Stress Reaction? (Read 2706 times)

wildchild


Carolyn

    Greg,

    It seems odd that it would hurt more after a week off. I'm not sure why that would be.

     

    I was diagnosed with a stress reaction in my left tibia in January.  I had an MRI, and the doc said he didn't see a fracture line but the bone looked different in the area where it hurt.  Like a different density or something. He said to take 6 weeks off from running, but I could walk if it didn't hurt.  I found that walking and biking didn't hurt but elliptical did. 

     

    But here was my mistake:  he said take 6 weeks off, and I had already taken 4 weeks off before I went to the doc, so I figured that meant 2 more weeks.  After only 1 week my leg felt much better, so I started easy runs and run/walks every other day.  I did that for 6 weeks - my leg always felt fine when I started and ached at the end. I really couldn't run two days in a row.  It wasn't getting worse, but it wasn't getting better, so I took another 3 weeks off.  Then I did the every-other-day thing for 2-3 more weeks till the pain was really gone. 

     

    In my first come-back attempt, if my leg started to ache, I would cut the run short, but I would RUN back to the car. In my second (successful) come-back attempt, if my leg started to ache, I would WALK back to the car.   I recommend the latter.  Sounds obvious, but we all know that runners run.

     

    I also agree with SloHand that an MRI is probably a waste of money.  I had already concluded that I had a stress fracture or stress reaction before I went to the doc.  He didn't tell me anything new.

    I hammered down the trail, passing rocks and trees like they were standing still.


      ...but I could walk if it didn't hurt.  I found that walking and biking didn't hurt but elliptical did. 


      Same here...I walked on the TM almost daily for 3 weeks...but the elliptical killed...I am glad to see it hurt someone else too...everyone told me it was the best low impact cross training during my time off-not for me!

       

      When I started back I just did 3-4 miles at a time for several runs-at recovery pace (for me, I think the pace was more important than the distance in terms of not re-injuring)...then just increased weekly mileage 3-5 miles a week until I was back up between 35-40.  I still iced daily for about 2 months after returning to running, and did/still do all PT daily.


      The shirtless wonder

        My name is Greg Rowe and I haven't run in almost 2 weeks.

         

        Today I saw a sports doctor, Dr. Swenson.  I spent the last two weeks waffling between thinking I had a tibial stress fracture to thinking that it was something else.  The Dr. said my symptoms are classic stress fracture symptoms but when he had me to a hop test (hop on the affected heal on a hard floor with no shoes) I felt no pain.  That is not typical of a stress fracture.  My injury therefore may have been caught early enough that I didn't do severe damage.  The Dr. still suspects that it is a bone issue just mild.

         

        But here's the good news that I have to share and I want everyone to share with every runner they know.   I can run on it almost immediately.  Everything you'll read on the internet says 6-8 weeks of no running followed by a gradual build up to return to full training.  So how is this possible?  With the use of a little brace called an air cast. 

         

        The air cast shifts some of the load from your bone to your muscle.  You wear it for all waking hours.  Once you are pain free, which typically takes 1 week in an air cast, you start your "return to running" buildup.  In my case, if I even need the air cast at all, I can start my build up immediately. 

         

        Dr. Swenson was part of a study in 1997 evaluating the use of air casts in tibial stress fracture recovery.  The results of the study were that the study group (the air cast group) returned to unrestricted training after 21 days (on average).  The control group (traditional approach) took 77 days on average.  See the abstract below.

         

        Let me tell you that 3-5 weeks of limited training sounds a hell of a lot better to me!  My fall marathon plans aren't completely trashed!

         

         

        1. Am J Sports Med. 1997 May-Jun;25(3):322-8.

        The effect of a pneumatic leg brace on return to play in athletes with tibial stress fractures.

        Swenson EJ Jr, DeHaven KE, Sebastianelli WJ, Hanks G, Kalenak A, Lynch JM.

        Department of Orthopaedics, University of Rochester, New York, USA.

        Abstract

        A total of 18 competitive and recreational athletes were enrolled in a randomized, prospective study looking at the effect of pneumatic leg braces on the time to return to full activity after a tibial stress fracture. All patients had positive bone scans and 15 had positive radiographic findings by Week 12. There were two treatment groups. The traditional treatment group was treated with rest and, after 3 pain-free days, a gradual return to activity. The pneumatic leg brace (Aircast) group had the brace applied to the affected leg and then followed the same return to activity guidelines. The guidelines consisted of a detailed functional progression that allowed pain-free return to play. The brace group was able to resume light activity in 7 days (median) and the traditional group began light activity in 21 days (median). The brace group returned to full, unrestricted activity in 21 +/- 2 days, and the traditional group required 77 +/- 7 days to resume full activity. The Aircast pneumatic brace is effective in allowing athletes with tibial stress fractures to return to full, unrestricted, pain-free activity significantly sooner than traditional treatment.

        PMID: 9167811 [PubMed - indexed for MEDLINE]

        Publication Types:

        • Clinical Trial
        • Randomized Controlled Trial
        • Research Support, Non-U.S. Gov't

        MeSH Terms:

        • Adolescent
        • Adult
        • Athletic Injuries/therapy*
        • Braces*
        • Female
        • Fracture Fixation/methods*
        • Fractures, Stress/therapy*
        • Humans
        • Locomotion
        • Male
        • Middle Aged
        • Orthopedic Fixation Devices*
        • Pain
        • Prospective Studies
        • Tibial Fractures/therapy*
        • Treatment Outcome

         

          I wore an air cast on my left leg last summer for about a month. Wore it everywhere. It didn't immediately allow me to return to running, but I suspect it sped up the healing process a bit. I still had to take a good bit of time off though...
            Air cast or not Greg, be cautious in your comeback. I had a tibial stress reaction that cost me 12 weeks. MRI showed elevated bone metabolism right where it hurt. I'm one of those lucky people that goes to an ortho that is a marathoner. He said no running until it was pain free. Take it slow and good luck with it. And Dixie cup ice massages still rule.

