♪ Bob and Brad, ♪
♪ the two most famous physical therapists on the internet. ♪
- Hi, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- And together we have the most
famous physical therapist on the internet
- In our opinion, of course, Bob.
- And we forgot to introduce Napoleon.
- Oh yes.
- Napoleon Bone-apart. (Brad sarcastically laughing)
Okay. Today, shin splints, or do you have a stress fracture?
This is a big question-
- Sure.
- A lot of people ask me to be honest with you, Brad.
- Yep.
- Because they're getting pain and let's talk
about shin splints real quickly, first.
Shin splints is a garbage can term.
It can mean a lot of things.
- Sure.
- But generally what it is, is what they
call medial stress, Medial Tibial Stress Syndrome.
So, which is a big name that you don't need to know.
But quite often that means there's pain on the,
am I in the right spot?
Yeah. On the,
- Medial aspect of the tibia.
- Which is the side closest to the other leg.
- Right. - Okay.
In here.
Yeah. We're gonna show it on...
Why don't you put it yours up right away too.
- All right.
- So you're getting pain right
on the inside here or right where this red mark is.
That's the most common type of shin splints.
Although sometimes people get it right here, too,
where that X is, on the out,
and that's a different type of shin splints.
- Sure.
- Where you're gonna normally get the stress
fracture is over in this, this medial part.
- Right, so we're talking about that big tibia bone.
It's solid.
If you bump that
into something or hurts like crazy, if you, you know
just bump your shin bone into the mattress or...
- Well, what happens is the muscles are pulling on this
for a long period of time and they're actually pulling away
on the bone and eventually it can actually weaken the bone
and develop a stress fracture.
So this can happen to any runner.
- Sure, very common.
- A lot of more common in women, but it I've
certainly seen it in men too.
So what you're gonna do
this is the top three signs and the
the one that's the most important of all is,
is that a stress fracture is gonna have localized pain.
What does that mean?
It's gonna hurt just in one small spot, instead of normally
on shin splints, it's gonna be tender all the way along.
If you run your thumb down here,
it hurts all the way along on the tissues all the way down.
But if you go here, oh, it doesn't hurt here.
It doesn't hurt.
Oh, it hurts right here.
- Ow,
- and it's one little spot and it
a lot of times it goes horizontal.
That may be, you know, that may be a sign
you have a stress fracture.
- Sure.
- And anyway, you guys don't have x-ray vision, I'm sure.
So you're gonna need to go see the doctor
on this, no matter what.
- Right.
But this at least gives you an indicator.
You know, what you might be dealing with.
The second thing is
if it tends to feel better in the morning,
it may be more likely to be also a stress fracture
'cause shin splints, often the muscles tighten
up in the morning and, and when you get
on 'em they still hurt in the morning,
where an actual stress fracture's gonna feel better.
- Right, so stress fracture responds with pain, more
to the weightbearing activities, especially with repetition.
I've known runners that have had 'em and it hurts more
and more throughout the race or throughout the event.
- Right. The other one is if you take your foot
and you turn it in like this, and I give you resistance
or you bring it up this way and I give you resistance,
and that hurts, that more likely is gonna be shin splints.
- Okay.
- Cause now you're testing the muscles.
You're not testing the bone at all.
- Right.
- So, in either case, you can't mess around
with shin splints or really with a stress fracture.
A stress fracture can get worse.
The fracture can actually grow and get bigger.
I know with runners, they tend to be a little obsessive
and they hate to give up their running.
But this is a case,
if you have a stress fracture, you have to, yeah.
You can train, do it in a pool.
- Right.
- You know, do the aqua jogging
or you can do I think biking probably.
- Bicycling, yeah.
- But you you're just gonna have to give it
up until it heals up.
- Sure. - So,
- All right. - All right.
Well, good luck with those things.