Tibial Stress Fracture

Patient

Q: I had a stress fracture (right tibia) in December 2009 and was released fully by my dr. in april 2010. It has now been another 5 months and i still have pain in my tibia after running only a short distance. Will the pain go away or should i just run thru it?

Doctor

A:   Repetitive stress injuries (RSIs) happen when too much stress is placed on a part of the body, resulting in inflammation (pain and swelling), muscle strain, or tissue damage, fracture in your case. This stress generally occurs from repeating the same movements over and over again, with no enough healing time so they are also called “overuse syndrome”. The most common types of repetitive motion injuries are tendonitis and bursitis. The “shin splint” is a stress fracture, is a common overuse lesion seen in athletes (running sports, dancing or ballet) and also in military recruits. The typical presentation is a complaint of increasing pain in the lower extremity during exercise or activity. The patient's history usually reveals a recent increase in either training volume or intensity. The suggested treatment strategy usually includes:  using a heating pad for periods no more than 15 minutes each time during the day, limit activities that produce pain or discomfort, and for to control the pain you can keep on  taking anti inflammatory medication (such as “Motrin” or “Aleve”). To answer your question: the healing time is different for each patient, and also depends on the severity of the initial injury. It is very important before to do any exercise or straining physical activity to have an initial warm-up and stretching of the muscles, also when you start an exercise routine the demands have to be progressive and gradual, review your training techniques, footgear and surface, the time and days that you dedicate to exercise must be consistent and regular to avoid more injuries. Eventually the pain will go away, but if this is not the case I suggest a re evaluation by your sports medicine doctor.

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