Tibial Stress Fractures

A tibial stress fracture is a fortunately uncommon cause of leg pain in athletes, especially running athletes or those who participate in repetitive landing from a jump, such as gymnastics. Typically athletes complain of pain that increases over a period of time, usually in response to increased stress. A common story is a runner who is increasing his or her training over a short period of time. Often he or she starts having pain that comes on with a run, and over the next few days or weeks, the pain comes on sooner and takes longer to go away after stopping the run. After a while, pain persists with activities of daily living, such as walking.

Tibial stress fracture
Note the increased uptake in the mid-tibia on the bone scan of this young athlete.

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In the office, the physician will perform a history and physical examination. Examination of a tibial stress fracture will often reveal a more localized pain than shin splints, although this finding is not always true. Usually tightness of the calf muscles and numbness and tingling are absent. X-rays will often show a tibial stress fracture if symptoms have been present long enough. Physicians often refer to the x-ray findings as “the dreaded black line,” which is a break in the cortex of the bone but no fracture all the way through the bone or any displacement of the fracture. If the symptoms are fairly recent, x-rays might not show a stress fracture, so further testing, such as bone scans or MRI’s, are often used. Tibial Stress Fractures and Athletes.

Treatment of a tibial stress fracture can be either surgical or nonsurgical. This is potentially a worrisome diagnosis, as continued stress on a tibial stress fracture could lead to a complete fracture and require surgical treatment. If nonsurgical treatment is elected, many physicians recommend complete nonweightbearing and use of a cast or walking boot. At a minimum, absolute refrain from the offending activities and sports is mandatory. If the fracture is not healing, we often consider surgical treatment. Tibial stress fractures, especially in the setting of delayed healing, involves placement of a nail down the center of the bone with or without additional bone grafting to try to stimulate healing of the bone.

Recovery from a tibial stress fracture is lengthy whether or not surgery is performed. Usually physicians will not let the patient return to sports or exercise such as running until the fracture has completely healed. That process can often take three to four months. At that point, activities are gradually introduced. The time to return to sports is lengthy, but if the fracture heals uneventfully, return to full participation with no limitations is often seen.

130 Responses to Tibial Stress Fractures

  1. hie, I met an road accident about an 4months ago.i broke my right tibia..compound fracture doctor planted a metal rod and two nail inside my leg…now I m walking without crutches. .can I play badminton after a few months..

    • Patients can usually return to sports and exercise after surgery for a tibia fracture when the bone has completely healed and the patient has regained full motion, strength and ability.

      • I broke tibia bone in 4 places in 2005. My leg gives out on me all the time and now my doctor says I they need to remove hardware. Years ago they said it wouldn’t do any good to remove hardware. I don’t know what to do in in pain all the time

        • My ankle knee and hip also hurts real bad.Im wondering if a boot or something will help my ankle knee and hip cause when I stand up at work for e few hours the pain starts right up

    • Dr.geier i have been having pain in lower left part of my leg the pain aint as bad as when im walking around can you please tell me could it be a stress fracture but i haven’t done any exercise since October but I need advice

      • I currently have stress fractures on both of my tibia’s. The pain hurts worse when walking down hills. Even the slightest uneven surface hurts.
        Can you pin point the pain you have? If you can pin point it to one location then it is probably a stress fracture.

        If you can not it could just be a pulled muscle you should have rubbed out. I recommend a massage. It helps a ton.

        I have had pulled tendons also in my tibia area. Which are just as painful.

        I would go to your PCP and ask for a referral to a specialist. I had a bone scan pick up my injuries. That thing lit up like a Christmas tree. The Orthopedic surgeon was in disbelief how bad my injuries were.

        I ran a good 30 miles after the initial pain started before I got medical treatment (air boots on both feet).

        If you google “running injuries” you will find the most information about pain in that area.

  2. I’ve been diagnosed with bilateral tibial stress fracture. My left leg is the one that hurts. My ortho doctor didn’t put me in a boot or cast. Just said no running. Is this protocol?

    • The treatment necessary for a tibial stress fracture can vary depending on the specific location of the fracture. Some stress fractures need periods of complete nonweightbearing, while others can potentially be treated by just limiting repetitive impact.

      • They don’t hurt anymore. When I’m resting, my shins feel like I rubbed icee cool or have a heat pad on them. Is this normal?

