WTW: Bone Stress Injuries

Shin splints?

Or is that my calf?

I probably need new shoes...

Why does this always happen right before my race?

What is it?

A bone stress injury is a broad term that can vary in severity of actual injury. 

Any where from swelling around your bone to a full stress fracture of the bone. 

In other words, it is an injury on a continuum that luckily is broken down (see what I did there?) into stages.

Stage 1: Bone Stress Response - sign of bone stress on an image (think xray) but the athlete is mostly symptom-free

Stage 2: Bone Stress Reaction - localized bone pain that worsens with activity, usually tender to the touch

Stage 3: Bone Stress Fracture - Very pronounced pain in a localized area and it is painful to bear weight on the affected limb.

Why does it matter?

If you like to run, walk, participate in athletics, or you routinely get shin splints, it matters.

Common areas include any bone from the hip down, including:

• The tibia and fibula
• Bones of the foot
• Your heel
• The femur
• The inside ankle bone (medial malleolus) 

What can you do about it?

So things are beginning to hurt? 

Start there, manage your pain. 

That would look like modifying activities, bearing weight as tolerated, and discontinuing stressful activities to allow the bone to heal.

You still want to maintain your fitness level, so offloaded conditioning like cycling or swimming. 

You will also want to ensure adequate intake of Calcium and Vitamin D in your diet. 

Once you noticed ~1 week of pain free activities, you can beginning a progressive loading program including but limited to:

• Jumping
• Strength training
• Gradual return to running

As you progress you should gradually return to your desired sport (running for this example.

• Walk 30 minutes
• Walk/jog 30 minutes
• Gradually reduce jogging and increase running until you can run the desired duration and distance
• Gradually increase pace

Got a weird injury or a burning question you want answered? Drop it in the comments below and I will talk through it on next week's "What's that Wednesday". 

-Dr. Jon Bailey, PT, DPT, OCS