Stress Fractures

What is it?
Stress Fractures is a common diagnosis given to runners suffering from pain either in the front (anterior) portion of their legs or in the inside (medial) portion of their legs resulting from small breaks inside the bone.  Stress fractures can not usually be seen on X-ray and can only be visualized by MRI.

Shin splints are an irritation of bone or muscle tissue due to excessive impact from repetitive stress on the shin bone or overuse of the muscle beneath your calf called the posterior tibialis.  If not treated properly Shin splints can progress to inflammation of your shin bone (periostitis) or stress fractures.  Stress Fractures are often confused and misdiagnosed as shin splints.

How did I get it?
There are a number of factors that contribute to the development of stress fractures.  Repetitive impact stress without adequate recovery is the most common.  High arched, rigid feet do not flex well and do not dissipate shock.  This causes contusions to the shin bone resulting in periostitis and stress fractures.  Women and slower runners are much more likely to get stress fractures.  In a recent military study, 100 female recruits suffered from leg pain, 7 of them had stress fractures.
 
How is it treated?
Stress fractures
require an accurate diagnosis.  Once diagnosed a runner will typically need to rest from impact related activities for 4-6 weeks.  However, they may begin biking, swimming and elliptical.
 
Custom Orthotics:
A proper foot orthotic can go a long way in taking the stress off of your shin bones and preventing future stress fractures.  The right custom-made, biomechanical orthotic can address the underlying cause of your shin pain.  Abnormal joint position, overpronation or foot rigidity can be addressed and the biomechanics normalized.  San Diego Running Institute orthotics are custom molded to your foot and designed with your specific body weight and activity in mind.  The restoration of correct mechanical function takes the abnormal stress off the shins and allows them to heal and prevents future stress fractures.

Stretching:
Often we are told by runners that they have been stretching in an attempt to help stress fractures.  The stretching exercise is directed at lengthening the tendon.  The problem is that stress fractures are not a “stretching deficiency”.  In fact there are really not safe, effective ways to stretch the shins anyway and if it is your bone that is suffering how could you stretch that?  Strengthening of certain muscles may be effective but it is important to remember, it takes 4-6 weeks before muscles begin to strengthen in response to training.  In addition anyone who has worked out in a gym can tell you that if you stop strengthening muscles they begin to lose strength and shrink within two weeks!

Rest:
Rest can not fix faulty biomechanics but it will allow time for your bone to heal.  Plan on no running or other impact activities for 4-6 weeks.

Drugs/Anti-inflammatories:
Drugs such as Ibuprofen are anti-inflammatory agents not healing agents.  They actually impair the healing process and many times allow the runner to injure themselves further.  Studies have proven that these medications are harmful to your body, can cause ulcers and strain your liver.

Ice:
Ice is often recommended and is another example of a non-healing modality.  A runner often reports that they have been icing their leg after running.  This may help with the pain and inflammation at the moment but how will it help to remove the abnormal stress that is occurring in your shins?  It won’t.  What it will allow you to do is further damage your shins eventually resulting in permanent damage.   Addressing the underlying biomechanical cause prevents further damage from occurring and allows you to complete your race injury free.

Steroid Injections:
 
Steroid injections are extremely painful and most doctors are reluctant to inject the shins anyway.  Steroid injections have also been shown to increase the chance of tendon rupture.

How long will it take to heal?
This depends on how long you have been suffering from stress fractures.  Many runners iced their legs and took anti-inflammatory drugs all the while the stress fractures were worsening in their legs.  They finally get to the point where the pain is unbearable even causing them to limp. By correcting the cause of the injury with San Diego Running Institute orthotics and following the treatment regimen provided by Dr. Runco you can expect 50-75% relief usually within four weeks.  Ask your San Diego Running Institute expert about how to get your stress fractures fixed today.

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