  3. I have had medial tibial stress syndrome for almost 3 years now, and the last time I was cleared for a stress fracture/reaction was last year. At first my left shin would only hurt when I was jumping or running. Now, it still hurts running and jumping but also after activity, the spot on my shin aches and it barely hurts to walk. I am going to get an MRI tomorrow, but how likely is it that I have a stress fracture?

    • I really can’t say or predict without being involved in your care. If a patient’s pain is increasing, coming on earlier or taking longer to go away, or is more pinpoint in location, then a stress fracture could be more likely.

  4. I have a tibial stress fracture from running and was told to use crutches for three weeks. In general, is this really necessary once the pain has subsided (as it has, in my case). Feels silly to use crutches when nothing hurts.

  5. Hi, i have a tibia plateau fracture that’ shattered my knee a little over a week ago. I had surgery and had a bunch of screws put in. I am now in recovery and just lay all day with my leg elevated besides when I have to use the restroom. Only concern is when I do go use the restroom or if I flex my foot my calf muscle is extremely sore. Should I be worried or isn’t just post op pain? It’s also painful to massage the calf even when not flexed, but when laying down there is no pain.

    • Laura, I can’t really give you specific information or advice, but you should run your concerns by your orthopaedic surgeon. It is possible for a patient to develop a blood clot in her leg after surgery, but she can also have pain related to the fracture and surgery.

  6. I have been experiencing pain for 5 weeks in tibia region and have ceased running during that time. I had been running through discomfort for 2 weeks prior to that. Over the resting time I felt as if the pain was getting better (still do feel it though, even just when walking) and I put off seeing a doctor until mid week 4 and had an MRI done at the 5 week mark, which showed a grade 1 stress injury. I am wondering, if I had the MRI done 3 weeks ago, when the pain was at its worst, is it possible the MRI would have shown a more severe injury and that the injury had healed down over the weeks?

    • I can’t say in your case, but if a patient has a stress fracture, an MRI later in the process could show less edema and a resolution of the fracture line.

  7. i m having pain both legs which is localised in my tibial bone .it increasd in prolonged standing walking and i can not jump.pain is pinpointing.whn touched at that point pain is unbearable.i m not athlete but why i got stress fracture and wht to do in my case.
    x ray n ct scan shows line on lower third of tibia

    • I can’t say without seeing it, but if a patient has a tibial stress fracture, then I would recommend seeing an orthopedic surgeon and following his or her advice for treatment.

  8. I got a stress fracture in my left tibia in Dec of 2012 while exercising. Was told it was shin splint so continued to run on treadmill for another month before insisting on X-ray which confirmed the diagnosis. Was initially treated by placing me on crutches x 12 weeks completely non weight bearing. During this time did bone density, took me off all ibuprofen, etc because of slow healing. Fast forward 2 years and I am currently still in a walking boot and on my third ortho dr and X-ray shows non healing. For a while they found I was vitamin d deficient but with supplements was able to get that corrected. I am only 40 yrs old so too young to have a fractured leg the rest of my life. All doctors have only tried crutches, PT, Walking boot but no body can find out why not healing nor do they seem to care enough to try to figure it out. Does anyone have any suggestions or know what I should try next? Permanent limp and at my wits end as I am a full time working nurse and mom of two young children. Please help!!!!

    • I don’t know if it is an option in your case, but surgery can occasionally help a nonunion of a tibial stress fracture heal.

    • My wife is going on 30 weeks. ..2 mri countless blood work, multiple xrays, she’s 36….very active. Crutches, walking boot, nothing is working. ….what do we do? She isn’t healing and the Dr is saying she may just have to deal with a stress fracture the rest of her life? Seriously?

      • I do gymnastics 5 days a week, 3 hits and 45 minutes every time sometimes 4 hours. I’m a kid and my knees go in when I have my feet together like they even touch!!!! And every practice they hurt like house falling on them hurt, and when I’m just laying down they throb, and pound, and hurt!!! Are they broken?

    • Check your diet. I would recommend paleo diet. Get off of all grains and sugars and hardly any fruit. Increase good fats like coconut oil, grass-fed butter, olive oil

    • I am not a medical expert but I hope this helps. There is a likely chance that your blood has high acidic levels which is witholding the nourishment required for your bonehealing. Try a more alkaline diet.

