Tibial Stress Fracture Questions

[Brad2]

Hello All,
Apparently I increased my mileage too quickly while training for a marathon, even though I thought I was adhering to a schedule closely enough.

The doctor said the same generalized things as all of my internet research: walking and standing should be okay, avoid vigorous walking and stretching. These injuries can sometimes take several months to fully heal. Get enough Calcium and Vitamin D, and proper nutrition in general.

What activities did you do in this situation? Obviously biking and swimming would be low impact, but do I need to avoid rock climbing? What about skiing? What about Cribbage and Backgammon?

Thanks in advance!!!

[AndrewLyonsGeibel]

I'm no Dr so take my thoughts with a massive grain of salt but I'd stick with the swimming and cycling. Rock climbing might be ok and I'd assume skiing to be risky. Do you by chance heal strike when you run?

[TallGrass]

Apparently I increased my mileage too quickly while training for a marathon, even though I thought I was adhering to a schedule closely enough.

The doctor said the same generalized things as all of my internet research: walking and standing should be okay, avoid vigorous walking and stretching. These injuries can sometimes take several months to fully heal. Get enough Calcium and Vitamin D, and proper nutrition in general.

What activities did you do in this situation? Obviously biking and swimming would be low impact, but do I need to avoid rock climbing? What about skiing? What about Cribbage and Backgammon?

So you got a "fracture" (broken bone, non-displaced) due to repeated "stress" (running) and want to know if you can continue to stress it to a similar degree to maintain or improve performance, much less avoid it becoming a displaced fracture, right? Whether you can continue the intensity that created the injury so you can keep in shape while expecting the injury to improve? Think about that...

I infer the fracture is in a weight-bearing portion of the tibia and not something like the medial malleolus which would be more sensitive to ankle flexation. Imagine the same crack in a wooden table leg or a piece of plastic pipe that you just glued. What could you do with the leg or pipe that would NOT interfere with the ends trying to glue back together, the "curing process"?

Walking, very light biking, standing, should only need a low % of what a healthy bone could bear. Full 100% is out for now. What is the potential reward and risk for playing the Over Under betting game for that unknown middle % with your leg?

Climbing (torquing moves, impact from swinging into wall), swimming (flexing like a leaf spring due to water resistance, think cracked oar shaft), skiing (torque to turn ala torsion bar, see "greenstick fracture"), are things you're considering?

If you have to lay off NOW for six to eight weeks for a "crack" fracture to heal, how many would you have lay off in the FUTURE if you separate it into pieces, much less need surgery to hold the pieces back together in alignment?

When training, why do you rest between runs, or vary the length and or intensity of workouts?

[B_2]

Did your MD advise a DEXA scan for bone density? Are you >50, then it may be especially warranted? Does osteoporosis run in your family or Vit D/Ca2+ deficiency or absorptive disorder? Or did you just work out too much too soon.?

A stress fracture is very unlikely to progress to the point of becoming displaced if you just avoid extremes.

You are right to avoid high impact activities for 6-8 weeks. If you bone density is compromised for some reason, it may take longer to heal.
Your meniscus is attached to your tibial plateau, so any extreme torquing of the knee will translate forces to your tibial plateau. I would avoid activities involving twisting motions with your foot planted ("closed chain") - I would count skiing and climbing as such activities. Anything that could end up in a big mistake/jolt/trip/crash...

Swimming, non-extreme biking (would avoid clip-in pedals for now), walking, light hikes ok, light resist rowing machine would be ok if you watch the knee angles. Walking and a strengthening program (weighted knee <=90 degrees where straight leg = 0 degrees) are probably the best - you want weight going through the tissue so your body knows the orientation the forces will be coming from to heal properly, but you don't want to encourage/prolong the inflammatory process or cause further damage. You also do not want a compensatory injury, as it is just human nature to alter our movement patterns to lessen the load on an injury, which then of course places more stress on other tissues.

Don't worry about "greenstick" fx - I believe that occurs in kids before their bones are fully calcified. The adult equivalent is a spiral fracture, indeed bad. But that requires quite a violent force in a healthy adult.

You may want to see a PT to check for strength/length discrepancies in your LE muscles and start addressing them with prescribed exercises and stretches. Many runners get them because running is so repetitive and linear/single plane of mvmt.
Good luck! It's temporary...

[Sean Nunn]

Hello All,
Apparently I increased my mileage too quickly while training for a marathon, even though I thought I was adhering to a schedule closely enough.

The doctor said the same generalized things as all of my internet research: walking and standing should be okay, avoid vigorous walking and stretching. These injuries can sometimes take several months to fully heal. Get enough Calcium and Vitamin D, and proper nutrition in general.

What activities did you do in this situation? Obviously biking and swimming would be low impact, but do I need to avoid rock climbing? What about skiing? What about Cribbage and Backgammon?

Thanks in advance!!!

The key word above is "sometimes". I have coached cross-country and track for 20 years. I have never heard of a stress fracture taking several months to heal, unless several means two. 6-8 weeks is the usual recovery time, followed by a VERY gradual increase in mileage. The best training for a runner/hiker IMO would be deep water running in a pool. If that is not possible, I am not sure there is a whole lot that you could do with your legs. Cycling or ellipitical machines are probably too much stress on the tibia. Also not sure about rock climbing or skiing. Cribbage is definitely out, but chess is OK.

[Brad2]

Wow thank you for the great responses!

No no no to all of the following: don't heal strike when running, not over fifty yet (only in my thirties), no family history of deficiencies etc., no leg discrepancies, and I know what else you're thinking, not overweight at all. Just ran too much too soon, classic case in fact.

To be on the safe side, rock climbing and skiing will be out for awhile, and my return to running will not be rushed and will follow some kind of prescribed schedule, erring cautiously. (And great reminder not to stress the other side of the body!)

So nope, I promise I'm not going to go hard until it breaks into pieces. I never even wanted to 'maintain or improve' performance, just feeling, you know, bored.

[TallGrass]

just feeling, you know, bored.

I hear ya. Anything upper body should be fine. Ever kayak? Level hiking trails so you don't have impact on descent should be fine, but I'd keep them short. I had a running stress injury that was the vicious cycle of layoff it, gets better, times go up, train, times go down, injury gets worse, layoff it, etc. Tried "running", not swimming, in a pool which was as boring as a stationary bike. It pretty much ended a season and didn't heal fully until I layed off of it for the winter. The body needs recovery time, and most important, listen to your body (leg). If it starts feeling sore or odd, lay off. Good luck!

[EshanBrett]

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[12ersRule]

You suck, EshanBot.

Hey, TG is back! Oh wait, that was 2017.

[nyker]

Hello All,
Apparently I increased my mileage too quickly while training for a marathon, even though I thought I was adhering to a schedule closely enough.

The doctor said the same generalized things as all of my internet research: walking and standing should be okay, avoid vigorous walking and stretching. These injuries can sometimes take several months to fully heal. Get enough Calcium and Vitamin D, and proper nutrition in general.

What activities did you do in this situation? Obviously biking and swimming would be low impact, but do I need to avoid rock climbing? What about skiing? What about Cribbage and Backgammon?

Thanks in advance!!!

From the lower extremity stress fractures I've had unfortunately, no easy answer here. Listen to you Doc and just be patient and listen to your body. You need to initially rest the injured area and then slowly work up to re-engaging in weight bearing activity on it. How long it will take nobody here can answer, your Doctor and PT will be your best guide. For other activities to do depends on the severity of your injury/pain. In addition to what is mentioned above, ellipticals could work, punching bag work (no kicking), weights (though without weight bearing on your leg/foot)...