Stress Fractures

Stress fractures are a common cause of lower leg pain in the athlete. These conditions are often initially diagnosed as shin splints. There are several differences between these conditions that may help in their identification.

Shin splints, also described as medial tibia stress syndrome, is an irritation of the lining of the shin bone (tibia) and one of the calf muscles (the soleus). Pain typically is most troublesome at the start of the run and hurts along a broad area of the medial side (towards the big toe) of the shin. Pain usually will lessen during the course of exercise and often returns when exercise stops. Usually there is not pain with daily walking. Shin splints usually respond to rest, icing, calf stretches and possibly changing footwear.

Stress fractures can occur in any bone in the body, most frequently in the bones of the lower half including the pelvis, femur, tibia, fibula and metatarsals. This injury occurs from repetitive stress to the bone, which weakens it, and produces a small fracture (or break) in the bone. Pain typically localizes to a small area and worsens with continued impact activities. Often pain will be present with everyday activities and may produce a limp. Typically stress fractures are identified with imaging tests such as x-rays, CT or MRI scans. Treatment often requires complete rest from impact activities for periods of 4-8 weeks, occasionally longer. Casting, crutches and, rarely, surgery may also be needed.

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