However, only about 30% of x-rays will show signs of bony injury (like thinning, or an actual black line indicating a fracture). The next step in diagnosis is getting x-rays. The bone of concern is often tender to the touch, but otherwise there are few other symptoms. Reports of training on a hard surface, or recent changes in shoe wear, are also tip offs for a possible stress fracture. The pain is typically worse after activity and improves with rest. 50% of stress fractures occur within the first 4 weeks of a new training program. They typically will describe a high level of activity (run a lot or play sports) and people also report a recent increase in activity (like in early Spring after a long winter of lounging around). How is a Stress Fracture of the Leg (Tibia) diagnosed? People with a stress fracture will report a gradual onset of pain without any recent accident. However, when a stress fracture develops in the middle of the tibia, doctors get concerned because these can take a very long time to heal (and sometimes they never heal at all until treated with surgery). The good news is that this area has a good blood supply, so the bone can get the nutrients it needs to heal. Stress fractures of the tibia usually occur near the knee (the proximal tibial metaphysis). However, contrary to popular belief, the shape and thickeness of someones bones, a persons weight, and the density of a person’s bones (think osteoporosis) does not have any effect on risk for developing a stress fracture. Studies on Ballet dancers showed that eating disorders puts someone at increased risk. For unknown reasons, Caucasians are an increased risk, and women are at 2x increased risk. Some people are at increased risk for developing these injuries. About 50% of stress fractures occur in the tibia (main leg bone), about 5% occur in the fibula (the smaller leg bone), and the rest occur in the thigh bone (femur) or in one of the foot bones. Almost all of the stress fractures occur in the feet or legs because they experience all the stress of your body as you run or stomp around each day (maybe acrobats get them in their arms from walking on their hands, but its never been reported in any science journals). And about 5% of military recruits will develop a stress fracture from all that marching. Some studies report that up to 20% of high-performance track & field athletes will develop a stress fracture from all that running. 90% of them occur in people under 30 years old. Over time those micro-fractures will turn into normal-size fractures, and that will be painful. The running will create too many “micro-fractures” and your body wont keep up with repairing them. But if you go running everyday, and your body isn’t ready for that activity, these cells can be overworked, and they will be unable to keep up with the stress. Small bone cells (called osteoblasts) live within our bones, and its their job to repair our bones after daily wear and tear. This is how we become strong at the gym (when we work out, we create small muscle tears, and our body responds by repairing the muscle, and also adding more muscle fibers to prevent the micro-injuries from occuring in the future). But after we finish working out, our body is able to repair those small injuries, and actually strengthens the bone or muscle so that it becomes more resistant for next time you work out. Whenever we go running or work out at the gym, our body experiences micro-injuries to the muscles and bone. A repetitve activity overwhelms our body’s ability to heal. What is a Stress Fracture of the Leg (Tibia) ?Ī stress fracture is a broken bone, however, unlike most broken bones that occur after a single big injury, a stress fracture occurs when many many small injuires build up over time to become painful.
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