  9. Hello Dr David I have a tibial plateau stress fracture from running in Aug/14 and was put on hinged brace, non weight bearing with use of crutches for 8 weeks, which I did follow exactly as recommended by my doctor. I had 3 MRIs done since Sep but still shows that fracture is present with a delay healing. My doctor has suggested bone stimulator device OL 1000sc which is very expensive but I was very fortunate to have its cost covered by my insurance and just started the treatment. What i would like to ask how effective this bone stimulator treatment can be? There are not much info about it. Pain has subsided considerably and I am off crutches/brace and walking normally with somewhat discomfort on knee region. Also what consequences/sequela that non healing stress fractures can bring to person if not dealt in the right ways for the short and long term. Thanks

    • Research shows conflicting results for bone stimulators, but they can occasionally be worth trying for some patients. The consequence of a stress fracture that doesn’t heal is continued pain or the fracture becoming a complete and even displaced fracture.

      • Ok. Here is my concern If a non healing tibia stress fracture goes on for a prolong period of time, can it causes the bone cells to die and never regenerate themselves again even with surgery? Thanks

  10. I am a female in the army. I was in a unit that only rucked up mountains and ran. I had shin pain and calf tightness/weakness to the point where I had a hard time walking. Long story short, I was told to continue running on my injuries. I have not ran in over a year and have shin pain everyday, mostly at rest, but with walking at times. What are the long term consequences for running on his injury?

    • Vanessa, it is really hard to know the consequences without knowing the cause of the problem. You might see an orthopaedic surgeon to find out if you have CECS, a stress fracture or some other problem.

  11. I had a stress fracture so the doctor gave me a boot but the boot wasn’t helping so I asked if the doctor could put me in a cast, so the doctor put me in cast for 6 weeks and it was fine for a few weeks but it started hurting evertime I run…that was summer 2013. Because I didn’t wanna give up the sport(soccer) I did not tell my doctor about it and I have been playing with it for a year and half. Should I go and tell him and if I do, does that restrain me from playing if so for how long approximately. How long does it take to get back after surgical treatment?

    • Surgery for a tibial stress fracture can take 4-6 months or more for return to sports. Return generally depends on full healing of the fracture, surgery or otherwise.

  12. So I’ve had a stress fracture for over 3 years now. The first time I was placed in a boot for 2 months and was limited to non-weighted activities. I come back to play my sport basketball and everything is find. Than a week or two later my leg starts hurting again. I take pain pills to tolerate the pain to play. I have a big lump on my leg. I went to the doctor and was told that my stress fracture is back. He recommend that I do shockwaved instead of surgery. I’m in Germany playing basketball and the shockwave involves me staying here another 2 months. Which should I decide to do? In college I had an bone stimulus that I wore for 1 hour each day and it didnt help. So which should I decide to do?

    • Demetrius, I cannot give you specific medical advice on this website. Generally surgery is at least an option for patients with nonunion of a tibial stress fracture. Your orthopaedic surgeon could better advise you as to the options and whether surgery could be necessary.

  13. How often do you see abnormal reactions in the bone after a rod is surgically placed? I had an IM rod put in a year ago for a stress fracture and due to continued pain had another bone scan that showed significant brightness over the distal and proximal screw sites and general brightness throughout the shaft compared to my good leg.

    • You would have to ask a neurologist for sure, but I’d think that if a NCV test showed normal conduction through the nerve, then it suggests no nerve damage.

  14. I believe I have a multiple small stress fractures in both of my shins. There is a slight constant pain which made me seriously consider it. I am going to West Point in one month and have laid off of weight bearing and other shin related exercises for about a week now. I have been swimming and doing upper body workouts, those are fine right? Also, I have been wondering if heat (bringing blood to the surface) or ice therapy would help. If not is there anything that would help accelerate healing? I am also taking vitamins and keeping up on calcium intake. Thanks Dr. David!

  15. I play volleyball and fractured my tibia plateau while doing so. It was non-surgical and I was on crutches for eight weeks with no brace. The fracture was also pretty small, and only showed up on an MRI. I am now walking on it entirely and it’s pain-free, but approximately how long might it take for me to go back to going to practices?

    • Eleanor, that’s a great question, although it is hard to say. I would definitely ask your doctor. Generally the fracture must heal completely, and then a patient slowly works through a jogging program and return-to-sports progression. It can take 4-6 weeks after the doctor allows it.

