Tibial Stress Fractures

The tibia (shinbone) is the inner and larger of two bones between the knee and ankle. It is the most commonly fractured long bone in the body. A tibial stress fracture is a hairline fracture of the tibia bone in the lower leg caused by overuse or repetitive stress. Symptoms are very similar to ‘shin splints’ with gradual onset pain on the inside of the shin.

Individuals suffering from a tibial stress fracture typically feel an aching or burning (localized) pain somewhere along the bone. Swelling may be present at the fracture site. The pain will get progressively worse as more weight is placed on it, eventually hurting while walking or even when not putting any weight on it at all. Instability of the leg and occasional loss of feeling in the foot can also be present.

Stress fractures are normally caused by overtraining or overuse. Other contributors may include repeated stress on the bone from pounding or impact on a hard surface, such as running on concrete. High impact sports such as running, gymnastics, and volleyball can increase the risk of stress fractures. It is also common in military recruits.

In some cases, the signs of a stress fracture may not show up on an X-ray for as long as four or five weeks or may never show up. It is not uncommon for other forms of imaging, including bone scans, CT scans and MRI to be ordered if your provider suspects there is a fracture present, but not visible on X-ray.

Once a tibial stress fracture is confirmed, your provider will discuss best treatment options based on the type of stress fracture (exact location on the bone) and your activity level. Nonsteroidal anti-inflammatory medicines may be suggested to help relieve pain and swelling.  To reduce stress on your leg, protective footwear or crutches may be necessary. Surgery is also an option.

In most cases, it takes 6 to 8 weeks for a stress fracture to heal, when surgery is not required. More serious stress fractures can take longer. Although it can be hard to slow down with a tibial stress fracture, going back to activity ‘too quickly’ can put you at risk for a larger, harder-to-heal fracture, requiring more down time or even surgery. Following the protocols given to you by your provider, will help to ensure a safe and speedy recovery.

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