What is this painful bump that might be a fibular stress fracture? Well, that is what we’re talking about today on the Doc On The Run Podcast.
Today’s episode comes from a question that was posted as a comment on one of the videos on the Doc On The Run YouTube channel. Specifically, the video was called “Fibular stress reaction versus stress fracture, what’s the difference?” and I was just talking about the difference between a stress reaction and stress fracture in the fibula in runners.
Specifically, of course we’re talking about the fibula. So, you have got two bones in your legs that come down into the ankle, you have the tibia or shin bone, and on the outside, you have this little bitty bone called the fibula. One of my professors in medical school said the fibula is a useless bone, it doesn’t bear any weight, it really doesn’t do much of anything. Well, that’s not entirely true, and if you think about that, if you run and you put enough stress and strain on it that you get a stress fracture in it, it must be doing something or it wouldn’t be taking all that stress, right?
The comment that this guy posted was really simple. He said, Hey I really appreciate the video, I go to the gym a lot and I was doing the treadmill at maximum speed and one day my fibula started hurting a lot after the gym in the lower leg on the outside and I found out it was my fibula. I took a day of rest and went back to the gym and I was running on the treadmill even when my leg was hurting.
Okay, all you listeners out there, is that a good idea or a bad idea? I shouldn’t have done that because now it got swollen and I can feel a little bump or a dome-shaped bump on the outside of my fibula. It’s been a few days. I put ice and started resting my foot and then in warm water. I did a lot of things. I wrapped my leg too. The bump is still there and I’m worried that it won’t go away. I can’t tell if this is a reaction or a fracture because I can still walk.
First of all, just because you can walk, that doesn’t mean that it’s a stress fracture versus a stress reaction. Just because you can walk doesn’t mean that you have one of those things and not the other. The pain has just slightly gone down but there is still a lump, and I cannot run if I try to. Okay, again, you think you have a stress fracture and you’re running. Is that a great idea or a bad idea for all you listeners out there? I don’t know what to do at this point and I need help. I can’t tell if it’s a reaction or a fracture due to the lump. How long will it take to heal? Should I start doing lighter cardio soon? Maybe the StairMaster. I feel like I could do that soon as an alternative to doing cardio from running.
All right, a couple of things. Number one, you can’t really tell based on whether or not you can walk if you have a fibular stress fracture versus a fibular stress reaction. That’s not the way you tell. Also, I don’t know where this bump is. He said down in the leg, so if it’s down really low, there could be a couple of different things. Number one, if it’s back here, it could be an issue with the peroneal tendons in the tendon sheath where it goes down around the back of the ankle. It could also be the peroneus brevis muscle belly. It could have been injured or swollen or even you might have a herniation of the muscle that could make that lump.
If it’s up higher, it could be the peroneus longus muscle. Probably more likely to have happened if you’re running on a treadmill at an angle. There’s lots of different things, but I don’t even know for sure if this is up high on the fibula, if it’s low on the fibula, it’s behind the fibula, if it’s on the direct outside of the fibula or the front of the fibula because you have a lot of different things that are attached to the fibula that could become injured and cause swelling.
Number one, if you have pain and swelling, this is never a good idea to run on it until you at least know what it is. I don’t even know which structure is injured here. The athlete who posted this question and comment basically is implying that he is sure that it’s the fibula, but it doesn’t sound like he’s seen a doctor, and it doesn’t sound like he’s making decisions based on reality. It’s all based on conjecture.
The first thing you need to do is figure out what’s really wrong. Then you can make decisions about what it is. Again, I don’t know if it’s a stress reaction or stress fracture. I don’t even know if it’s the fibula that’s injured. How long is it going to take to heal? I have no idea.
Number one, I don’t know what’s injured and nd number two, I don’t know how bad it’s injured. The first thing you should start doing is tracking your pain if you get injured because you’re going to lose that information later. How quickly your pain goes away is often indicative of how severe or not severe that injury might be. Should I start doing lighter cardio soon? Well, I would say, anybody want to guess? No, you shouldn’t start doing cardio because you don’t even know what’s wrong. You don’t know how bad it is. You don’t know how long it’s going to take to heal. Should I start doing the StairMaster? Again, no, you don’t know what’s wrong. You don’t know how bad it is.
You haven’t tracked anything to even see how bad it is and you don’t know how long it’s going to take to heal. And you have no idea what the consequences would be if you started running, started doing cardio, started doing the StairMaster or anything else to try to maintain your running fitness immediately that might stress that structure that’s injured.
You have to know which structure is injured. You have to know how bad it is. You have to know what is not going to stress and strain it before you start trying to maintain your running fitness.
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