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Post tib stress fracture - healed?
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Aside from getting another bone scan, what is generally the way to figure out if it is safe to start running again?
I've been off running for about 8 weeks. For the last month I've had no pain, and all I've done is bike and swim. For some reason this past week I've had some tenderness in that area, maybe about two inches directly above the medial malleolus. But I can't tell if that is soft tissue or bone pain.
Below was my bone scan report from about 5 weeks ago. I don't know if the wording in it really indicates where exactly the issue was, how high or low on the bone...
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Delayed stating imaging demonstrated focal punctuate mild accentuated activity cortically based in the posterior medial left tibia. This was not associated with any definite anatomic changes. This likely represents a healing grade 1 stress fracture.
Last edited by: SBRcanuck: Feb 18, 19 14:21
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Re: Post tib stress fracture - healed? [SBRcanuck] [ In reply to ]
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When was the last time you had pain walking around? Generally I would say if its a Grade 1 and you haven't been feeling pain during daily activities you're safe to start running again (very slowly & minimal distance) after around 8 weeks.

Although obviously people heal at different rates and I'm not a medical professional, just have experience with tibial stress fractures.
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Re: Post tib stress fracture - healed? [SBRcanuck] [ In reply to ]
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I ran on the treadmill, first for about 10 minutes (no pain), then some pain at around 15 minutes (stopped didn't want to push it). Took a few more day off tried it again, then ran on the treadmill every other day. I was not smart about my initial recovery, pushed it too soon, should have taken six weeks off at least. Your eight weeks of rest could be enough depending on how serious your injury was.
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Re: Post tib stress fracture - healed? [SBRcanuck] [ In reply to ]
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SBRcanuck wrote:
Aside from getting another bone scan, what is generally the way to figure out if it is safe to start running again?

The best way is to be formally assessed by the relevant practitioner in your area and go from there.
In terms of when is it safe to start? Different specialists will have slightly different criteria. The "hop" test is used by some. I would be careful as even though it may be "just" a stress fracture the last thing you want to do is re-injure it with too rapid return to running/loading of it as this will have you out for even longer than 8 weeks. Hence why I recommend having your return guided by someone in the know who can personally assess you.
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Re: Post tib stress fracture - healed? [TMR] [ In reply to ]
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TMR wrote:
When was the last time you had pain walking around? Generally I would say if its a Grade 1 and you haven't been feeling pain during daily activities you're safe to start running again (very slowly & minimal distance) after around 8 weeks.

Although obviously people heal at different rates and I'm not a medical professional, just have experience with tibial stress fractures.

Yes and no. At least in my experience.

I've had at least 3 cases of tibial stressies many years ago. Each time, I couldn't feel any pain just walking, I even walked the entire marathon in IM on the advice from my physio that "If it doesn't hurt, you're not doing any damage". So lack of pain while walking isn't necessarily in itself a guide that you're ready to run.

However, I do agree that 8 weeks sounds an adequate time to allow healing for a grade 1. It certainly was from my experiences. I was generally back in about 6 weeks, even in about 3 weeks on the last. By that time, my stressie-radar was finely tuned and I ceased running promptly incurring minimal damage.

Unfortunately, not all stress fractures are created equal. Depending on the location and the impact forces from running/walking, some fractures will compress with impact while others will cleave. The former generally heal quicker.

The good thing about stressies, if they have satisfactorily ossified, there will be no recurrent weakness.

Again, this advice is not a medical professional.
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