Shin Splint to Tibial Stress Fracture - What Good Would a Dr. Do? (Read 1221 times)

I'm reasonably concerned I've got a tibial stress fracture.... I've had shin pain for some time and did all of the classic wrong things: ramped up mileage and intensity too fast. Now, I've got fairly localized (size of a quarter) pain on my shin. Pain can be noticed when walking but isn't "bad." Isn't bad enough that I couldn't "run through it," either, though I suspect that'd be unwise, too. My last run was last Wed. Rested until last night when I got on the bike, which didn't aggravate it at all. Five days later, pain is reduced a lot, though I can still feel it a little when I walk or rub it, and it's still rather sore when I try to bounce on it. Here's the question: Treatment for shin splints: RICE, return to exercise slowly when pain is gone. Treatment for tibial stress fractures. Appears to be about the same. Perhaps a bit more emphasis on making sure pain is really gone, gone. Being a Type-1 diabetic, I tend to keep a close watch on my own self medically, and tend to avoid tests, scans and physicians who are unlikely to tell me things I don't already know or would prescribe treatments I haven't already read about or considered. Am I missing something? What could a doc tell me or prescribe differently than I'm suggesting... or, more important, what would they be likely to suggest differently than what I'm suggesting?

Treatment for stress fractures varies depending on the severity (RICE, or a boot, or surgery and everything in between). A doctor would be able to tell you the severity of the injury (based on an X-ray or MRI for example) and prescribe a more specific treatment. PT might also be an option and you'll likely need a referral from a PCP to get that. All that being said...If the pain is going away on its own already, it doesn't sound too severe. RICE, with emphasis on the R, might be sufficient. I'm not a medical doctor; however, nor do I even pretend to be one on internet message boards.

As promised, here is what my appointment entailed: Moved my foot and leg around, no pain. Put pressure on various areas. Nothing was painful, but could notice discomfort on tibia on the inside, in the lower third. Asked if I had pain when at rest. I reported that it sometimes aches a bit. Doc decided symptoms could go either way, leaning towards SF because of the aching. Did an x-ray in house. X-ray showed nothing - inconclusive. Scheduled a bone scan at local hospital. Won't have test or results for about a week. Until results are in, suggested no load bearing exercise on leg, provided crutches. This sucks. So, assuming that I have a good doctor, that is what a good doctor would do.

Nate, sounds like you have a good doctor.

My sports med doctor thought I had stress fractures in both legs, but the MRI was clear. My pain was originally in the lower part of the tibia, but now fluctuates up and down into the ankle area. I'm in my 4th week of PT and have ordered custom orthotics. PT includes ultrasound, massage, lots of stretching, and lots of balance exercises (including wobble boards and standing on one leg while rocking forward and back and from side to side). I've been told to be consistent taking the anti-inflammatories (something that is hard for me to do, since I hate drugs of any kind) and icing. After a few weeks of no activity, I can finally ride my bike trainer, run in the pool (in moderation), and use the elliptical. No treadmill until the orthotics are in. BTW - this all started when I bought a new pair of orthotics at the running store and ran just 3.5 miles in them. I've since been told you never run in orthotics until you've walked in them for awhile to break them in.

I wasn't trying to scare anyone - just posting my experience, as the original poster wanted to know what a doc would do. The good news is that the sports med doctor did not tell me I couldn't keep running once this is under control. I was told that stress fractures frequently do not show up on x-rays, so that was why I was sent for the MRI.

Just found out that my custom orthotics shipped today, so I should be able to get them at my next PT session on Wednesday. They said they would start me out just walking with them for an hour at a time. This is week 5 of PT and no running. I go back to the doc on Thursday and am starting to write out my list of questions. How is everyone else doing?

Just thought I would update. I've had the orthotics for 2 weeks and am getting used to them. For the first time in my life, my shoes are comfortable and my toes point forward when I walk. I am cleared to WALK on the treadmill at a slow pace, but no running until the pain is gone. Biking continues to be OK, so I've logged about 200 miles on the indoor trainer to keep my sanity. Water aerobics is still bad since it is too much jumping. Most of my pain now comes from going up and down stairs and on days when I have been on my feet too long. I'm in PT for another 4 weeks (extended from the original 6) and it is definitely helping. In addition, I bought my own wobble board and foam roller. I use the wobble board at least 10 times a day (I keep it at the end of the kitchen counter so I see it all the time) and have made big improvements in my ability to stay on it. My DAILY routine now includes toe raises, heel raises, balance exercises, elastic band work, bridges with the balance ball, stretching, wobble board, and foam roller. It takes time, but I am determined to run again! I now wear shoes almost all day long since I have orthotics for running shoes and dress shoes. I never did wear high heels, but for now, I am committed to wear only flats since even a slight heel (1") aggravates my lower leg. I went to the Nordstrom website (since they are known for shoes) and did a search for "removable insole" and made a list of available shoes that I liked. Then I went shopping. I found a pair of Privos that are extremely comfortable and well made. In fact, the removable insole from them is very cushioned and just as thick as my custom one. I absolutely love these shoes and bought a second pair in a different color. In addition, I found the Clark's un-pump to be a very good choice. BTW, I lined up the heel of my custom orthotics with the ones I bought at the running store and then measured the distance between the center of the arch - it was a full 1 inch difference! No wonder I never liked shoes! So how is everyone else doing?