First I’d like to say that I’m not going to the doctor for this because I figure that even in the worst-case scenario of a stress fracture, the only treatment is rest. So that’d be $900 down the drain for the advice of “rest your ankle”.
However I’d like to know how my experience compares to those of you dopers who have had stress fractures?
About two months ago I began to dramatically increase my mileage. I always had shin splints but no big deal. Then, about 3 weeks ago, there was one day where I ran 16 miles and then my ankle has been in agony since.
It’s much more localized than a regular shin splint (over maybe a 1"x1" area) and much more painful. There’s a hard lump over the painful area, right over the bone but no discoloration. It’s on the inside side of the bone, a few inches above the heel. The pain comes and goes–it’s hurting about half the time. I’ve compared it to driving a small nail into the bone.
What aggravates the pain the most is doing jump kicks (which I’ve tried to avoid) but often the pain comes for no reason. I’ve not ran for a week and there’s been no improvement over the last 3 weeks which is kind of driving me nuts. So does that sound like a stress fracture or some unglorified, wussy injury like tendonitis?
No one can force you to go to the doctor, but your condition can’t be diagnosed over the Internet. Since you have not gone to the doctor, I’d thank you not to belittle advice you HAVE NOT RECEIVED; particularly when your pain is severe and driving you nuts. I would not have merely told you to “rest your ankle” but provided a diagnosis, alleviated your pain, given advice on the chance of this reocurring and how you should modify your training. ruled out other less common diagnoses, and made sure you understood the importance of NOT resting your ankle but continuing to use it. Not rocket science, I agree, but well worth the $40 or so I would be paid for this consultation in Ontario.
Tendonitis can easily last six weeks in a severe case. If the lump is over the tendon, this may be the diagnosis.
Stress fractures are hairline fractures that are often impossible to see on X-ray, and are better visualized on bone scan. There may be a lump which forms (the callous, part of bone healing) 3-6 weeks after the initial injury which makes the fracture better visualized on repeat (late) X-rays. Mild fractures heal with rest and support (crepe bandage); severe symptoms often do benefit from immobilization. You would almost certainly benefit from taking ibuprofen 400mg three times a day on a regular basis.
No doubt you will reply to this, as I’m sure you always know better.
Dr_Paprika: Thank you for your information and response. I know that Internet diagnoses aren’t worth anything; I simply wanted others’ input on what a stress fracture felt like.
There is a current thread on cracked ribs–and as it turns out, cracked ribs mean incredible, crushing pain, not mere annoying pain. I just wanted to hear if stress fractures operated the same way–constant, steady, unending nearly-unbearable pain, visible swelling, or what? The difference in experiences was stark enough for the OP with the painful rib to conclusively conclude that he, in fact, did not have a cracked rib, and I was hoping for something similar here. I was NOT looking for an online diagnosis… I should’ve emphasized this more clearly in the OP.
I agree that a consultation is well worth $40, but this is the United States, and the cheapest specialist in around here is $160… and that’s the very simplest visit: no X-Rays, no nothing. The $900 was not an exaggeration… it was a guess based on a couple of visits and X-Rays. Believe me, I’d be going if I could afford it. 'm sorry that I came across as belittling; please accept my sincere apologies.
In any case thank you for your information and advice.
A couple of years ago I got two hairline stress fractures in my right foot as a result of playing a lot of basketball. I finally went to the ER after my feet were bothering me for weeks. They did the x-rays, told me what I already suspected (broken foot, gotcha), and told me to stay off it as much as possible. The pain wasn’t really all that bad, I just couldn’t run or jump for several months.
You’re not kidding about the cost, though. I was lucky to have insurance cover 100%, because the bill came to over $1,000! Included were ridiculously high charges for crutches and a plastic immobilizer-thingy which I never used.
Unfortunately, you know what I and everyone else is going to say. Go to the doctor. This is not a pile-on, just a reminder that while my case was simple and straightforward, your problems might be serious and require proper medical attention.
