Fatigue fracture on the shin

definition

A fatigue fracture is most often a so-called stress fracture, which occurs particularly in competitive and running sports. They most often affect the lower extremity. The initial small cracks eventually result in a fracture, which is often diagnosed late.

For a lot of general information on this topic, please also read our topic: Fatigue fracture

Causes of a fatigue fracture on the shin

Basically, a fatigue fracture is caused by a constant excessive stress caused. The resilience of the Shin bone used beyond its ability over a longer period of time. Small cracks and crevices develop in the bone substance. Of the Bones are stimulated to break down and build up the substanceeventually creating the fracture. Furthermore, one can differentiate between a fatigue fracture in a healthy or a previously damaged bone. Is the bone already unstable, for example due to an underlying osteoporosis, one finally speaks of a Insufficiency fracture. The fragile bone can no longer withstand a normal load and spontaneous fractures occur.

To step Fatigue fractures in healthy bones on, is from a Stress fracture spoken. They occur especially when there are sudden changes in training. These include Changes in running speed or des Underground or else very long runs. Also one very sharp increase in weight can cause a fatigue fracture. In women, this is particularly favored by a narrow calf with little muscle mass and a thin shin bone.

You might also be interested in the following topic: Stress fracture

Symptoms

In contrast to a normal fracture, symptoms of fatigue appear more slowly. Typically, a sharp dull pain first occurs during exercise and physical activity.
In periods of rest, the pain subsides and goes away for a while. Since many patients do not assume that there is a bone fracture, the symptoms continue to increase until the affected leg can hardly or no longer be loaded. In contrast to a normal sudden bone fracture, there is no complete loss of function of the bone. In addition, other symptoms such as swelling in the affected area of ​​skin can occur.
Swelling often shows up in the area of ​​the foot.
If a fatigue fracture on the shin develops very slowly, a tumor-like swelling can often be felt on the shin due to the healing cloud, the so-called callus.

If the symptoms occur elsewhere, it could be a fatigue fracture of the heel.

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Pain in the fatigue fracture of the shin

Since, in contrast to acute trauma, a fatigue fracture develops insidiously, the symptoms, i.e. the pain, appear first creeping on. The pain is often considered by sufferers Rheumatic complaints misinterpreted. At first there is only slight pain and this only under stress, while it then disappears again at rest. If the leg is not spared, the pain becomes more and more severe and at some point is not only present under stress, but also lasts at rest (also at night) on. This is usually the point at which those affected should consult a doctor at the latest. In contrast to osteoarthritis or rheumatism symptoms, the pain improves when you run.

diagnosis

Usually there is a fatigue fracture diagnosed very late. Many athletes don't take the initial shin pain too seriously and hope for improvement if they take a little break from the sport. But since the symptoms get worse, most of those affected only go to the doctor if there is no improvement and a significant reduction in performance has already set in. The doctor will first take a medical history, primarily focusing on the occurrence and duration of the symptoms. They give an initial indication of an underlying disease. The doctor then palpates the affected leg as part of the clinical examination. Most of the time, the leg that is not painful is also examined in order to compare the sides and identify changes in the diseased leg more easily. The patient will possibly pressure pain in the diseased leg specify. The doctor can hardly feel the fine cracks and crevices.

To reliably diagnose a broken bone, you must imaging procedures be performed. In addition to conventional X-rays, computed tomography, magnetic resonance tomography and skeletal scintigraphy are also possible. The last two methods, in particular, are being used more and more frequently in making diagnoses, as they provide particularly high image quality and can also display soft tissue structures very well. In this way, diseases of the surrounding muscle and tendon structures can be excluded. Also pain-causing bone tumors like that Osteosarcoma can be excluded by means of the exact investigation procedure. Once the diagnosis has been made, the doctor can initiate appropriate therapy.

therapy

Fatigue fractures usually treated conservatively. If a bone fracture is present in the Initial stage, exercising, especially jogging, is usually enough for one to pause for a long time. The shin bone then has enough time to regenerate and to fill the fine cracks and crevices with new bone substance. Depending on the physical situation and the age of the patient, this healing process takes six to eight weeks or even with severe fatigue fractures up to half a year. The affected leg should be spared well and therefore not be fully loaded.

Often, severe or advanced fatigue fractures also occur Plaster casts for use. They keep the leg still and make sure that the leg is not strained after all. Pain relievers and anti-inflammatory drugs can be taken at the same time. In extreme cases, the hernia may need to be treated surgically. Then the break will eventually be with Screws and metal plates treated. The advantage of an operation is the quicker resilience afterwards. This can be the case, for example, if the crack in the bone has progressed very deeply. After the healing is complete, the load can be resumed. For athletes it is important that Slowly pick up exercise and gradually increasing the load so that the leg can get used to the sport again.

When do i need a cast?

A cast is usually required when a Stress fracture has occurred if it is not a preliminary stage of the fatigue fracture. The plaster of paris or the splint is used to relieve the broken bone. Mostly the plaster of paris is a so-called Walking castthat can be performed with. The plaster of paris should usually be worn for a period of two to six weeks to relieve the stress fracture. The load can then be gradually increased and the treatment can be supported by physiotherapy.

You can find more information here: Plaster of Paris

Time for the fracture to heal

If the shin is spared, a fatigue fracture usually heals without consequences out. The duration of therapy usually extends to six to eight weeks, then slowly and carefully you can try to do sports again. But it can under certain circumstances up to six months take until the leg can be fully exercised again. Even if the process can be slow, impatience should not start with a burden earlier. If pain occurs again, the burden should be reduced again, otherwise it will again Inflammation of the bones can come as a precursor of a fatigue fracture.

How long should i pause sport?

In the case of a diagnosed fatigue fracture of the tibia or an impending fatigue fracture, it should definitely Sports can be avoided and other unnecessary burdens should also be avoided. Especially in the initial stage or a preliminary stage of the fatigue fracture, this protection is often sufficient as therapy. During the sports break, the bones now have the opportunity to regenerate on their own. Usually should six to eight weeks without exercise. The duration usually varies from person to person and depends on the patient's pain and the signs of healing in the x-ray.

prophylaxis

The so-called stress fractures occur in healthy bones most common in athletes in front. You can avoid a fatigue fracture by taking care of your shins do not expose to very high levels of stress over a long period of time. Competitive athletes should also set up their training plan with a professional trainer and a sports medicine specialist. This ensures that the body has enough time between training sessions to recover and fill its resources. Fatigue breaks can also be prevented with the right running shoes. Well-fitting sports shoes that are able to absorb the bumps and changes in a running surface are important. This especially avoids the fine cracks in the bone. Corresponding inserts can also cushion the impact. Accordingly, athletes and beginners should choose a suitable pair Running shoes from a professional seek advice.