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X-rays are usually the first diagnostic imaging exam that is performed. X-rays use low levels of radiation to provide images of dense structures in the body, including bone.Orthotic inserts worn in the shoes can correct foot problems such as overpronation.One or more of the following diagnostic imaging exams may be used to confirm the presence of a foot stress fracture. Gait analysis can identify any biomechanical problems of the foot which may have increased the chances of injury. Do you need to change your footwear? Running shoes last about 500 miles or 6 months, after which you should change them. Training errorsĪnalyse training methods to identify if or how this contributed to your injury.

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This increases the likelihood of sustaining further shin pain from medial tibial stress syndrome (shin splints). After a period of rest, they may be tight and in poor condition. It is especially important to stretch and strengthen the muscles at the back of the lower leg when returning to weight-bearing exercise. But do not use the tape to resume running if you have a suspected tibial stress fracture. It works by supporting the muscles of the lower leg and pulling them towards the bone.Īs a result, this helps reduce the rotation of the tibia. TapingĪ simple shin-taping technique helps reduce the strain on the shin. Therefore, it is important to follow up with another x-ray after a period of rest. However, you may see some signs after 2 or 3 weeks. Initially, stress fractures do not show up on an X-ray. Running in water with a buoyancy aid or belt is also an excellent substitute for running on the road.Ī doctor will x-ray the leg and advise on when it is safe to resume training. Concentrate on other technical aspects of your sport if possible. Substitute swimming or cycling if pain-free, or use the opportunity to work on upper body strength in the gym. This allows your injury to begin to heal. Avoid all running and weight-bearing activities. If you suspect a stress fracture then rest for around 8 weeks. As a result, the bone is subject to additional torsion or twisting stresses. If your foot overpronates and rolls in, flattening the arch of the foot, this has the effect of rotating the shin bone inwards. Overpronation or over supination increases the stress on the tibia bone. Or simply increasing your training too fast. Sudden changes in a running surface, for example, going from grass training to lots of track or road running can increase the chances of a stress fracture. The obvious cause of a tibial stress fracture is overuse, however, there are a number of factors which can increase the chances of sustaining a tibial stress fracture. Lots of small impacts on the bone even though they may be very small, result in a cumulative build-up. Therefore, there is more load on the bone. This is because your muscles are unable to absorb some of the load. In particular, fatigue causes the distribution of forces in the bone to alter. Continuous muscle contractions and stress forces of impact cause the tibia to overload. Long bones such as the tibia have an outer sheath surrounding the hard compact bone called the periosteum with the inner core containing bone marrow. The most common site, however, is two to three inches above the bony bit on the inside of the ankle (called medial malleolus) on the tibia bone.

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Either of these bones can develop stress fractures.

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Its purpose is mainly as an area for muscles to attach. The tibia is the larger, thicker of the two and its role is load-bearing. The lower leg consists of two bones, called the tibia and fibula. Often you then see new bone growth where it has begun to heal. If you suspect a stress fracture of the tibia then rest for at least 4 weeks before taking a second X-ray. It is the new cells along the line of the fracture which will become visible. This is because a stress fracture will not show up on an X-ray until it has begun to heal. It can be difficult to distinguish a tibial stress fracture from a case of shin splints.

If you have a stress fracture you may also feel a particularly tender spot at the exact point of the stress fracture.

You may even have swelling over the site of the fracture.

When pressing in over the area your leg will feel tender and sore.

Symptoms often occur after running long distances.

Pain on the inside of the shin, usually on the lower third.

Tibial stress fracture symptoms are very similar to shin splints (medial tibial stress syndrome) and include:

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