As our group come to an end of a scholastic outdoor track season, there were several competitive runners who developed tibial stress fractures. These runners usually participated in the hurdles or any event that required high impact on the lower extremity. These patients have an extremely difficult time in participating in practice or in meets.

Recently a patient visited our office and stated that she had extreme pain in both legs. This was a young 15 year old female who ran daily and participated in track and field competing in hurdles and relay. Her mother stated that the pain was gradual and started to increase on daily basis and worsened during track practice. Also, the mother stated that the school's trainer said it was shin splints and started a taping regimen without any further recommendation for follow up.

While in the office, the examination revealed some swelling and severe pain on the shin or the anterior tibial. This pinpoint pain causes guarding. Sometimes, there can be bruising or redness. On gait analysis, the patient can produce a limp or what we call an antalgic gait.

While in the office, x-rays were taken of the both legs and no apparent fracture was noted. Sometimes, a noted line or translucency can be noted consistent with a stress fracture. Diagnostic tests such as bone scans and MRI?s are appropriate modalities and due to her age, the radiologist recommended an MRI. This test was performed and tibial stress fractures were noted on both legs.

This patient was immobilized with CAM walkers and instructed to be non-weight bearing for the next 6 weeks. X-rays were taken during the follow up and this patient was sent to Physical Therapy. This young lady went back to participating in track and her outcome was successful.

Tibial Stress Fractures can be caused by over activity, high impact and poor training technique. These types of fractures cannot be overlooked as shin splints or compartment syndromes. Tibial Stress fractures can develop into chronic conditions where patients cannot participate in any sports.

Other etiologies for this condition are diet, hormones and biomechanics. Physical examination and diagnostic studies can aid in the diagnosis. Some treatments can include immobilization, activity modification, diet, orthotics and physical therapy.

Do not let Tibial Stress Fracture be ignored as mere accidents. Get it treated because this can be the difference of champion or a runner who thinks they have chronic stress fractures.....