Acceptable activities when recovering from tibial stress fracture
History: had a tibial stress fracture going back to last june. Was originally diagnosed as posterior tibial tendonitis for which received PT and took 5 weeks off of running substituting aquajogging in the lead up to LP. Ended up racing LP on a leg that didn't feel quite right. Took a couple of weeks off post LP before starting to run again. At that point had return of the focal shin pain. Finally had enough, went back to my ortho, had a bone scan and finally had a diagnosis for the stress fracture. It was apparently very small and something that should've healed in 6 weeks per my doc. I took 8 weeks off of running. Was told by my ortho it was ok to continue to do those things that did not cause impact. Only thing I did during the first 6 weeks was ride my bike. After 6 weeks I started with some time on the elliptical just to add some variety. Also during this time I had orthotics made to address to some significant anatomic issues that caused marked pronation on my left foot. Thought all was well but upon resuming running I started having focal pain again. When I say resuming running we're talking 10 minute runs. I took a week off thinking (ok desperately hoping) it was something different that a little off time would cool off. Started running again this past week and a half. Don't have any pain really while running but when I push on the bone in the area of the original stress fracture I have signficant pain identical to before. I'm trying to avoid a repeat of this past season so I made the decision tonight that I just need to stop and take another 6 weeks off from running again.
Currently in the Nov O/S (although haven't been doing the runs, just the bikes) and my thought is to continue to follow the plan but substitute aquajogging for the running. However, I'm interested in the thoughts of the smart medical folk here regarding whether I am risking delaying the healing by hammering out these T, Th, Sat FT rides. When I was told by my ortho it was ok to ride my bike I don't think he realized the type of riding we do in the O/S. I can live with not running for a long stretch of time but it would really suck if I couldn't work hard on the bike as well.
Thanks in advance for advice.
Comments
Hey Aaron. Sorry to hear about the stress fx.
I think the first step should be more studies (another scan to see what the fracture status is?? x-ray??) I think if you're still having focal pain, a new study is definitely warranted to see what you're dealing with (has something changed: bigger/smaller/the same/etc). Also if it's still not healed at this point, it might be time to go with a more aggressive treatment option to help speed up the process.
In the mean time, I would take it easy on both the bike and run until you know for sure. What might "feel okay" now might be setting you back down the road. The good news is you can still do plenty of deep water running. Break out your HR strap and get a water belt. you can still do all of the OS workouts in the pool (you'll be as shelled, trust me!). HR zones are about 10-15 beats lower so adjust accordingly and give it a try.
And while you're in the pool,. as Keith's OS tells him all the time...swim, swim, swim.
I'm in the same boat. I fought a stress fracture most of this year and still did IMWI, walked most of it. I thought I was good a month or so ago but after a few weeks of running the pain came back to the shin. We didn't do a bone scan figuring it was a stress fracture so I'm now going to wait the full six weeks then come back slowly. One good thing is that my doctor is my wife's cousin and a runner/triathlete as well so I feel comfortable working with him. One thing he did recommend is using an ultrasound bone healing machine. I do at least 1 treatment a day, 2 most days, to try and increase blood flow to the area. Hoping this helps. I'm continuing to ride 4-5 times a week on the trainer and will probably jump to the Jan OS as my A race isn't until September.
Dave
How'd you score the ultrasound machine? Is it a home unit or are you going to PT? Did it require an Rx from the doctor? Going to ask my Ortho for that when I see him Wednesday.
aaron, when you see your ortho on friday ask him about a bone stimulator/ultrasound unit. there's a good chance your insurance company will rent it for you and he/she should have info on the company to contact. to speed up the process, might be worth a call to your insurance company to see what kind of DME (durable medical equipment) they cover and if that kind of unit would accepted??
I used one when I broke my foot a few years back. easy to use at home.
Well, saw my ortho today. Given I was having recurring pain he was glad I came back. Of course since I haven't run in a week I was having absolutely no pain although I was able to provide him with exact location of where it had been. Had xray in his office and it was completely normal. No line, no indication whatsoever of where the stress fracture was to have been per bone scan, no bony changes. Didn't want to do another bone scan as in his experience even after stress fractures healed area can still light up due to residual hyeractivity in area. He gave me a couple of options that basically revolved around my doing what i wanted. Either not running and focussing on swimming / biking going forward or slowly reintroduce running, listen to body with regard to doing too much too soon, ice after runs, stretch. He was confident that given what he saw on xray (or didn't see for that matter) that I did not have any indication of a fracture and that I could proceed (starting slowly) without concern for risking further injury or complete break . So, tonight I start my slow journey to getting back running. Easy run on the nice soft mill for me.
Hope your healing goes well and we're both able to hit it in the January 0/S