Today on the Doc On The Run podcast, we’re talking about whether or not you really need a fracture walking boot for a tibial stress fracture.
There’s no question, stress fractures are some of the most common injuries that afflict runners. And if you really ramped up your mileage, and you’re a track athlete, or you just started cross country and really started ramping up your miles a lot, well, you may develop pain in your shin that is initially misdiagnosed as shin splints, but it might actually be a tibial stress fracture.
Now, if you have a tibial stress fracture, and you have pain in the front of the tibia, right where you feel that ridge in the middle of your leg, on the front of your leg, on the shin bone, well, that could be a tibial stress fracture. And tibial stress fractures can be a real problem.
If you keep running, and you ignore it, and the inflammation gets worse, the bone starts to break down, and then it actually cracks, that is a huge problem. So you can’t ignore that pain, and you don’t want to neglect it, and you don’t want to just let it get worse.
Of course, the most common treatment for a tibial stress fracture is to put you on crutches, in a cast, or more commonly, a fracture walking boot. So the name implies that when you get a fracture, you can walk with it, and it will heal.
But a fracture walking boot isn’t really always that helpful and not always necessary for a tibial stress fracture. So it depends very much on your circumstances and of course what your doctor tells you. But I just wanted to try to explain why a tibial stress fracture happens and what it is that a fracture walking boot actually does when you wear a fracture walking boot, and you have a tibial stress fracture.
Tibial stress fracture is a thing that happens from too much impact, when stress is applied through the tibia or the shin bone between your knee and your ankle.
It can happen because you are forcibly pronating your landing asymmetrically, or you’re just plain running a ton, and you’re really ramping up your mileage, and you’re pounding away on your tibia, and your shin bone starts to get injured. But this is a stress issue. It’s an impact issue.
It’s not a thing where you’re landing and twisting your foot, and it’s the twisting motion that actually causes the injury. So if you have a metatarsal stress fracture, and you’re landing on your foot, and your foot sort of collapses across the ground, well, you need a fracture walking boot to hold the foot still and change the forces that move through your foot.
But when you wear a fracture walking boot, it really doesn’t do that much for the tibia in terms of reducing the forces because it’s basically your weight standing on the tibia, sort of longitudinally loading the tibia from your knee down through your ankle, just pushing all the force right through the bone.
Well, that downward force doesn’t go away when you put on a fracture walking boot.
Now, if you have a crack in the tibia or the shin bone, and we’re worried that it’s going to bend, well, a fracture walking boot will protect against that.
But that’s not really the problem that most people have with a tibial stress fracture.
In many cases, I think it’s better to do what just hurts less. So if you’re wearing cushy running shoes, they have a lot of mid-sole cushioning material. They’re soft, and they absorb impact, and when you step on it, it feels a lot better than when you walk barefoot on hardwood floors, and it feels a lot better than when you walk barefoot on concrete. And in some cases, it actually feels better than when you are wearing the fracture walking boot.
So the fracture walking boot can offer a lot of protection, but a lot of times, it’s just really not that necessary and not really that helpful for a tibial stress fracture. But if your doctor told you to wear one, keep wearing it. Don’t be stupid. Don’t try to just listen to a podcast and then change your mind on what you should do!
Talk to an expert and then do whatever the expert tells you, so you can get back to running as quickly as possible.
Pain is the best tool to help an injured runner decide when run. You don’t have to figure out what to write down. We made a simple Pain Journal PDF for you.
If you have a question that you would like answered as a future addition of the Doc On The Run Podcast, send it to me PodcastQuestion@docontherun.com. And then make sure you join me for the next edition of the Doc On The Run Podcast!