At my yearly checkup I mentioned a small bump on my leg. My GP said let’s grab an Xray and the result was:
Right Tib & Fib: Early horizontal stress fracture of the anterior cortex of the mid tib diaphysis with associated healing response. No complete fracture visualized.
I have known about this bump for several years and figured it was just something I had from skateboarding & BMX (pedals hitting me) years ago. I am 40 and 2010 was a year of many run PR’s & high run mileage with no issues. Also have done a ton of races over the past 5 years (4 IM’s, qualified for Boston, etc.) with no shin issues. It was a surprise hearing about it. The “pain” is about a 1 out of 10 and I don’t really notice it is there until I run long(12+) or hard and then it is only about a 2 of 10.
My Questions:
How long did you lay off running? I was told 6-8 weeks. Is Aqua running really worth doing?
Did you change anything afterwards to prevent getting another fracture (i.e. shoes, running gait, etc.)?
While healing, what other sports did you do? Which other sports won’t hurt the healing process? Wondering if my biking should be kept to a Computrainer with no climbing & no group rides. Not sure if Masters is a good idea with fast/hard flip turns.
I have had two DR’s opinions:
DR #1 – my GP, took the Xray and is VERY conservative. He doesn’t think running is healthy and doesn’t advocated doing any running even when you are healthy told me take 6 months off from running and recheck
DR#2 – my sports DR / chiro who mostly see athletes and and does tri’s/marathon as well said either (1) rest 4 weeks and Xray again or (2) keep training as you have been and we will Xray in 4 weeks. He thinks 6-8 weeks off is the max I would need if necessary.
Thanks in advance for any advice! I have checked some of the older posts as well. Just trying to get more opinions……
DR #1 – my GP, took the Xray and is VERY conservative. He doesn’t think running is healthy and doesn’t advocated doing any running even when you are healthy told me take 6 months off from running and recheck
I have opinions but will instead allow those who are qualified to address your issue respond to this post. The only thing I will say is that this GP response doesn’t surprise me. It would be interesting to know what this knucklehead does for fun or recreation - sits home and plays D&D on the weekend? Eats Cheetos, plays video games and masturbates? I just can’t get over the whole anti-running and dealing with patients in absolutes like so many physicians do. Maddening.
My GP is about 80 and seems very healthy & spry. He is a huge advocate of reasonable amounts of daily exercise - just not running and any exericise done for hours on end. Knowing him for about 10 years, he for sure takes a minimal approach on eating, alcohol, and giving out prescriptions.
The older I get, the more I agree with his approach…but I still want to run! And run often and far…
This sounds odd to me if you have had this bump for 4 years with only minimal pain.
I would get either a bone scan or an MRI to look at this area closer. The bone scan will tell you if there is active bone turnover indicative of an acute stress fracture. MRI will also give you good detail and help clarify if this really is a stress fracture.
If this is a stress fracture, 6 weeks of pain free activity should be long enough for complete healing. Sometimes people will need crutches for the first 2 weeks if walking is painful but usually after that you can walk without crutches if you have no pain.
I allow biking and swimming as long as you are pain free. Water running is boring but will allow you to maintain some semblance of running fitness. I will let people use the elliptical trainer at 2-4 weeks if they remain pain free. (get the general idea? you need to remain pain free).
Running gait analysis after you are healed is not a bad idea to look for major mechanical issues.
And by the way, can I suggest getting a new PCP? This coming from a Family/Sports Med doc.
Best of luck.
You don’t likely have a stress fracture. It is common to have an area of ossification there (your “bump”) with repetitive physical trauma and the radiologist is likely just dictating what he is seeing (but really shouldn’t actually give out a diagnosis like that), esp with an older family doc ordering the films since he now has to absolutely go by that reading.
As was mentioned, a triphasic bone scan can shed some helpful info to know if this is an “active” process since the treatment of no running doesn’t sit well with many athletes (and would be inappropriate if not a stress fracture of course).
But yes, 6-8 weeks off of axial loading things like running is usually long enough to heal a tibial stress fracture, although some focal tenderness is often noted for quite a while after (up to 3-4 months).
It took me 10 weeks before I ran after a femoral stress fracture. As stated, I had some pain in the area for months afterward, but not acute like when the injury presented itself. I’m not a doctor, but your experience is nothing like mine, or those I know about, and I’d be skeptical of that diagnoses.