  16. I am a runner and was diagnosed with a distal tibial stress fracture in my left leg last year. I ran with pain throughout the summer thinking I had a case of severe shin splints before finally seeing an orthopaedists and having an MRI done. I was put on crutches and advised to be completely non-weightbearing for 3 months. That wasn’t feasible for my line of work (I’m a personal trainer) so I was given the okay to have limited time away from the crutches as needed for work only and was on the crutches at all other times. The pain in my shin did go away and I returned to running (very gradually!) after the 3rd month. Now that my running is picking up again for the summer I’ve started experiencing the SAME pain. I’m not happy. My Ortho said if the pain returned we would be looking at putting a rod in the bone. This sounds terrifying to me! I’m concerned that it will put an end to my running completely and I’m avoiding making that appointment to see him again for this reason. What is the recovery period for this type of surgery? Is the rod permanently placed? Will it affect my running? Scared but also don’t want to further damage my bone by running on it!

    • If surgery is needed for a tibial stress fracture, it is usually a rod placed down the bone plus bone graft added to the fracture site to help it heal. Recovery can take 3-6 months. Good luck! I know that is scary!

  17. i was diagnosed with a tibia stres fracture and had put on a cast for 6 weeks now after taking it off the xray shows the stress fracture is still not fully healed! there is no pain! i am a soccer player and i realy need tu play! i am helpless what should i doo? and i want to know how long it takes to completly heal stress fracture without a surgery!

  18. Hi, it’s been almost six weeks since i smacked my knee and was diagnosed with 1mm depressed, non-displace TP Fx. I did NWB completely for 2 weeks, RICE, then it felt fine and started walking again regularly 3 weeks in. I’m wondering if this was a bad idea, it feels OK but gets stiff and sore at the end of the day. I want to return to running/cycling ASAP but now worried I might have worsened the fracture after doing research research on this.

    • Nonsurgical treatment for a nondisplaced tibial plateau can be appropriate if it can heal in the appropriate position.

  19. Hello,

    I was was diagnosed with bilateral tibia plateau stress fractures about two months ago. Since then I have done several things to help myself recover, sitting, non weight bearing for a month, crutches, wheel chair etc… I was recently told by my doctors to start putting weight back on my knees by using crutches or a scooter and also by walking around my house. Now, my question is; are my knees and shins supposed to hurt when using crutches and walking around the house? I know I will have some pain, since I have not been using my legs, but my knees, shins and ankles all ache. Is this normal?

    • Generally patients don’t have much pain, but I suppose that increased stress from new weightbearing can cause a patient to have discomfort.

  20. I began running in February after being mostly sedentary. I thought that I had shin splints, but the pain didn’t go away. I stopped running in April, and then accidentally slammed the shin that was hurting into a trailer hitch on our truck. It didn’t hurt to walk, but it did hurt going up stairs. I finally went to the doctor a week ago, and there was a visible fracture on my tibia. The doctor said that it is 50% through the bone. I’m in a boot for 6 weeks with crutches, but I was told that I could put as much weight on the leg as is comfortable. It didn’t hurt to walk before I started wearing the boot, but with the boot, it hurts to walk. Also, I have a Stinging pain at the fracture point sometimes when I am resting it. Is this normal? Should I be concerned?

    • It is hard to say without being involved and seeing the x-rays. Soreness at the fracture site can be common as a patient starts bearing weight, but it is hard to say if it is problematic in your case specifically.

  21. About 14 weeks ago I was diagnosed with a tibial plateau fracture. I’m still at the non weight bearing stage because it is still not healed. At this point, is surgery a better option? To ensure that it’s strong ?

    • If an orthopaedic surgeon determines that a fracture isn’t healing, then surgery to put plates and screws in and possibly add bone graft con be considered. Surgeons often have different opinions in when to abandon non-surgical treatment and proceed with surgery.

  22. Hi, I went to the sports medicine doctor because I had a vague discomfort in the arch of my foot after running 20 miles. I didn’t think it was much to be concerned about but wanted to be cautious because I had a marathon in two weeks. When I went in, the doctor sent me for an MRI, and it turns out that I have a tibial stress fracture. The crazy thing is I have never felt pain in my shin while running and it doesn’t hurt at all. The doctor squeezed the spot where the fracture is showing up and I definitely flinched. But, I am wondering how is it possible that I have a stress fracture that I can’t even feel?


