What’s the difference between a mild stress fracture and a serious stress reaction in a runner? Well, that’s what we’re talking about today on the Doc On The Run Podcast.
If you get a stress reaction or a stress fracture and you have pain and tenderness in your foot when you’re running, this is obviously going to be a bummer. And you’re probably wondering, what’s the difference between a mild one and a serious one?
In this case, I had a call with a runner who asked me an interesting question. What’s the difference between a mild stress fracture and a serious stress reaction in a runner, and she actually thought it was based on the amount of tenderness or pain that she had. Although it stands to reason that the more tenderness, the more pain you have, the worse it is, that’s not really what delineates a mild stress fracture from a serious stress reaction.
I’m not going to get into the grading scales of these things. But basically, even though they’re both called a stress fracture of different grades on certain classification schemes physicians use, all you really need to know is that the only difference between those two things is a very small crack, a crack that’s not really visible on an X-ray, not visible on an ultrasound at all, unless your doctor is both really good and you’re really lucky or on a CT scan. It might be very visible on an MRI, but probably on a CT scan.
So, what I mean is that when you get a stress reaction, all you have is tenderness, you don’t have a crack visible on image, any imaging study at all anywhere, even if it’s a CT scan, and you have tenderness when we push on the bone, manipulate the bone or you run on it or something like that. That’s a stress reaction. There’s no crack, it’s just inflamed, irritated and it’s bothering you.
When it turns into what we call a actual stress fracture, it has to have a crack that we can see somehow. Again, the best way to see the crack is with a CT scan and even a little crack might show up on a CT scan, but it probably won’t show up on an MRI because the slices are too big. It might show up on an ultrasound, but most of the time we’ll see the inflammation around the bone but maybe not the crack at all and you almost never see it on an X-ray when it’s a mild stress fracture.
A severe stress reaction, lots of pain and swelling around the bone. It’s not cracked yet. A mild stress fracture feels like a serious stress reaction, but you can find a tiny crack someplace. The truth is, is that when you get right at that border crack versus no crack doesn’t make that much of a difference in terms of how long it’s going to take you to actually get back to running.
If you want to learn more about stress fractures, about what all the things you need to think about if you’re really trying to manage it so you can maintain your fitness and get back to running as quickly as possible, check out the stress fracture masterclass, you can get it for free, www.docontherun.com/stressfracturemasterclass. So, go sign up and I’ll see you in the training.