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Stress Fracture lower leg (Read 87 times)

Christirei


    Hey all, i was diagnosed yesterday with a stress fracture in my lower leg, just above my ankle on the medial side....

     

    doctor orders, air cast for a month and no running or jumping, then a follow up to see how things are. I have never had a stress fracture, i've only dealt with soft tissue injuries so far, but just wondering about other people's experience with something like this and recovery time? doctor hinted that returning to running is going to be a very slow process and obviously i certainly don't ever want to go through this again, but i don't have any frame of reference....just hoping to hear from some of you about your experiences


    an amazing likeness

      My experience (3X)...

       

      Despite all the fancy lingo...you're dealing with a broken bone. The difference is the bone damage is from repetitive loads and not a single traumatic load.  Obvious, but I say that because for me rehab has followed the same pattern for both...

       

      step one -- let the bone heal to the point loading it wont do additional damage;

      step two -- start rehab which will encourage bone healing and not do any damage;

      step 3 -- work w/PT to id changes needed to not re-injure as you ramp up;

      step 4 -- build up.

       

      I've used lots of walking and elliptical as step 2 leading into step 4.  For step 3...we agreed on a shoe change (ok), mileage cut back (-25%) and weight loss (which hasn't happened per plan!)

       

      For me, the walking and elliptical during rehab has made the return to running a fairly short runway. Having access to a treadmill for the early runs is a help, as is off-pavement (track or trail) options.

      Acceptable at a dance, invaluable in a shipwreck.

      Christirei


        Thanks Milktruck! i do have access to ellipticals,bikes and treadmills at the gym i just joined about a month ago and plan to start cycling indoors while the air cast is on (doc said bike and swimming were the only cardio i can currently do) and then yes, i'm guessing i'll be working with a PT at some point. i also have two very nice gravel trails close by so i don't have to run on concrete right away

         

        its the waiting and letting it heal that i know i will struggle the most with

        JMac11


        Taper Czar

          I had a tibial stress fracture in high school, so it sounds like almost exactly the same location as yours.

           

          Recovery time for these is going to vary so much, as with many injuries. If you ask some people about soft tissue injuries, they will give you horror stories of dealing with it for years. For others, a couple weeks off.

           

          For stress fractures, I think more so than other injuries, proper time off is key. Soft tissue you can get in a gray zone where you may come back a bit earlier if you're diligent with your PT work (and there are arguments around doing so to prevent scar tissue from forming). This isn't the case with stress fractures. You have to take it easy.

           

          I stupidly tried to rush back after just 4 weeks off (and I wasn't very good about keeping off my leg). I lost probably 6 months because I was dumb with it.

           

          So I guess my main point to you is take it slow.

          5K: 16:42 (9/20)  |  10K: 34:49 (10/19)  |  HM: 1:15:28 (3/20)  |  FM: 2:36:31 (12/19) 

           

          Next Race: Whatever COVID-19 will allow me to run 


          an amazing likeness

            its the waiting and letting it heal that i know i will struggle the most with

             

            It will go by quicker than it feels like right now as you're looking forward with dread.

            Acceptable at a dance, invaluable in a shipwreck.

            RunnerKSA


              I've been running for well over 40 years and have had my share of injuries.  I find that stress fractures are actually better injuries than the vague hip/hamstring things where you can't even sit comfortably, much less run, or the knee things that no one can quite figure out.  Stress fractures heal.  Yes, it takes time, but you will get there.  Be good about staying off of it- even around the house.  Ibupropen can interfere with healing, so watch out for that.  I did OK with elliptical after about 3 o4 4 weeks, even though it wasn't supposed to be on the list of what I could do.  I felt biking hurt mine (a little higher up the leg than yours, but similar) more than elliptical.  I didn't have pool access at that point. 

              Walking was good as I got released to do that.    Good luck and keep us posted.

              Out there running since dinosaurs roamed the earth

               

              kilkee


              runktrun

                If you can be honest with yourself about when and how it hurts, you can use pain as a guide to return to activity.  Since the doc recommended a boot, I'd wear that for a few weeks before even testing out just weight bearing walking around the house.  Once it's healed enough to not hurt during daily activities (like walking to the kitchen, etc), you can inch along with some elliptical or bike.  But be very mindful of pain during or after any activity.  Pain after activity, even dull pain, indicates it was too much stress and you need to back off and rest more.  It's a balance of resting enough to let your bone build back up faster than the stress broke it down.

