Is there any difference in healing between a stress fracture versus a traumatic fracture? Well, that’s what we’re talking about today on the Doc On The Run Podcast.
This is a great question. I saw somebody who basically had what was really a traumatic fracture, but then she was told it was a stress fracture, which didn’t make sense because it wasn’t from training for a race or something. She actually had one incident where she cracked the bone.
I’m talking about bones that are not displaced here. So, if you basically, if you jump off a ladder, you break it and it’s moved out of position, completely different story. Stress fractures don’t generally wind up that way. They’re usually, if there’s a crack in the bone because of a stress fracture, the bone is not displaced. It’s not angulated. It’s not moved out of position, and we do not have to take you to the operating room to put it back in position and hold it there.
So, with that qualification aside, you need to understand we’re talking about similar looking bones on an X-ray. One of them caused by running way too much and not enough recovery in between workouts, the other caused by some kind of trauma, like jumping off the ladder or tripping and falling and catching your foot against a root when you’re actually running and snapping the bone, that kind of thing. But they look the same on the X-ray, that’s what I’m talking about.
The short story is that are there any differences. The other couple of differences, the first is the time to the injury. In that what I mean is that if you if you have a lot of tenderness, because the time that it took to get the injury kind of escalated very, very slowly with a stress fracture and you were aware of it and now you have a little bit of tenderness, the amount of tenderness that you have because it built up gradually and you noticed it sooner, may actually be better than the traumatic fracture.
That’s what most people think of when they think there’s a difference in the healing time that the stress fracture doesn’t hurt as much as a traumatic fracture, so it’s going to heal faster. But that’s not really the real reason why, when you get a stress fracture in a bone.
The second difference is that the stress fracture is really loading of that bone that causes injury to that bone and primarily only that bone most of the time. So, there’s not usually a lot of other soft tissue injuries. However, when you have trauma, like if you fall off or the roof of a house or something and you land or even catch your foot under a root, it’s a high force injury. And so, it kind of squishes, bruises, damages the soft tissue and you get a soft tissue contusion in addition to that.
In addition to the bone being damaged, sometimes you can actually have so much squishing of the soft tissue and damage to the soft tissue that you’ve actually got some kind of compromise or damage to the blood vessels that are going to help heal that bone. So, if you have a lot of bruising, a lot of swelling, it looks really Frankenstein-ish as if you know somebody ran over your car or your car over your foot and it really looks bruised and it looks terrible, it’s probably unfortunately going to take longer to heal than a standard stress fracture that’s not really that bruised and not really that swollen because it’s mainly about the associated soft tissue injuries that can happen with trauma, that don’t usually happen with stress fractures.
If you want to know more detail about stress fractures specific for runners who are trying to run with stress fractures and figure out what to do to maintain your running fitness, you can get all that for free. It’s a presentation I put together. It’s a masterclass, it goes into a deep dive on those topics. You can get it for free at www.docontherun.com/stressfracturemasterclass. So go check it out, and I’ll see you in the training.