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stress fracture???


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Ok so I am beginning training for my for first marathon and I got what I thought was shin splints (I've had them before so I'm familiar with the pain and treatment) so I took a few days off, rested iced compressed and massaged and when I went back to running the pain was worse and only in one leg in one spot. It hurts to touch and aches when I'm sitting or laying down. I'm 99.9% sure its a tibial stress fracture. I know that a bone scan or MRI is a definitive diagnosis but I'm a college student and those are freakin expensive. So my question is what do I do? Just rest til the pain is gone? Is there a brace or something I should get that will speed up the process? Help!
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As long as the bone isn't displaced, there's nothing a brace/cast would do. You just need to rest it and let it heal. If you insurance or the university provides student insurance you should definitely get an X-Ray. You don't need an MRI to detect a fracture.

a stress fracture will take 3-6 weeks to heal. you shouldn't do anything other than light walking on it for that time. i have one too, and it sucks to have to take time off from activities :(

 

 

Check if you're covered for a bone scan under your college's medical plan.  

With a tibial stress fracture, you would not be able to jump up and down on one foot (barefoot) ten times, because the pain would be too great.  Not so for shin splints.

When you're ready to run again, consider running in minimalist footwear (Vibrams, etc).  They reduce the chance of shin splints because: 1) people tend to land softer in them, 2) you'll probably shorten your stride in them (shorter strides reduce impact forces), and 3) they have a lower heel (the shin works harder to decelerate the foot in shoes with a raised heel, especially if you overpronate).  Make sure to transition very slowly to minimalist footwear. 

Is the pain on the inside or outer half of your shin?

I run in Vibrams, and I think they're great.  However, you will get shin splints in whatever shoes you wear if you don't run with good form.  Vibrams/barefoot form is different than running shoe form.  Also, shin splints take about two weeks to heal from, assuming you follow r.i.c.e.

Original Post by cherimoose:

Check if you're covered for a bone scan under your college's medical plan.  

With a tibial stress fracture, you would not be able to jump up and down on one foot (barefoot) ten times, because the pain would be too great.  Not so for shin splints.

When you're ready to run again, consider running in minimalist footwear (Vibrams, etc).  They reduce the chance of shin splints because: 1) people tend to land softer in them, 2) you'll probably shorten your stride in them (shorter strides reduce impact forces), and 3) they have a lower heel (the shin works harder to decelerate the foot in shoes with a raised heel, especially if you overpronate).  Make sure to transition very slowly to minimalist footwear. 

Is the pain on the inside or outer half of your shin?

Have you run a marathon in minimalist footwear? What was your time? Did you also train in the minimalist footwear (how many miles a week)?

A lot of people that use racing flats or other very light shoes in races, actually train in more protective shoes. A lot of very low mileage "runners" who can get away with training in minimalist footwear, seem to be trying to talk high mileage people into believing the "hype." The fad is already fading. The podiatrists are getting lots of business, and are warning the public about achilles tendonitis and forefoot stress injuries. The original impact force research has mostly been discounted, and is now being studied with a more rigorous approach. Achilles tendonitis is worse than shin splints, by far, but either one can end your running if not resolved.

As for your three points. 1) and 2) would be accomplished just as well or better, by putting a small stone under the heel portion of the insole of a regular running shoe. I am not suggesting this, but am pointing out that a training method that helps a person improve their form isn't necessarily somthing to do all the time. Actually, you can learn to land lighter, and shorten your stride, while wearing just about any kind of shoe. Different people end up being at their most efficient (best running economy), and most injury resistant, with different kinds of shoes, so it is worth some experimentation along those lines. It is like trying out different types of skis (there is no "best" kind of ski for everyone). Some specialty skis you might want to just use part of the time, but not as your "main" pair.

 

oldguysrule couldn't have said it better!!!  Definitely get your shoes checked (once you're able to run again), your gait analyzed and see if you need to make alterations to either one.  I personally could never run in vibrams/minimalist shoes because I know I overpronate, and if I don't have some kind of corrective shoe for it, I get injured.  Also for the long-distance marathon training, you'd definitely need something much more supportive unless you've trained in vibrams for a lengthy period of time and were able to "break into them".  I used to work at a running shoe store too (I know I'm such a running geek!), and would see the effects of the wrong shoe for the wrong person (i.e. stress fractures, etc.).  I'm no expert, so if you can talk to a doctor, that would be the best bet!

Original Post by oldguysrule:

The fad is already fading. The podiatrists are getting lots of business, and are warning the public about achilles tendonitis and forefoot stress injuries. 

Most injuries with minimal footwear are caused by not transitioning properly.  With proper transitioning, the injury rate is no greater than with those who wear regular running shoes (about 20-26% for new runners, depending on which study you look at).  The OP has had a history of shin problems, and since that is often worsened by the raised heel of conventional running shoes, it's worth trying shoes with a lower heel to see if they help.  It's what people always ran in until the fad of thick-heeled running shoes started in the 1970s.

I'm scared I have stress fracture too, but in my sacrum. I went to the doctor today and he didn't ask me a single thing - not how or when i did it, not anything about then pain or my medical history. He gave me pain medication and sent me on my way. As mad as I am about the non-help I recieved, from everything I have read you need to just really really take it easy. I'm a runner too, and I know how hard taking time out is but I heard that if you don't take it easy, you can end up with really severe fractures that may never heal quite right. Hope it all works out :)

Still can't get over that stupid doctor... was I wrong to worry considering my history? Female, Vegetarian, no period for > 3 years with history of severe anorexia, still underweight and experiencing bad bone pain? I feel like had I spent more than 30 seconds in his office and had told him, I may have been paid a BIT more attention....