                 

                Keep you activity to very short intervals and build up every other day.  Even things like swimming and biking can put more stress on the bone than you might realize.  Once you get back to running, trying starting out modestly, with something like 4 x 1min jog, 4min walk for 20mins total activity. Take next day off.  If no pain, try 4 x 2min jog, 3min walk. Next day off. Then 5 x 1min jog, 4min walk for 30mins activity.  Etc.

                 

                I agree with RunnerKSA that this injury is a bit more predictable; it doesn't make the waiting any easier!  But at least you know what is wrong.

                Not running for my health, but in spite of it.

                Christirei


                  one thing i noticed today, for the past several weeks i have purposely been pushing the pain away, ignoring it, doing my best to downplay it at all costs. i mean....i've been maintaining almost fifty mile weeks for the past three weeks...so obviously i wasn't listening to what my body was telling me Smile but i honestly told the doctor yesterday that it didn't hurt to walk, and he didn't make me go on crutches...

                   

                  today has been normal except for my missed run this morning, and as i was walking around doing errands today, i realized just how much it hurts. i was looking forward to being done so i could sit down. i think since i now with the air cast on it i notice it much more and i'm not trying to ignore it anymore, i'm actually paying attention to the pain of it and yikes... i'm done for the day ! i was thinking of going to try out the bikes at the gym tomorrow morning, but i don't know if i will now.

                   

                  one thing i tell people is that if i stopped running every time i have an ache or a pain i would never run....but when things like this happen i feel like i have got to do a better job to stop before situations get to aircast level

                  DavePNW


                     the vague hip/hamstring things, or the knee things that no one can quite figure out. 

                     

                    Ha! You've captured my running injury career.

                    Dave

                    JMac11


                    Taper Czar

                       

                       

                      one thing i tell people is that if i stopped running every time i have an ache or a pain i would never run....but when things like this happen i feel like i have got to do a better job to stop before situations get to aircast level

                       

                      This x1000. I remember with the stress fracture though, I couldn't run without a limp. That should have told me there was something majorly wrong, but I just kept going along. I remember my high school coach, when I first told him of the pain, just telling me it was my body getting used to running more. The other big thing about a stress fracture that was so different for me than other injuries was it got worse as I kept going: most of those niggles get better as your warm up. That was what told me it was time to stop.

                      5K: 16:42 (9/20)  |  10K: 34:49 (10/19)  |  HM: 1:15:28 (3/20)  |  FM: 2:36:31 (12/19) 

                       

                      Next Race: Whatever COVID-19 will allow me to run 

                        If you are wondering whether you had perhaps ignored the warning signs, I can tell you that I once had a stress fracture of the third metatarsal that came on with no warning at all. In fact, I had no pain until about five hours after completing an eleven mile run one very cold Sunday morning and that's when I suddenly realized that my foot was hurting.

                         

                        But don't be discouraged. My Dr. advised me that I could continue working out so long as I do absolutely no weight bearing exercises.  So I replaced all of my runs with stationary bike because bike is not weight bearing provided I stay in the saddle. No running and no elliptical because they are weight bearing.  And that worked.  Six months later I completed a half marathon albeit slowly because I was able to maintain aerobic fitness during my recovery.

                         

                        You can do this. Good luck!

                        I intend to live forever . . . or die trying.

                        darkwave


                        Mother of Cats

                           

                          The other big thing about a stress fracture that was so different for me than other injuries was it got worse as I kept going: most of those niggles get better as your warm up. That was what told me it was time to stop.

                           

                           

                          The standard for when to run/not run that I generally follow: 1) How much does it hurt - if it exceeds 3 on a scale of 1-10 I don't run unless a medical professional is telling me to do so. 2) if my gait is off, or I'm adjusting my gait so that things don't hurt, then I need to stop running. 3) how is it trending during the run - if it stays the same or improves, I will generally keep going or just cut stuff a bit short; if it's getting worse, I shut things down. 4) how is it trending long term - if it seems to be getting worse over multiple runs, then I need to back off. But if it's improving as I maintain the same load, or stays the same as I increase my load, then I keep going. Sadly, being able to run totally painfree is a myth as you get older and more experienced. It's all about learning to read your body.

