![]() Symptoms are often worse with exertion – particularly at the beginning of a workout. The clinical presentation of MTSS includes vague, diffuse pain over the middle to distal posteromedial tibia. Prolonged insult may lead to a tibial stress fracture, and many authors now believe that MTSS and stress fracture represent two different points along a continuum of bony stress reaction. Stress reactions occur when the normal adaptive remodeling response cannot keep pace with excessive training loads, i.e., high demands with inadequate recovery times. ![]() Healthy bone responds to this stress by remodeling itself more densely. The stress of exercise can temporarily weaken bone. Research suggests that traction periostitis may be an inflammatory precursor to a tibial stress fracture. Following the protocols given to you by your provider, will help to ensure a safe and speedy recovery.Early etiological theories focused on myofascial strain, but current evidence shows that a bony stress reaction is the most likely cause of MTSS. Although it can be hard to slow down with a tibial stress fracture, going back to activity ‘too quickly’ can put you at risk for a larger, harder-to-heal fracture, requiring more down time or even surgery. More serious stress fractures can take longer. In most cases, it takes 6 to 8 weeks for a stress fracture to heal, when surgery is not required. To reduce stress on your leg, protective footwear or crutches may be necessary. Nonsteroidal anti-inflammatory medicines may be suggested to help relieve pain and swelling. Once a tibial stress fracture is confirmed, your provider will discuss best treatment options based on the type of stress fracture (exact location on the bone) and your activity level. It is not uncommon for other forms of imaging, including bone scans, CT scans and MRI to be ordered if your provider suspects there is a fracture present, but not visible on X-ray. In some cases, the signs of a stress fracture may not show up on an X-ray for as long as four or five weeks or may never show up. High impact sports such as running, gymnastics, and volleyball can increase the risk of stress fractures. Stress fractures are normally caused by overtraining or overuse. Other contributors may include repeated stress on the bone from pounding or impact on a hard surface, such as running on concrete. ![]() Instability of the leg and occasional loss of feeling in the foot can also be present. The pain will get progressively worse as more weight is placed on it, eventually hurting while walking or even when not putting any weight on it at all. Swelling may be present at the fracture site. Individuals suffering from a tibial stress fracture typically feel an aching or burning (localized) pain somewhere along the bone. Symptoms are very similar to ‘shin splints’ with gradual onset pain on the inside of the shin. A tibial stress fracture is a hairline fracture of the tibia bone in the lower leg caused by overuse or repetitive stress. It is the most commonly fractured long bone in the body. ![]() The tibia (shinbone) is the inner and larger of two bones between the knee and ankle.
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