5 times per week...so I did nothing but the elliptical for the next 3+ months. No pain from it but it does bore me to tears. Just the past couple weeks I've tried the run/walk scenario maybe 3-4 times to substitute from the elliptical and each time when I felt pain, I stopped. Running on natural surface (mulch, grass, etc) doesn't cause the pain quite as quick.... and the asphalt trail at the park is a little better than the concrete sidewalks around town. Also, I should mention I did buy good supportive running shoes...Brooks Adrenaline.

I also have been taking calcium and Vitamin D supplements even though I don't think I'm deficient. The 1st appt I had when they took xrays was about 1.5 weeks after the original injury....they would not have been able to detect the stress fractures on the xray except for the fact that it had already started to calcify (i.e. heal).

This whole thing is frustrating because it's not only taking longer than I expected, it's taking longer than the Dr. expected. I've done everything (and then some) that was prescribed to me.

Thanks everyone for the replies.

[10-K]

Didn't you just hike an out and back from Sam's Gap a month or so ago ?

[Pedaling Fool]

Like I said, I've had a stress fracture plus two stress reactions, and my doctor (a well-regarded sports medicine doctor who's written books about athletic injuries) told me very clearly to stay off the bone until it stopped hurting. You don't just jump back into weight-bearing exercises right away--you have to let the break heal, and that takes time. That's why I told the OP to gradually ramp up activity based on pain. Only once the bone is healed do you do exercises to increase bone density. So, sitting around and waiting for it to recover is exactly what the OP should do, contrary to your advice.
I also know a sport's doc and he ok's the light exertion for stress fractures, but that's how it is, even with experts, ask 10 of them and you get 10 different answers...

Plus, I also have experience with stress fractures in the feet, even simply walking hurt, did I sit on the couch until I could walk pain free:rolleyes: I didn't give advice to go all out, but weightlifting doesn't necessarily mean maxing out. If you can get off the couch you can weight train, i.e. squatting is nothing but sitting up from a couch, just more repititions.
If that doesn't satisfy you, PM me and I'll give you the number of my sports medicine doc. You can make an appointment and hear it from the horse's mouth.
Don't be silly, like I'm going to call you doc:rolleyes:



@John Gault, you are wrong. Every time there is pain in a fracture that means that it is opening back up. Nothing good can come from further stressing the already overstressed area. My orthopedic Dr. is a marathon runner and well experienced with running injuries. I trust what he said to be true. And, ummm....there is a happy medium somewhere between jumping (causing further injury) and being a couch potato!

@ burger - I definitely did not overdo anything for the 1st 5 months. During the 1st 6 weeks I did absolutely nothing (which drove me crazy but that's what I was told to do). After that re-check from the Dr. he told me to get on the elliptical or recumbent bike a 4-5 times per week...so I did nothing but the elliptical for the next 3+ months. No pain from it but it does bore me to tears. Just the past couple weeks I've tried the run/walk scenario maybe 3-4 times to substitute from the elliptical and each time when I felt pain, I stopped. Running on natural surface (mulch, grass, etc) doesn't cause the pain quite as quick.... and the asphalt trail at the park is a little better than the concrete sidewalks around town. Also, I should mention I did buy good supportive running shoes...Brooks Adrenaline.

I also have been taking calcium and Vitamin D supplements even though I don't think I'm deficient. The 1st appt I had when they took xrays was about 1.5 weeks after the original injury....they would not have been able to detect the stress fractures on the xray except for the fact that it had already started to calcify (i.e. heal).

This whole thing is frustrating because it's not only taking longer than I expected, it's taking longer than the Dr. expected. I've done everything (and then some) that was prescribed to me.

Thanks everyone for the replies.
Worked for me, with my stress fractures in the feet, but you just take it easy. I guess I'm just a freak of nature:rolleyes:

[Appalachian Tater]

Ouch. That you are still having problems six months later is concerning.

You definitely need to rest that leg and avoid stressing that bone if it isn't healed and you still have a lot of pain. Stress fractures tend to reoccur and yes, they are caused by stressing the bone with heavy activity.

If you have a chronic stress fracture (and you might at this point) you may need surgical repair of the bone or a brace, electrical stimulation, etc.

If you can't afford to go back to the MD maybe you can qualify for Medicaid or work out a payment plan with your MD who may not want to stop treating you just because you no longer have insurance since you are already under his care, it won't hurt to ask.

Swimming is always the best exercise in situations like this.

Good luck.

[WingedMonkey]

Swimming and running in the water will help build strength until you can do weights.

[Blissful]

I think its important to note that not all "sports drs" are created equal. I had one "sports dr" tell me essentially I'd never hike again. And another who said that was ridiculous and did all he could to get me going to attain my goal - and did it with the right regimen. Suffice it to say, i went with dr #2 and have hiked the trail twice. Also some sports mds are better gifted in certain areas. #1 was more spinal. #2 was for limbs.

[royalusa]

I think its important to note that not all "sports drs" are created equal.

Which reminds me of a Q&A I love:

Q: What do you call a medical student who graduates dead last in his class?