                          Everyone's gotta running blog; I'm the only one with a POOL-RUNNING blog.

                           

                          And...if you want a running Instagram where all the pictures are of cats, I've got you covered.

                          Tchuck


                            I have never had a stress fracture but have treated many over the years. Firstly, how did the doc diagnose it? Was it seen on x-ray or a bone scan or is doc just treating your symptoms. Here are some insights.

                             

                            1. If walking on it is causing a lot of pain then you are loading it too much. If you told your doc you nad no pain with walking and then he gave you an air cast and allows you to walk.....If you are now saying it hurts like heck to walk.....communicate this with your doc. You are not being honest.

                             

                            2. Address the cause. It appears training error is cause (overuse). I would also analyze your gate or weknesses. Are you working hips and glutes? Are your vitamin D blood levels well above 30? If not you are less resistant to bone stress injuries. I like above 40.

                             

                            3. If biking or elliptical or walking, you are still loading the shin so determine if you should be doing this. Any significant irritation will slow your healing response. Your body wants to heal but you need to eliminate obstacles. This also means no icing or NSAIDs.

                             

                            4. If you decide to off-load completely also realize that movement (active recovery) is so important. While seated do toe taps, calf pumps, quad queezes, extensions as much as possible during day.

                             

                            5. Allow time to completely heal and your plan coming back must be gradual as Kilkee states because your bone and connective tissues have to adapt to the new stresses. Side story: My brother had Covid and did not run for 3 weeks or do too much at all. He has not had an ache or pain for 5 years. His first run back he decides to do 6 miles and his foot starts hurting. I have been helping him manage it but one stupid mistake and 3 weeks later he is still dealing with it. That first week or two he should have been more gradual with ramp up. For you it will need to be 6-8 week process of gradually getting back.

                             

                            6. With time off from running focus on getting good at something else. Do an Air Dyne using arms only until you can bike/elliptical without pain. AND, work your upper body and abs like crazy to improve your look and strength in these or certain areas. Gives you a new focus and keeps you sane.

                             

                            7. Note: On the bright side, medial tibial pain or stress injury is better than anterior shin pain and fracture which can lead to the dreaded "black line" on x-rays which require longer recovery and sometimes surgery.

                             

                            Good luck and be smart.

                            SMART Approach Training - Run Injury Free. www.smartapproachtraining.com

                            Christirei


                              thanks so much for the responses all, it is encouraging just to be able to relate to others who have had similar experience

                               

                              Tchuck :

                              1. xray and in office exam but i passed on the MRI because it's expensive and doc told me that he would prescribe the same course, the MRI could show how severe it was but i decided to just go back for a follow up in four weeks

                              2. i have taken it much easier today except for a bike ride (stationary bike indoors) this morning, but generally just resting

                              3. i have my daughters take supplemental vitamin D but i myself do not....i might change that

                              4. Doc already told me i would be working with a PT after this is healed up to start running again, i am kind of dreading how slowly it might go, but last year i worked with a great PT who specializes in working with runners and i'll definitely request to go to her again

                              5. i do strength train four days a week already, and will definitely not be giving that up, but i'll have to adjust a few things...i am very thankful i still have that as an option, and i don't do weight lifting type of things, more like strength and conditioning (my chronic bum hamstring made me implement this several years ago)

                               

                              darkwave and teger : yes, i generally try to follow those rules for knowing when to run or not....unfortunately i'm part of the 2020 game here on the forums and the playoffs just kicked off...that definitely skewed my thinking. and i had a little niggle but then it went away, so i kept going on it....then within just a couple of days it went from annoying little twinge to CAN. NOT. RUN. 

                               

                              thank you all again, it helps to talk to people that understand

                              kilkee


                              runktrun

                                This is a bit old and there's now a lot more peer reviewed data supporting this approach, but I thought this article made a lot of sense:

                                http://www.runningwritings.com/2015/04/the-bone-stress-injury-model-new-way-to.html

                                 

                                Aches and pains are unavoidable, but now that you've crossed a threshold of pain and injury that affected your gait, you really need to back off until there's no pain with normal activities.  Pain = bone breaking down faster than it can rebuild.

                                 

                                BUT the good news is that once you are pain free, your return to running could be much faster than the old standard of 6-8 weeks non weight bearing, as long as you are honest with yourself about pain as you start running again.

                                Not running for my health, but in spite of it.

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