^ Haha sorry, rant over.

i think it's worth at least trying for some kind of diagnosis... some issues with similar symptoms favour early, gentle movement, and others a longer rest.

armandouc, in this singular instance, is incorrect - a stress fracture takes a couple of weeks to show up on an x ray (once healing activity begins). and, if you continue to stress a little crack like that, you may not allow it to heal enough to make itself known. however, in my experience, they'd start you with a (possibly inappropriate) x ray to rule out a big break, before moving up to a bone scan or mri.

but if you've got pinpoint pain, it might not be as hard to work out as you'd think.

take note of your symptoms and additional stressors as they evolve*.

also, i'd wait a long while before trying to run on that, vibrams or no.

*you can introduce compensatory imbalances by limping around or walking funny.

Original Post by h_m_h:

I'm scared I have stress fracture too, but in my sacrum. I went to the doctor today and he didn't ask me a single thing - not how or when i did it, not anything about then pain or my medical history. He gave me pain medication and sent me on my way. 

Still can't get over that stupid doctor... was I wrong to worry considering my history? Female, Vegetarian, no period for > 3 years with history of severe anorexia, still underweight and experiencing bad bone pain? 

Considering that you obvious symptoms of the Female Athlete Triad, he needs to be informed of his irresponsible behavior, either directly, or, if you're unable to do that, to your local medical board.  You have serious symptoms that need to be checked out more thoroughly.  Try to see another doctor if he won't listen to you.  Good luck.

 

Original Post by cherimoose:

Original Post by oldguysrule:

The fad is already fading. The podiatrists are getting lots of business, and are warning the public about achilles tendonitis and forefoot stress injuries. 

Most injuries with minimal footwear are caused by not transitioning properly.  With proper transitioning, the injury rate is no greater than with those who wear regular running shoes (about 20-26% for new runners, depending on which study you look at).  The OP has had a history of shin problems, and since that is often worsened by the raised heel of conventional running shoes, it's worth trying shoes with a lower heel to see if they help.  It's what people always ran in until the fad of thick-heeled running shoes started in the 1970s.

That article suggests weeks to a couple of months for the transition. That might work for a young person that grew up spending most of their time barefoot ( a rare entity these days). It takes a lot longer than a few months to actually build up your foot bones. But, again it depends on what distances you are talking about. I spent most of the first 10 years of my life barefoot (one block from the beach in Florida). As an adult, it took me many years to work my way from seriously cushioned trail shoes down to almost minimal ones (Keen). Taking 5 degrees off the heel to toe rise takes an equivalent amount off the maximum steepness that you can climb comfortably. That specific thing alone can take about a year to adjust to (assuming that you do some steep hill work).

A higher heeled shoe works your anterior tibialis muscle more, and a sore AT is often misdiagnosed as "shin splints." True shin splints (4 different kinds of bone strain are classed as shin splints) or bone stress fractures, are due more to impact, or strain on calf muscles. People can get shin splints from jumping rope, or high impact aerobics, where you are mostly on your toes. Really fast walking (with a heel to toe roll) gets your AT very sore, but almost never causes real shin splints (because impact forces are very low, and calf stress is low).

Original Post by armandounc:

As long as the bone isn't displaced, there's nothing a brace/cast would do. You just need to rest it and let it heal. If you insurance or the university provides student insurance you should definitely get an X-Ray. You don't need an MRI to detect a fracture.

......wrong (About the boot AND the MRI)....... I went to a pediatrist today and he gave me a brace to wear for a stress fracture. It's a soft black cast-like a boot. Does it hurt when you walk? You'll need to rest for 2-4 weeks if it's stress reaction, 8 weeks if it's a stress fracture. do you have insurance? If you go to a pediatrist & they say you probably have a stress fracture then they'll submit it to insurance and they'll most likely cover it. but you need a pediatrist first. He'll try an x-ray first and it might detect it there first, but it's likely you'll need an MRI. He says x-rays only detect it 20% of the time. You'll NEED the MRI almost always. If the pain goes into one spot and it's severely painful it's at the least a stress reacation and at the most stress fracture. You need a brace, a pediatrist, and an MRI, along with rest.

Hope I helped! Stress fractures are dangerous, get help soon!

Original Post by h_m_h:

I'm scared I have stress fracture too, but in my sacrum. I went to the doctor today and he didn't ask me a single thing - not how or when i did it, not anything about then pain or my medical history. He gave me pain medication and sent me on my way. As mad as I am about the non-help I recieved, from everything I have read you need to just really really take it easy. I'm a runner too, and I know how hard taking time out is but I heard that if you don't take it easy, you can end up with really severe fractures that may never heal quite right. Hope it all works out :)

Still can't get over that stupid doctor... was I wrong to worry considering my history? Female, Vegetarian, no period for > 3 years with history of severe anorexia, still underweight and experiencing bad bone pain? I feel like had I spent more than 30 seconds in his office and had told him, I may have been paid a BIT more attention....

^ Haha sorry, rant over.

go to a pediatrist. Physicians to squat for leg pain. they deal with colds and stuff.

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