A: Doctor

[Blissful]

. Well, that time has come and gone and these fractures still aren't healed! ).

Has this been checked with a follow up x ray? Or are you saying this b/c of pain? Because it could now be more of a neurological pain nerve path issue. I had a friend who had this, had a fracture and the nerves were continually irritated despite the fracture having healed. It required a pain bloc and eventually surgery to cut part of the pain nerve path (which actually orginated farther up in the thigh I believe).

[Blissful]

Swimming and running in the water will help build strength until you can do weights.


There is nothing better than water PT. I had it for my ankle. And I was close with fracturing my ankle when I ripped out both tendons on each side. It took 2 years to finally overcome. I can get tendonits easily if I walk with bare feet, don't stretch the calves, etc. I actually finally overcame it by hiking Shenandoah southern sectin in 2 lb boots. It strengthened it enough by this regimen. Only time I dared wear those things. My toenails were killing me but my ankle was happy.

[ashevillain]

Didn't you just hike an out and back from Sam's Gap a month or so ago ?

No, you must have me confused with someone else.

[Camping Dave]

I was just diagnosed with a tibial stress fracture yesterday. This was most likely caused by a combination worn out shoes and improper running technique during one of my 3(ish) mile runs that I was doing 3x per week. ... Anyway, just to update a bit. It's been almost 6 months since I originally injured my legs and I still have pain...too much pain to run, in fact.

I'm no expert, but I play one on Whiteblaze ... And I am also a guy who suffered terrible shin splints when he started running 2 years ago. They persisted until I improved my running style. 9 miles per week is a very small amount of running for such a serious injury. It's not the shoes fault. Running on an elliptical won't help your technique either.

If you really want to run, learn proper technique.

[Ashevillian]

Oh no, we are using the same WB name, sans the capital "A", don't get me in trouble.

[Pedaling Fool]

Well 10-K, at least now you know you're not losing your mind.

[flemdawg1]

I was just diagnosed with a tibial stress fracture yesterday. This was most likely caused by a combination worn out shoes and improper running technique during one of my 3(ish) mile runs that I was doing 3x per week. I was told no running, hiking or biking for at least 6 weeks (my next dr. visit).

I have been an fairly avid weekend day hiker over the past few years. I'm at the point where I know my limits better while hiking than I do while running (only been seriously running since January).

If anyone here has had the same injury I have a few questions. Were you able to return to hiking sooner than running? Or did you just stay away from it all for the given length of time? Did hiking on inclines/declines cause pain after it healed? Where any other alternate activities suggested? I wish I had access to a pool because that seems like it might be OK but I've even read reports of that causing pain to the fracture.

I had a femural stress fracture from training for (16 weeks) then running 2 marathons within 8 weeks. I didn't do any running or hiking for a couple of months and it was fine. No cast crutches or surgery. Yes it sucks not being able to run, but you'll be back before you know it.

[blitz1]

I think its important to note that not all "sports drs" are created equal. I had one "sports dr" tell me essentially I'd never hike again. And another who said that was ridiculous and did all he could to get me going to attain my goal - and did it with the right regimen. Suffice it to say, i went with dr #2 and have hiked the trail twice. Also some sports mds are better gifted in certain areas. #1 was more spinal. #2 was for limbs.
This is so true! You could ask running friends who they've gone to for injuries if you're still having trouble.
I'm sure John Gault's advice is well-intentioned, and for some types of injuries you can indeed just work through them, but for stress fractures this is completely the wrong thing to do, and will delay healing or worse (I'm a board certified rheumatologist, though stress fractures sure weren't a specialty for me). To heal a stress fracture the quickest, you really shouldn't be doing anything that causes pain. Even then, healing times differ greatly, as noted above, and the 6 wks is more of a minimum than an absolute guideline. Sure, some stress fractures will heal anyway if you are active, but tibial is hard, and can be slow.
However, as also noted in the responses, this may not be a stressfracture any more, or it could be a combo of stress fracture and a second condition, so a reeval may be helpful.
good luck.

[jbwood5]

As a trail hiker and ultradistance runner I'd suggest some contrasting soaks of, first ice water, and then very warm water with a cup of epson salts dissolved in the water. The idea is to force circulation in the area around the crack and hopefully speed up the healing. 4 to 10 minutes of as cold as you can stand it and a few minutes of warm compresses (warm being hot but not to burn the skin). If you can soak your leg in a couple of buckets and still immerse the cracked area, that is the easiest way. Otherwise you have to use compresses which is a PITA. Massage with essential oils may help too, but the general idea is to get nutrition to the area through your circulatory system. That is how the body eventually repairs itself... but it takes time. If you can walk a quarter of a mile with no pain (or very little), do those gentle walks and gradually increase them. If not, exercise by swimming or running in a pool with a bouyancy vest. Exercise promotes circulation and circulation promotes healing. If possible avoid drugs for an older nagging injury unless you can't do without. Drugs may prolong healing according to a lot of written reports. Increase weight bearing activities slowly and you will come back stronger if you give it enough time. Good luck.