Can a tibial stress fracture still hurt after 11 months? Well, that is a great question and that is what we’re talking about today on the Doc On The Run Podcast.
Can a tibial stress fracture still hurt after 11 months? Well, good question. This question came from Simon on one of the YouTube videos on the Doc On The Run YouTube channel and as you can guess from the title, I am sure Simon is pretty frustrated. And so, he sent in a question, and he says that he got an anterior tibial stress fracture. Well, that is not good.
My guess is, I do not really know, but my guess is, is that he was misdiagnosed with shin splints for a long time. And so, I’m not sure if some of that 11 months was when he was misdiagnosed with shin splints, or if he was really told right away that he had a tibial stress fracture and just didn’t get better.
But he said that he was training for a 5K when this thing started, and his question that he sent to me was, can a tibial stress fracture still hurt 11 months after the incident? He says that his MRI shows only a small white area so is this pain from a tibial stress fracture, or is it a phantom pain more likely? Well, those are good questions.
A couple things to point out here in his questioning is that number one, he says that it’s hurt for 11 months after the incident. I don’t know what the incident was. Was it one specific run where it cracked and it started to hurt or was it 11 months after he was finally diagnosed with tibial stress fracture, and he had been misdiagnosed with shin splints, and then he got an MRI. I don’t know when the MRI was, if that was recently or if it was a long time ago, but it says only a small white area. I have no idea what that means.
It could be sclerosis. It could be where the bone gets harder. It could also be where you have inflammation within the cortex of the bone right before it cracks, and so it wasn’t a crack at all. I don’t know. I don’t know based on that little description of what that MRI really means. I wouldn’t make a decision on that unless I looked at it myself.
I will tell you that I actually did a lecture called Phantom Limb Pain Causes, Prevention, and Treatment at the University of California, San Francisco Medical Center for the UCSF Department of Clinical Medicine on October 5th of 2001. That was a long time ago. The interesting thing is that I did a lecture at UCSF for the medical department on this topic a long time ago, and I read everything that was published at that time on phantom limb pain. There’s a lot of really interesting stuff that I learned.
One of those things is that what phantom pain is, is painful sensations that you get in any body part that has been amputated and is no longer there. So, first thing, Simon, if you didn’t lose your leg, no, it’s not phantom limb pain. It’s definitely not phantom limb pain, and I know that he probably still has his leg based on his question, but really, he’s asking, well, what would I do?
Well, what I’d do is really simple. If you think you have a tibial stress fracture and you don’t think you have shin splints, number one, I would figure out how bad the tibial stress fracture is right now so that you can make a plan to recover.
Step two, I would then carefully reduce the stress and the strain on the shin bone that has that stress fracture. No matter what it looked like on the MRI, I would do that and you want to do that so that the stress fracture can start healing and calming down as fast as possible.
Step three is after you reduce the stress and strain on that, after you know the severity of the tibial stress fracture, then I would immediately, like today, tomorrow, immediately start training and testing to rebuild running fitness right away so that you don’t get weaker.
The athletes who get injured again are getting injured, I believe, because they are weak from the recovery process of not running, not training, whatever. So, if you’ve been not training, not running, not doing anything for 11 months, you’re at very high risk of getting another overtraining injury. But if you look at the largest study of injuries in runners, a meta-analysis, they found three things.
Number one, the three things that put your risk of an overtraining injury are, number one, being male. Number two, high mileage runner. No surprise. And number three, you’ve been injured before.
If you’ve been injured before, you are probably at risk because you’re weaker and stiffer from the process of sitting still for nine or for 11 months. So, this is what I would ask you to do. I would figure out the severity, I would figure out how to stop wearing the boot or using crutches, whatever you’re doing, so as long as you’re reducing the stress and strain on that enough that your severity goes down.
If you want to learn the exact process of how I do that, well, I created a worksheet for you that you can get for free that will help you figure out what to do with a tibial stress fracture. And all you have to do is go to www.stressfracturesecrets.com and you can download that, print it out, and use it. What it will do is it will help you figure out exactly what the severity is right now.
If you do not understand the severity of your stress fracture, there is no way you can monitor it and start testing or start working out and confirm that the severity is not getting worse. That is the process I would do with Simon if he called me. That is the process I would do with anyone that has a tibial stress fracture who is not getting better and is sitting around for months and months without improvement.
Reference:
Segler, CP. Phantom Limb Pain: Causes, Prevention, and Treatment. University of California. San Francisco, Dept. of Clinical Medicine, San Francisco, CA, October 5, 2001.
#974 Stopped sports for 2 months and got 2 more stress fractures »» |