Fibula Stress Fracture (2)

Hi folks!

After a couple of months feeling pain on the inside of my shin, I consulted a doctor who immediately asked for an MRI. There was bone edema on my tibia, so the main concern was a stress fracture on the tibia, exactly where the pain was

The MRI was done three weeks after consulting the doctor, and it took another one to get the results. During this time, I did not run at all, but I’ve been swimming quite a bit, biking 7-10 hrs/week mainly easy spinning and also doing aqua jogging. No pain, no discomfort during this time. Actually my legs are feeling great.

The MRI showed a stress fracture on the fibula, close to the ankle joint. I’ve never felt pain or any discomfort in this location.

Anyway, I’ll take another five weeks of no running, and then, another MRI to see if it’s improving.

I’m not seeking medical advice here; I will be following the doctor’s guidance to the heart, but it would be nice to read other stories of stress fractures on the fibula, how the recovery process was, the return to running, and if you regret doing (or not doing) something. It’s not a common injury (according to the internet and the doctor), so some reports would be nice.

Thanks!

Hi labtri,
I had one of these in 2019. It was painful and i had to get an MRI to find out what it was. I remember one day catching the bus home from work pre-diagnosis and walking back home from the bus stop was very painful. The next day I went to the doctor. I was in the boot of shame for a few weeks and got around with a knee cycle. During this time I still swam with a pull buoy but stopped cycling for a couple of weeks. I started seated indoor cycling after a while and was probably off running for about 3 months in total.
I put my fracture down to lots of treadmill running. This may or may not be true but I reckon treadmill running can alter your stride a bit.
Be patient and you will recover fully.

Thanks for your feedback Keithh.

I was also running a lot on the treadmill (like 5 hours a week) My running improved a lot during this season.

Did you feel pain while cycling when you got your diagnosis? I feel absolutely nothing. Yesterday I did a crazy hard Vo2 workout on the trainer and there’s no sign of pain (the doctor advised to do not do low gear work, everything else I’m “allowed”)… It was the first one in about a month.

Hi labtri,
I felt no pain on the windtrainer. Same as you I did no low cadence work on the trainer and I just worked my way up from 15 mins to 90mins. Then I went back out on the road.

I’ve been there. Sort of a diffuse pain for a couple of weeks, just kept going. Mine was almost certainly ramping up the mileage too quickly. Was racing in Louisville KY and it started to hurt sharply during the run. Left leg. By the time I was close to home (3 hr drive), I almost could not push the clutch in for the pain - thought I might need to try my ‘shift without the clutch’ skillz. Went to my sports med doc the next day - xray showed the stress fracture pretty clearly. I was told - no running for 12 weeks, wear the boot for a few weeks, ok to swim and bike as long as there is no pain. I was mostly in the pool and, later, on the indoor trainer. Yup, about 12 weeks… Even walking was painful for what seemed like a long time - maybe 10 weeks - and it did not seem to feel any better/different. But when it felt better, there was no gradual reduction - one morning it didn’t hurt to walk around and it felt perfect every day after that - like a light switch turned the pain off. Weird.

That’s quite uncommon, since the fibula is not a weightbearing bone. Almost all of the load is placed on the tibia, not the fibula.

I would definitely check the following things, just to make sure you know why the fibula broke, as it’s very uncommon to do so.

How is your running economy? Too much pronation, too much landing in supination?
How is your food intake and bone density in general? This is a quite common problem in lean endurance athletes
Are the muscles around the fibula causing any problems? You could get these assessed and/or treated by a PT. Dry Needling does wonders for the deep muscles that attach to the fibula.

You should spend your time off running to get to the root cause of the cause of this injury. Good luck!

I’ve had a bunch of sfx, but my very first one was L fibula in 2005. It healed just fine with 6 or 8 weeks of not running (I can’t recall exact time as it was almost two decades ago). I wish you the best; keep us updated.

Deep Water Running
If can access a gym you can also use an elliptical trainer which is non impact.

Hit the weights strength train and build some capacity especially in tendon areas as these are the places that lose capacity the most.

Seated and standing calf
Prone hamstring curls or supine using a skateboard
Wall Sits/Isometric Spanish squats for patella tendon.

These actually should be staples of any running/triathlete in training

Hi labtri,
I felt no pain on the windtrainer. Same as you I did no low cadence work on the trainer and I just worked my way up from 15 mins to 90mins. Then I went back out on the road.

That’s nice, I’ve been cycling 2+hours a session, since week two with no pain… I actually could cycle on the very first week with no problem but kept it as conservative as I could.

I’ve been there. Sort of a diffuse pain for a couple of weeks, just kept going. Mine was almost certainly ramping up the mileage too quickly. Was racing in Louisville KY and it started to hurt sharply during the run. Left leg. By the time I was close to home (3 hr drive), I almost could not push the clutch in for the pain - thought I might need to try my ‘shift without the clutch’ skillz. Went to my sports med doc the next day - xray showed the stress fracture pretty clearly. I was told - no running for 12 weeks, wear the boot for a few weeks, ok to swim and bike as long as there is no pain. I was mostly in the pool and, later, on the indoor trainer. Yup, about 12 weeks… Even walking was painful for what seemed like a long time - maybe 10 weeks - and it did not seem to feel any better/different. But when it felt better, there was no gradual reduction - one morning it didn’t hurt to walk around and it felt perfect every day after that - like a light switch turned the pain off. Weird.

Such a mysterious injury. My symptoms are a bit different than yours. Could tell where you had pain? outer shin, closer to the knee or anckle?
Thanks!

That’s quite uncommon, since the fibula is not a weightbearing bone. Almost all of the load is placed on the tibia, not the fibula.

