calf/lower legTIBIAL STRESS FRACTURE
DEFINITION:
- Also known as “fatigue fractures”.
- The development of a crack/defect in the tibia bone of the lower leg, usually secondary to cumulative trauma/overuse. (See illustration).
MECHANISM OF INJURY / HOW IT OCCURS:
- Resulting from cumulative stress to the tibia. Often seen in runners, gymnasts, and sports involving impact such as volleyball and basketball.
- May see with a change in running surface, for example grass to road.
- May see with an increase in level activity over a short period of time.
SYMPTOMS:
- Pain, usually over the lower third of the tibia.
- Symptoms often start slowly and progress to significant pain with continued activities.
DIAGNOSIS:
- Physical examination reveals point tenderness over affected area. Swelling may be present.
- Radiographic studies. Note that x-rays may not demonstrate the fracture until actual healing begins to occur. Serial x-rays are helpful. May require more advanced studies such as Magnetic Resonance Imaging (MRI) or a bone scan.
TREATMENT/REHABILITATION:
- Rest – at least 6-8 weeks is required, sometimes taking longer.
- May need to unload with crutches for a short period of time.
- Ice.
- Gradual progression of activity level.
- Muscle strengthening to improve fatigue resistance.
- Proper foot wear, replacing old, worn athletic shoes. (See recommendations under footwear for runners).