Stress Fracture of the Tibia

What is a Stress Fracture of the Tibia?

A stress fracture of the tibia or shinbone is a thin fracture, also called a hairline fracture that occurs in the tibia due to excess stress or overuse. The tibia is a weight-bearing bone in which stresses can accumulate from activities such as running and jumping.

Causes of Stress Fracture of the Tibia

The most common cause of stress fractures of the tibia is repetitive stress or overtraining for sports. It may also be associated with weakness of the bone due to a condition called osteoporosis. Women are more likely to develop stress fractures.

Symptoms of Stress Fracture of the Tibia

Symptoms of a stress fracture of the tibia include:

• Pain which is initially present with strenuous activities and later with regular activities
• Swelling and tenderness
• Bruising (rarely)
• Difficulty walking at a later stage

Diagnosis of a Stress Fracture of the Tibia

Your doctor will review your medical history and symptoms and based on this a physical examination will be performed. Any swelling or bruising will be noted. Diagnostic tests can include the following:

• X-rays: During this study, high electromagnetic energy beams are used to produce images of the broken bones. However, stress fractures may be difficult to visualize on X-rays.
• Bone scan: This is an imaging technique in which a radioactive drug is injected into the bone to detect any damage or disease.
• CT scan: Detailed images of the tibia are obtained using X-rays from different angles.
• MRI Scan: An imaging study that uses a large magnetic field and radio waves to produce detailed images of the tibia.

Treatment for a Stress Fracture of the Tibia

Treatment for a stress fracture depends on the location and severity of the fracture. It includes:

• RICE therapy:
  • Rest: Your doctor will advise you to avoid high-impact exercises and activities. Weight-bearing on the affected leg is limited until the area is healed which can take 4 to 8 weeks. Inadequate rest can lead to worsening of the fracture and sometimes arthritis. You may be able to participate in low-impact activities but you should discuss this with your doctor.
  • Ice: Apply ice for 10 minutes at a time to relieve pain and inflammation.
  • Compression: Pressure should be applied to the affected site to reduce pain.
  • Elevation: You need to elevate your leg to relieve swelling.
• Medications: Your doctor will recommend over the counter anti-inflammatory medications to reduce inflammation and pain.
• Physical therapy: After the initial rest period, your doctor will recommend special non-weight-bearing exercises and other techniques to strengthen the bones and improve range of motion.

If these methods are found to be ineffective, your doctor will recommend using

• Splints: These are made of plastic and fiberglass and are used to immobilize the joint.
• Casting: This acts as a protective shell made of fiber or plaster molded in a way to protect the broken bones.
• Bracing: Braces are made of plaster or fiber and act as a protective shield to align the damaged bone.

Recovery may take up to 6-8 weeks after which you can return to your regular activities.

Rarely, conservative treatments are ineffective and the structural integrity of the tibial bone is compromised. Surgery is then recommended to stabilize the tibia. An intramedullary rod is usually used for this purpose.