I would definitely check the following things, just to make sure you know why the fibula broke, as it’s very uncommon to do so.

How is your running economy? Too much pronation, too much landing in supination?
How is your food intake and bone density in general? This is a quite common problem in lean endurance athletes
Are the muscles around the fibula causing any problems? You could get these assessed and/or treated by a PT. Dry Needling does wonders for the deep muscles that attach to the fibula.

You should spend your time off running to get to the root cause of the cause of this injury. Good luck!

Very good considerations indeed.
How do supination would affect this consideration? What could be done do minimize landing in supination?
I do supinate a bit, although my shoes does not usually wear on lateral side.

Massage and stretch those muscles that you mentioned was also suggested by the doctor. They feel tight. I read somewhere that in some cases, they can brake the fibula, not the impact itself.

I’ve had a bunch of sfx, but my very first one was L fibula in 2005. It healed just fine with 6 or 8 weeks of not running (I can’t recall exact time as it was almost two decades ago). I wish you the best; keep us updated.
Very happy to hear that you had a completely recover in a relative short period of time. thank you very much for your support Dr.Tigerchik.

Deep Water Running
If can access a gym you can also use an elliptical trainer which is non impact.

Hit the weights strength train and build some capacity especially in tendon areas as these are the places that lose capacity the most.

Seated and standing calf
Prone hamstring curls or supine using a skateboard
Wall Sits/Isometric Spanish squats for patella tendon.

These actually should be staples of any running/triathlete in training

Thank you for your considerations garwood.
Deep water running is a new activity for me and I’m actually enjoying it. It feels like it’s helping with cycling as well, IDK, hard to say…

Thank you all for your support and feedbacks

Hi folks!

After a couple of months feeling pain on the inside of my shin, I consulted a doctor who immediately asked for an MRI. There was bone edema on my tibia, so the main concern was a stress fracture on the tibia, exactly where the pain was

How did this turn out? Unfortunately, I have a slight pain in my left shin and am headed to my sports medicine doc today. It feels exactly like my previous stress fracture and in about the same spot. I’m already in the boot, fearing the worst - and my A race in Australia is 7 weeks away. Ugh.

Hi there!

Well, the second MRI showed that the bone edema on the tibia had reduced significantly, although it did not go away completely.
The stress fracture on the fibula, however, did not improve much!

Since I had no pain in the fibula, and the pain in the tibia ceased, I resumed running gradually with no problems whatsoever.

Sometimes the inner side of my shin (tibia bone) feels a bit sensitive to the touch (as it has always felt, to be honest), but it does not hurt to run.
The place of the fracture (fibula bone) is fine too.

I did not regret at all to acqua jog during this period of time… It helped to preserve at least some running fitness and its quite good for the mental aspect IMO.

I hope you manage to race your event!!

Not a doctor and didn’t stay in a Holiday Inn Express last night.

I’m dealing with a nasty broken fibula from a low sppe bike crash in gravel 10 days ago, so my case is a little different. Currently in an ace and a splint. I’ve been told to put no weight on my left foot at all and if I do that, I likely won’t need surgery.

I can’t help but wonder if stress fractures take longer to heal than expected (past experience, first and second hand) because we don’t feel as much pain and increase the load too quickly. In addition to not running, you may wish to consider keeping as much weight of your ankle as possible. Can you use a knee scooter? I can’t because the a large divot of flesh missing right below the kneecap.

The worst part - I can’t travel the 5 hours to my 50th high school reunion, so life’s pretty damn good.

Best wishes for a speedy recovery.

Ouch - that injury sounds gnarly. But I suspect that you are right. The last time I did this (my 1st), I had no idea what the initial pain was and just kept running. Until my fibula broke. Smarter (a little) this time, it felt ‘funny’, I took a week off running and then did a 2 mile ‘test’ run. For sure sore after that and went to the sports med doc. X-ray generally reveals nothing this early (true here), so I was told that I could do anything that did not cause pain. But, as you suggest, I’m also trying to reduce normal activities like walking. I have a boot - not sure how helpful that is. Might look into the knee scooter!

Just saw this was old… going to reply to the update
.

I’m sorry :frowning: keep us updated, ok?

Will do! Will get an MRI next Friday. Tried to restart my old Exogen bone stimulator, but it has timed out. Race is 7 weeks from yesterday. Will be comparing the pool schedule with my calendar over the weekend and blowing the dust off the water running tools…

So, hopefully this post will help someone in the future. I’m not advocating the ultrasound bone stimulator (maybe there are multiple products in this category, but I have used an Exogen previously) but my experience is that the cost is very high with medical insurance and tricky to qualify for (about $5000 and only, typically, for non-union after 12 weeks - of course I am sure that there are many more situations that could be approvable). I had one of these a year ago - it works for a while and, despite the electronics being very robust and capable of practically unlimited use, software makes the device unusable after one round of treatment. This corporate ripoff, outside of the current post, is a disgrace. So, I have another stress fracture and can’t wait 12 weeks for insurance (World champs in 7 weeks). So, here is the PSA…you can rent these without an Rx for $200/month and unlimited uses during that time. If anyone is interested, PM me and I’ll provide details. I ordered mine, came by 2-day air. It’s on my leg now. Will it save my race? No idea. But I have so much invested in this - hours of training, many $ in prep, the travel alone is many $1000s. If the Exogen digs me out of the hole, it’s worth every penny. And if not - heck, probably negligible compared to all of the other sunk costs. Bottom line - need a Exogen to (maybe) speed fracture healing and not willing/able to deal with insurance? No problem. FWIW, I was water running today (ugh) and will do that, mostly, for the next 6 weeks, then test the leg. Getting old stinks.