  23. Hi,i have had a tibial stress fracture for about 6 months now and i have tried everything other than surgery to heal it, but ive got nothing. ive went to many doctors about it and i get the different results everytime. Im a 16 year old boy that plays football, basketball, track, and baseball. What i have came to is the fact that im going to have to have surgery on it. The surgery would be the rod in my shin, but ididnt know what i would have after for the 4-6 months of recovery time. Do you know if i would have a boot or if it would be a cast? Or possible anything other than that? I need a reply soon if you could thanks.

    • Generally once the fracture has healed after surgery, the patient doesn’t use a cast or a boot. Often he does wear a boot in the early recovery phase.

  24. Hello, i was training for niece marathon and 5 weeks ago i had pain in the calf and shin i had a mri done and it showed medial stress syndrome stress injury to the proximal diaphysis also grade 1 staring to calf Sunday would be 5 weeks still feel some pain in the local area Do you think i can hurt myself if i run the marathon on sunday??

    • It is possible to aggravate a calf strain and cause further injury. Plus those can be painful injuries to try to train or compete with.

  25. I went to the orthopedist and got an MRI for pain in the upper tibia, outside of the patellar tendon area. Thought it might be patellar tendinitis. The ortho found a small stress fracture and just told me not much to do other than rest and maybe vitamin D. It’s been a month or so and still pain when I press that area. Do you find it odd that he didn’t prescribe crutches? I’m wondering if I’m delaying healing by walking around.

  26. I have a tibia stress fracture that I fought the pain for 5 weeks prior to seeing a podiatrist who confirmed stress fracture via mri and booted me for four weeks. The pain seems to be unchanged and the pinpointed pain area seems to be even higher up by leg.

    I am type 2 diabetic, could my diabetes be preventing me from healing and maybe even contribute to the injury site expanding? Can a fracture lead to any type infection?


    • Diabetics can be slower to heal fractures. Generally they aren’t at risk for infection unless there is an open wound.

  27. My mother suffered frm right tibial plateau hairline fracture around three months back when she was hit by a strong wave on the beach..she was on complete bed rest with cast on her leg ..now her fracture has healed but still she’s unable to walk..she’s getting physiotherapy sessions but she’s hving a really hard time walking she can walk with the help of a stick or walker can easily flex and extend her leg bit wem she tries to walk without any support she’s unable to do it..her ankle hurts as well..y is it so ?

  28. I have a tibial plateau stress fracture. I am on crutches, no weightbearing, I have a j-splint that I wear except to shower and sleep. I am having a burning/stinging sensation on the outside of my knee where the fracture is. Should I be concerned about this. I am 55 and do not want to deal with this the rest of my life.

  29. Hey DR. I have been dealing with a Stress Fracture in my right tibia probably 3 inches above my Medial Malleolus for about 11 months now. I went to a Nurse Practitioner last year in the middle of basketball season as I play high school level. I got an Xray and she said it was just shin splints and i was Cleared. I continued to play for about another month until I could not bare it. I went to my Sports Med. Doc and got a MRI and my leg was on fire. I got booted for six weeks and then I was cleared. Only my leg started to hurt again after a few days. SO I just kept going on for about 3 months then I went back after reading about how a dead space can form. So I got the boot on again and used crutches for 3 weeks out of my 6 in the boot. Now i go to physical therapy but my leg still bothers me when im sitting down in the same spot. i think its muscular pain and not my bone as i think it was musclar pain the second time i had it on but i mistaked it for bone pain. Sometimes my feet go numb and I was thinking maybe compartment syndrome as well. What do you suggest i do.

  30. Hello doc….
    I had an accident on april 2015 on which my tibia and fibula were broken..it was a displaced fracture. Doc inserted ha rod with 2 nail above and 2 below…but there is a small gap remain which are not healing…iAm very worried plzz kindly give me some suggestion..

  31. My daughter is a college level soccer goalie who was experiencing leg pain around the knee and was limping. The trainer diagnosed a tight IT band and patella femoral syndrome. She kept her eligible to play for over a week until my daughter decided not to play and rest her leg because the pain was increasing. After 3 weeks of her initial complaint she was sent to the doctors who took an x-ray and MRI. He diagnosed, delayed healing tibia stress fracture. She is now non weight bearing 6 to 9 weeks. Any input or information regarding recovery would be appreciated. Does ultrasound or pneumatic compression device (splints) help with the healing process? Thank you

    • I wrote an Ask Dr. Geier column about these injuries, so you might check that out. As for ultrasound and e-stim, there is debate about the effectiveness of those devices for healing, but they can’t hurt. Some tibial stress fractures need surgery if they don’t heal appropriately.