             


            I look my best blurry!

              Good luck!  I hope it works out.  Let us know how it's going!


              The shirtless wonder

                I just returned from a run. The doctor wanted me to run to test it. If I failed the hop test after the run I was told to put the air cast/brace on. I made it one whole mile before the pain was too great to bear. The hop test doesn't send me through the roof with pain but I can barely walk and the hot spot aches like crazy. So, I am icing and in a few minutes the air cast goes on. It sucks but at least I have a path for recovery.


                I look my best blurry!

                  Just wondering why you even needed a hop test if it was already too painful at one mile?  You had already failed the run test.   You are worrying me.   Honestly, your situation SUCKS!  I wanted to lie to myself and everyone around me to keep running but I wasn't going to heal my hip.  I'm not saying you are lying to anyone, but listen to your body.  It is telling you what you need to know.  Get that damn stress reaction healed!  Air cast or whatever.  I'm being passionately concerned because I don't want to read your report about your full blown stress fracture or worse.   You don't want to have to take 6 weeks off - no elliptical, no bike, no walking.  That's what I had to do.   XOXO


                  Prince of Fatness

                    I made it one whole mile before the pain was too great to bear. The hop test doesn't send me through the roof with pain but I can barely walk and the hot spot aches like crazy.

                     

                    Dude, one mile, pain too great to bear?  The pain should be your guide.  Shutting it down sucks but think big picture.  Consider it.

                     

                    I'm dealing with an injury right now so I know the feeling.  It's not easy to back off the training.  Change your focus.  Change it from "I must train now" to "I must focus on recovering as quickly as possible so I can get back to training",  It's the only way.

                    Not at it at all. 

                    Teresadfp


                    One day at a time

                      My son was diagnosed with a stress reaction in December.  He has gone for physical therapy, deep tissue massage (his leg muscles were all tight as a drum), and extra training.  He has done everything EXACTLY as told.  He's missed all of his senior outdoor track season so far.  He's going to try the 800 tomorrow to see if he can qualify for the state meet.  It has been incredibly frustrating for him, but I've been proud of him for having the wisdom to listen to adults and think of the big picture - he has a lot of years of running ahead of him.

                       


                      The shirtless wonder

                        My focus is definitely on recovery.  Why else would I take nearly two weeks off?  That is not at ALL like me.

                        I ran today only because the Dr told me to.  I very obviously failed the test (and I expected that).  I'm rather surprised at how much it hurt during the run and how much it hurts right now.  I have no doubt at this point that I have a stress fracture.  I had hoped when it started to hurt that the pain would go away after loosening up a little but that was not the case. 

                        I'm optimistic about the time frame for returning to running based on this Dr's research.  While I'm optimistic I doubt I can return in 3 weeks even if those in his study group were able to do so. 

                        Once I'm able to run unrestricted I will reevaluate my goals.  For now my goal is simply to run like a normal human being.

                        Time will tell.  I'll update this thread with my progress.

                        Greg


                        The shirtless wonder

                          about your full blown stress fracture or worse.   You don't want to have to take 6 weeks off - no elliptical, no bike, no walking.  That's what I had to do.   XOXO

                           

                          The point I wanted to make is that a tibial stress fracture shouldn't need 6 weeks off.  Based on this Dr's research the return to training should be signifntly quicker.  The air cast/brace group returned in 21 days.  The traditional rest group took an average of 77 days.  Those are some pretty impressive numbers.  If this wasn't affiliated with the University of Rochester I would be rather skeptical.  Heck, even with the affiliation I'm skeptical.  I have a hard time believing that I could return to training in just three weeks.  But they are the experts. 


                          Greg


                          I look my best blurry!

                            I'll be checking on you!  I hope it works out.  If it does, I will be really interested in all this info.  I'm a non-practicing physical therapist.  I have 3 kids and do a lot of running right now.  My background is all pediatrics but you never know what I'll do when the head off to college.


                            SMART Approach

                               

                              The point I wanted to make is that a tibial stress fracture shouldn't need 6 weeks off.  Based on this Dr's research the return to training should be signifntly quicker.  The air cast/brace group returned in 21 days.  The traditional rest group took an average of 77 days.  Those are some pretty impressive numbers.  If this wasn't affiliated with the University of Rochester I would be rather skeptical.  Heck, even with the affiliation I'm skeptical.  I have a hard time believing that I could return to training in just three weeks.  But they are the experts. 

                              Greg

                               

                              Give yourself some time. If things are not progressing like they should, consider an ultrasound bone healing system. I have seen phenomenal results using it on athletes with all stress fractures including tibial. A college athlete was back practicing in two weeks after using it. I cross country athlete was on crutches for 8 weeks and still pain and could not bear weight. She used the bone healing system and was pain free in 4 weeks and walking fine in. Running in 8 weeks. I used it for my shoulder and had docs in awe!!! This is just another option for you. It does require a physician prescription and insurance may or may not cover it depending on your plan but many plans cover tibia.

                              Run Coach. Recovery Coach. Founder of SMART Approach Training, Coaching & Recovery

                              Structured Marathon Adaptive Recovery Training

                              Safe Muscle Activation Recovery Technique

                              www.smartapproachtraining.com


                              I look my best blurry!

                                  I used it for my shoulder and had docs in awe!!! 

                                 

                                TChuck - That is because you are awesome!