- Hi, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- And together we are the most famous
physical therapists on the internet.
- In our opinion, of course, Bob.
- Brad, what are we talking about today?
- Today we're going to talk about stress fractures, Bob.
We're going to talk about stress fractures.
How you get them,
how you treat them,
and how long it takes to get rid of them.
- Generally stress fractures of
the lower extremity we are talking about.
- Right, very common
and that's what we are going to talk about.
Typically below the knee.
Those are the ones we're going to talk about.
Often times in the tibia, the big bone right here,
excuse me if that hurts,
- You see that bone right there?
- Yeah there we go.
That big bone that one that you hit right there.
If you bump your knee or your shin on something
that's why it hurts because it's tender to that
kind of force.
And then we're going to look at the foot and
we can have it in the navicular bone, its a common one.
Or in the
- Metatarsals, I've seen them in young girls in the
metatarsals.
And they call it the raise here, but very easy to
A lot of times in the fifth metatarsal,
that's one, two, three, four, five, the fifth one
on the outside here.
- The one connected to the pinky toe.
- Yep.
- Okay.
- So, symptoms, well how to you know you have
a stress fracture?
You know Bob, you were talking before that sometimes
the symptoms are consistent with shin splints.
- Right.
And in fact, shin splints is a garbage can term.
What they mean is, shin splints is used a lot of times
to describe a whole bunch of disorders.
And one of them is a tibialis, posterior tibialis
becomes inflamed
and eventually, if it keeps pulling on the bone
like it does it becomes a stress fracture.
- Sure.
- So, shin splints could be a stress fracture
is what I'm trying to say.
- Right.
- If you're feeling pain the the shin,
it could either be a stress fracture or
to might become a stress fracture.
- Sure.
So if your a runner or your out walking a lot,
sometimes the stress fracture it's fine at first.
So first one quarter a mile or half mile feels fine,
but by the time you get into your walk or you run
halfway through it or a mile or two, more pain
and more pain to the point where you limping.
You can't even get home.
- I think the whole thing about this is
you can't ignore shin splints.
- Right.
- You know, I mean if you think your going to tough
it out and run through it.
I've seen runners that have done this,
and it became a stress fracture.
- Sure.
- There's just, I'm sorry, you can't ignore pain.
- Right.
- You have to figure out what's causing it
and try to solve it.
- Right.
Sounds very uncomfortable.
- Yeah.
_ So stress fracture actually is a fracture of
the bone,
but its not like you broke a bone.
It's just a very microscopic, so it's not big but
very painful.
- Quiet often what's happening is, you have two little
cells that are laying down bone,
and little cells that are absorbing bone.
And the one that are absorbing bone are
working harder than the one laying down bone.
- Sure.
- And it can have to do with diet, and can do with
exertion, if your overworking.
- Right.
A lot of the times people who go
from doing nothing or change their sport.
- Yep.
- Like my daughter, she went from swimming
now she's in basketball.
She's getting pain in her knees right now.
- Going from a non- weightbearing sport
to a weightbearing sport.
Or just increasing your mileage too much
for a walk or a runner.
- Other symptoms,
night pain, it might bother you at night.
If it's really bad, it will just be constant
pain all the time.
It will be quite tender.
You will be able to draw on your bone here
and touch on your shin
and you will find that spot that's very tender.
- Yeah, I actually went on one of the girls
I diagnosed it on, I just went on her foot
and actually just pushed on one of the metatarsals here,
and I could feel a point of pain there.
She had had them before,
so I knew there was a good chance she had them again
and she did unfortunately.
- All right.
Another thing, females, older females,
your more at risk for it because
of osteopetrosis.
And typically have a higher risk
of osteopetrosis so the bones aren't strong.
Sure yeah.
S0 if you do have it and you want to treat it,
or you have those symptoms,
you can treat it with the PRICE.
P. R. I. C. E
Protect it, Rest it, Ice it, Elevate it
- and compress it.
- Sure.
And just decrease weight bearing.
Your going to have to get away from the activity
that irritates it.
If its real bad you might have to have crutches.
- It's really hard on runners.
And one of the things we did with our runners,
is that when they were going through that
period of time, we had a workout in water.
And could actually run in water.
And if they have access, they can get a heck of a workout.
- Sure. You better believe it.
- My son is actually running in college now.
And they, two days a week now,
they don't run.
They just do things like that in the pool.
- Sure.
- And they get a good workout,
but there injury rate was very low this year.
- Sure. You bet.
Scans, other things, they will do x-rays or CAT scans
for it,
but you know, you go to the doctor by then.
If you do have a stress fracture, it's not going
to go away quickly.
It's probably going to take 4 to 12 weeks
depending on how you treat it
before it goes away.
- Yeah, The bones got to heal.
There's just no way around it.
Again, it's not a good news scenario for
someone as a runner.
- Right.
- I'm sorry.
You mentioned the ibuprofen too Brad.
- Oh yeah.
If you have inflammation, use that for
inflammation, is part of the treatment.
If you go to the doctor they're not going
to be able to do much for it.
They are going to say keep the weight off it.
If it's in your ankle or your foot, they might
give you one of those cat walkers.
So you would wear one of those boots,
where you walk on them like club foot.
So good luck if you think you got one of these.
But be careful, don't overdo it, and I don't know
what to sat Bob.
- It's a sad one.
- All right, take care.