  32. Hello Dr. Geier. I’ve had several tibial stress fractures over the past year. I’m a 37 year old woman who is slightly overweight. I took up running for weight loss and discovered I really enjoyed it. I never had much pain, but after about 6 months of running anywhere from 2-5 miles 3-4 times a week I started to have numb feet. I went to the doctor who sent me for a bone scan that showed I had multiple fractures in both the proximal and distal tibias of both legs.

    I stopped running for about 10 weeks and was given the go ahead on week 11 to gradually start running again. I only had gotten back up to about 30 minutes of jogging when I had the same numbness. I went back and confirmed this time I had stress fractures mid tibia in both legs. I gave it a full 15 weeks of no running and was cleared again. This go round, I went to two different orthopedists.

    I’ve been super gradual and careful now not to run back to back days and to alternate walking and running, never running more than a mile without stopping to walk to evaluate how things feel. I even had a running gait analysis done to make sure it wasn’t a mechanical issue. Both my shoes and gait checked out ok. I woke up this weekend with a numb foot and very sore shin splint in my right leg. I feel reasonably certain this is another fracture.

    Is there a certain test or type of specialist you recommend? I’ve seen 2 orthopedists and my family doctor along with a running gait specialist at my gym and just keep getting told to “rest it.” This is the 3rd issue in under 10 months. My last orthopedist insinuated that my weight was causing the fractures and that I needed to lose 30lbs before running. That’s a catch 22. I’m running to lose weight (and because I enjoy it).

    I’d appreciate any advice you would care to offer.

  33. Hi Doctor,
    I have a broken tibia which is near ankle. My doctor advised me to put on cast boot. He also said me that bone was not misplaced so there is no need of sugary. But, I feel more numbness in my fingers and more heavy when I use those boots. I feel more comfortable with stretching band that are used for sprain. Please let me know what I can do in this situation.
    Thanks in advance for your advice.

  34. I fractured my left tibia around July 25-ish and i had crutches from mid-August to late October, but I’m still feeling major pain. I only had a knee brace, so now should i be getting a cast on instead? I’m 14 in 8th grade and i hurt myself from marching band.

  35. i was diagnosed with a stress fracture in my left tibia. it happened when i did a lots of skipping. the fracture showed up in an xray. my doctor puy me in a boot type cast for two months.
    but accidentally i stepped on my injured foot the 9th day when i slipped while walkin with a cruch.
    i am feeling a little bit pain in the fractured bone since then.
    are there any chances that i have hurt it again? will the damage done (if any) be confirmed when i see my doctor again
    after 2 weeks?

  36. Hi my son recently had an accident and fractured his tibia, he has a splint on it now and he has it elevated all day except when going to the restroom but when he gets up to go to the restroom he complains of a pretty strong burning sensation, is this normal?

  37. When does RICE cease to become effective? Wouldn’t ice hinder healing? I’m on Medical, and these doctors just seem incompetent. I just went for what I’m quite sure is a stress fracture upper tibia, from running, and he prescribed RICE and ibuprofen, both of which I’m under the impression are for soft tissue damage and inhibit healing/circulation. Can you clarify? Shouldn’t he have prescribed crutches? The pain in my knee is considerable, and I’m quite sure it isn’t any kind of soft tissue damage.He also ordered an X-Ray, which does not show stress fractures, and the way their system works it’s going to be at least a month – 5 weeks before I can see an Ortho doc. I’m afraid this injury may heal incorrectly, if I go that long without a specialist advice. Medical sucks.

  38. I stopped running for 9 weeks after being diagnosed with a stress fracture, but starting back slowly now. I have only done 2 short runs at this point. I just touched my tibia at the site where the stress fracture was, and it is a little sore. There was no discomfort when running. Is it normal for the area to still be tender for a while upon resuming running, or is this a clear signal that more time is needed for healing?

