This week I returned from a hiking trip where I travelled many dozens of miles carrying heavy loads in alpine terrain and above treeline. It’s normal to feel cramped and tired after such a trip, but even after several days, shin splints and mild numbness in my big toes have not gone away. That leads me to wonder if I have finally received that most dreaded sports injury and the bane of infantry men everywhere - the tibial stress fracture. Having never had one, I don’t know what to expect. How do you tell the difference between an ordinary shin splint and a stress fracture? The medical tests to make such a diagnosis run more than $1000. Even professional runners sometimes don’t know they’ve got one. So how can I? The web literature seems vague to me - localized pain is about all they point to - not very helpful. Can any runners or other knowledgeable souls out there comment on the specific indicators which differentiate between the two?
[sub](I don’t think this is IMHO, but move it if you like)[/sub]
It’s tough to differentiate without studies. Two or three weeks after the fracture occurs, sometimes calyx formation (new bone) can be seen on plain x-ray, but sometimes not. Nuclear bone scanning is still the best way to tell if there is an occult (unseen) fracture there. Advances in CT and MRI technology make these imaging modalities helpful too, but certainly they’re not cheap.
check out this link for a good discussion on the topic.
A vibrating tuning fork can be used as a test for fractures, as mentioned here. How sensitive or reliable it is, is another question. A recent lit review failed to find any research investigating this.
Theory (and books) says a tuning fork will detect hairline fractures.
I’ve never experimented on a known fracture just to see. And I’ve never found it to ever detect a hairline fracture for me with either a high or low frequency tuning fork so now I’m wondering why they ever teach that. Maybe you need to press hard right over the spot, but in that case you don’t even need a tuning fork, any piece of metal would do.
In my experience, pressing a tuning fork on a sore spot will make it hurt more regardless of whether it’s fractured or not. I had my friend the orthopod over yesterday, and he said it’s a useless test, get a bone scan for christ’s sake. I’ll defer to his judgement.