I agree $1000 is an awful lot of money for the diagnosis. More sinister diagnoses are indeed possible but are usually in the context of recurrent or unexplained fractures.
Rib fractures also tend to be hairline fractures in the absence of severe trauma. The ribs are generally immobilized by three layers of muscle and rarely require treatment apart from pain medicines. The dangers of punctuing a lung or kidney are real but happen pretty infrequently. When you take a deep breath, the ribs move because the lungs have to “grow” to accomodate an incoming breath. So a rib fracture is in constant motion, and the pain tends to be steady for the first week or two (then settles down as the callous forms to heal the bone, a process that takes maybe 6-8 weeks).
Stress fractures of the ankle move less than the ribs, but support much greater forces (half your body weight). The pain is more intermittent, but probably more severe particularly if you angle your foot the wrong way.
Tendonitis tends to be within 6 cm above the heel and on the front (anterior side) of the bone. An ankle fracture tends to be on the posterior side of the bone. If your 1 by 1 patch is in the middle of the shin, it could be a tibial stress fracture or swelling of the anterior compartment (the layer of tissue that onnects the tibia to the fibula, the two bones in your leg – the tibia being on the inside and far thicker than the fibula).
Walk on it to the extent you can, don’t jog before you can walk, don’t play otehr sports before you can jog, consider a crepe bandage, ice it ten minutes on and off, wear long socks, elevate your leg at night under a pillow, take ibuprofen regularly three times a day, and consider using crutches or putting on a cast if the pain gets worse or lasts longer than another three weeks. Best advice I can give you without seeing it – and of course the usual risks about such advice apply. I did not mean to come across as snarky and am sorry I misinterpreted the intention of your first post.
IANAMD and I have never had a stress fracture. Nor have I had any “shin splints.” (But I did stay in a Holiday Inn Express a few years ago.) “Shin splint” is a catch-all term that can include a multitude of problems, including a stress fracture or swelling of the anterior compartment that ** Dr_ Paprika ** alluded to. I don’t know what you mean by “always.” Surely you didn’t have them as a child. You may had stress fractures which healed, but running 16 miles on a stress fracture is sure to make it a larger fracture. Don’t you have insurance?
Dr_Paprika, thank you very much for the invaluable information… the difference between a cracked rib and a stress fracture was quite interesting. What you say gives me a clearer picture of what a stress fracture feels like… I’m not going to self-diagnose, but it is indeed on the middle of the shin, and on the inside side of the anterior bone (tibia, I assume). In any case I’m going to take your advice, with the pillows and ibuprofen. By “walk on it to the extent you can”, do you mean walk on it as much as possible, or walk normally as long as you can handle it? Thanks so much!
RayMan Thanks for sharing your experience. I do appreciate it… and “go to the doctor” is exactly the correct advice, so no pile-up feelings here. It’s just that my insurance has a $2000 deductible and I’ve got $0 applied towards that deductible, so any money would have to come out of my pocket.
barbitu8 – I meant “always” to the extent that I have been running and playing sports (for about 10 years now… ugh… feeling old). Normal shin splints, as I have experienced them, are a very generalized pain (e.g., you can’t press on one particular area to make it hurt) instead of localized, lasts for a day or two. I did have to give up running for six months some years ago, but can’t remember if it’s the same injury or not… Again, you are correct that going to the doctor is by far the best solution, but I just can’t afford it–$2000 deductible with $0 applied towards it thus far this year. Thanks for the help!
I mean walk on it normally to the extent you can handle it. The reason for this is interesting (to me, I was an engineering student): bony repair occurs most quickly on areas of bone that are under more stress (force; load). Resting the bone completely is “safer”, but healing takes longer and more muscle wastage occurs. Using a fractured area a lot leads to more rapid healing but also a high rate of reinjury. Best is initial rest, a day or two only, followed by graduated increase in use as tolerated; to balance an increase rate of callous healing with a lower risk of reinjury.