  39. 45 yr old healthy runner & have developed a stress fracture in a tibia that already has a rod in it.
    Bone scan is hot.
    Endocrinology is fine.
    Now what??
    Haven’t run in 6 months & being told to wait 6 more. Seriously? Waiting is all there is?

    • Hey, I just wanted to say that I also have a stress fracture in a leg that already has a rod in it. Did your doctor say anything about why it happened? How long have you had your rod? Mine was fine for years before this occurred, and it seems like everyone says that this is impossible–to get a stress fracture in an already rodded bone. Clearly, however, it isn’t.

      • I also have a rod in tibia from accident 7 years ago, now have a stress fracure at the old break site( mid leg). I am not a runner, just an active 54 year old weighing 110 lbs. I dont know how it happened, just started having pain that gradually got worse. Went to orthapedic surgeon, had xray that showed nothing, then had bone scan, that showed the stress fracture. Dr now suggests that I see a traumologist. Not sure what they do, but willing to find out to get rid of pain.

  40. I’ve recently been diagnosed with a tibial stress fracture on my right leg and it hurts when I put any weight on that leg. My doctor said that if the pain gets any worse then I will need to wear a boot. It seriously hurts to walk from class to class everyday and I constantly have to stand or walk around, but it makes me nervous because I know that it can turn into a full break. Should I be wearing a boot already/could I ask my doctor if I can go ahead and wear one? And are they very expensive?

    • Usually insurance pays for the boot, so I don’t know how much they cost out of pocket. They definitely can help with leg pain from a stress fracture.

  41. Hi, I’m a teenager who enjoys sports! About 2 years ago, I was diagnosed with two stress fractures on my left tibia. They suspected I may also have exercise induced compartment syndrome (although no tests were performed). They didn’t put me in a boot or anything, but it did take 9 months to heal the first time. I then returned to activity and everything was great for a few weeks. Towards the end of indoor track and into the beginning of soccer, my leg started to hurt again. So I rested again and refrained from an over amount of activity. I have done some physical therapy to help the muscles. This is now the start of soccer, and yet again my leg hurts down my tibia and now my right leg is starting to hurt. Is this normal? I’ve had an MRI with contrast, countless X-Rays, and months of rest and rehabilitation. Yet, nothing seems to help get rid of the chronic pain. Is there something else I can be doing? Do I have any other options? Is there something else my doctor can do to help my leg(s) heal?

  42. I was diagnosed with a proximal tibial fracture the first week of December (2015)–my MRI report stated no more than 30-40% of the bone was affected, I completed about 9 weeks of rest and very limited light exercise (including 3 weeks in a double hinged brace), 6 weeks on the Alter-G treadmill (beginning at 50% and completing at 80%), and am now about 3ish weeks into a running/walking plan. While running, I have had no sharp pain at or near the site of the fracture, and haven’t had any tenderness at the fracture location the following day. I did however notice a spot lower on my tibia that is somewhat tender to the touch (not a light touch, it takes a deep poke to find the tenderness). I do not feel any pressure in the lower leg like I did before the onset of the stress fracture. Could this tenderness be related to the fracture that was located about 4 inches above it? Is it common for people to feel ‘pressure’ or ‘iffy’ about their healing when inclement weather rolls through the area?

  43. I have pain when i play basketball in the medial tibia region. I can pinpoint the exact part that has pain. As i press on that area i feel pain but nothing too unbearable. As i play basketball i begin feeling pain in my legs that worsens over length of activity. I’ve had 2 x rays and it didn’t show a fracture. Any idea if it might be something else?

  44. Hi David,
    I am a 24 year old female Ironman triathlete and final year medical student from Australia. I have been suffering from a posteriomedial stress fracture (confirmed on bone scan) on my left and a similar feeling on the right.

    It has been a year now since I first experienced the pain and I have had periods of up to 2-3 months without even walking or riding and it doesn’t seem to be getting any better.

    I am eating well, in a healthy weight range, have been to see a number of physical therapists and doctors that have all given me similar advice. I returned to running after 6 weeks of minimal weight bearing via gradual increase in walk/run intervals from 30 seconds up to 10 x 1 min run, 1 min walk.

    I still cannot complete these 10 intervals without feeling pain in my legs. I am wondering if I have done permanent damage or if there is something I might be missing.

    Any advice is appreciated.

    Kind Regards,

    • I don’t know that anything jumps out at me. I have seen a number of competitive female athletes in their teens and 20s with osteoporosis seen on bone density studies despite being otherwise healthy. I hope you get better, Charlotte!

