Is two weeks on crutches better than one week when I have a tibial stress fracture? Well, that’s what we’re talking about today on the Doc On The Run Podcast.
I recently got a great question from a runner who was asking me about fracture healing and trying to figure out is two weeks on crutches better than one week. And because I had actually recommended one week on crutches given the circumstances with this particular runner with a tibial stress fracture. This doesn’t mean that if it’s used, I don’t think this is your specific medical advice. I’m just telling you I think about it.
The first thing is that is two weeks better than one? The short answer yes, it is better for fracture healing if you have a tibial stress fracture or a tibial stress reaction, because you’re spending less time on the foot for a longer period of time, which stands to reason it should help that injury to recover, remodel and heal faster. But maybe it’s not better for you as a runner.
You have to think about this. The thing I always think about with injured runners is that you have to have the minimum restrictive intervention. What do I mean by that? You have to be able to move as much as possible and you want to be restricted in terms of not running, not working out, wearing a fracture walking boot, not moving your foot, not stepping on it. All of the things that cause weakness, stiffness and a propensity for reinjury later, all those restrictions should be limited to the minimum you need to get to the next level.
So, that’s why I don’t use standard protocols. I don’t say four weeks for this or six weeks for this based on the injury. I base it on the athlete, and it’s different for different athletes depending on the severity of their injury, their overall health and everything else.
If you have a tibial stress fracture and you’re an athlete, the goal is not to just get the fracture to heal completely. The goal is to get the fracture to heal enough that you can continue to exercise, workout and train. The longer you use the crutches, the longer you wear a cast, the longer you wear a fracture walking boot, true, the more probability it’s going to heal completely but the more risk you will get weakness, instability and various forms of tissue compromise that put you for at a higher risk of another overtraining injury as soon as you get back to training to start running again.
It’s really a delicate balance between trying to get the fracture to heal by leaving it alone, and making sure that you don’t leave your whole running system in your body alone so long that you get an exponential increase of risk of re-injury. That’s the way to really think about it.
If you want more detail on tibial stress fractures and other things that kind of masquerade as shin splint. I go into all those topics in the shin splints masterclass. It’s a thing you can get for free. It’s at www.docontherun.com/shinsplints. So go check it out and I’ll see you there.