  45. I am a 53 year old active male who plays ice hockey weekly, bikes 12-15 miles (15mph) 3x per week, and runs 3-5 miles (9:30 mile) 3x per week. This has been my routine for many months.

    On JAN 31, during a flat run on a cushioned treadmill, I felt a sharp pain just above my ankle on the inside of the tibia. After two weeks of rest, I attempted a short jog but stopped after one stride due to the same sharp pain I initially felt. Following another week of rest, I woke up FEB 20 to swelling and bruising in the area of the initial pain.

    Saw my physician, who diagnosed a stress fracture and put me in a walking boot, and sent me for an X-ray and referral to an orthopedist. X-ray was negative and orthopedist also diagnosed stress fracture, and sent me for MRI.

    MRI was denied by insurance company, so I stayed in the boot for a month. Follow up X-ray with orthopedist on MAR 29 showed signs of bone growth mid-tibia, with pain on pressing in that area (not the initial site of pain). Orthopedist diagnosed second stress fracture site and again ordered MRI, and put me on crutches to be non-weight bearing as much as possible.

    MRI approved and performed APR 8. Findings compatible with stress fracture, as there is abnormal hyperintense T2 signal within mid to distal shaft of tibia. Cortex appears intact. A few areas of abnormal hyperintense T1 signal.

    Orthopedist said if I was a 20 year old athlete, he would recommend surgery without hesitation. He does feel a surgical solution is best route with me, as I would like to resume my active physical life.

    My concern is that almost 2 1/2 months after initial injury, my pain is increasing rather than decreasing, both in quality/quantity (throbs constantly now as opposed to initially intermittent pain) and location (now extends to Achilles’ tendon area and heal when I bear weight on the leg).

    Do you feel surgery will get me out of pain and on the road to recovery sooner than just sitting around waiting for healing? Is my age a contributing factor in this decision? I’m looking for the BEST way to relieve the constant pain and the BEST way to get back to being active.

    Thanks in advance for your comments.

  46. I had a tibial stress reaction at the end of my indoor track season. I had two weeks left in the season and I finished it with great performances. I then took off three weeks and am now returning to running, but my shin still really hurts just as bad as it did during my indoor season. I have a national title on the line this outdoor season, can I finish this season without my performance suffering (it ends June 21)?

  47. Hi David,

    I am a 30-year-old male middle distance/long distance runner. I was diagnosed with a tibial stress fracture about seven months ago. After about four months of nothing but cross training without any pain, with the doctor’s green light, I tried to get back into running every other day on soft surfaces. While I have not had any noticeable pains running, nor is the bone tender to touch anymore, the leg feels much different than the other, like a dull soreness that does not seem to go away. Is that normal, or is there a chance the bone is still not fully healed or did not heal correctly?


  48. Dear Sir i had a lateral malleolus fracture two line showing on x ray and its operated in normal cast. After six weeks my cast was removed successfully and doctor told me bone is healed and you can walk without crutches. But on x ray two line still visible in x ray. Now i can walk or should i wait 15 more days to heal completely.i am trying to put some weight with the help of crutches.

  49. hi. ive been in the army for about 3 years. in 2013 i was told i have shin splints…but then it gradually turned to stress fractures. it still hasnt healed to this day even with self healing and recovery. whats my next option?

  50. I received a very strong kick on the inner side of my shin just above the ankle bone. I noticed after several days there was a bump in the same area. I can walk and run ok, it hurts only when I press hard on it. Am I fractured? I haven’t gotten the x-rays done given the fact that it doesn’t hurt when I do exercise. Please advise.

  51. I am a male professional track and field athlete (high jumper). I have been diagnosed with multiple stress fractures in my tibia (jump leg). After 2 months of using the bone stimulator the ct scan showed a small amount of healing. Now I face with having the surgery. If the surgery is completed correctly should I be able to high jump at a high level? I don’t want to get the surgery if my shin will never be strong enough to take the impact of me applying force to the ground to high jump at a high level..

  52. Hi,
    I am a 27 year old male. A couple of months back I pushed myself on treadmill. Though it wasn’t much but it was over-exertion for my body. I felt some pain in my shin but ignored thinking it as normal muscle pain. I reduced my run but kept playing Cricket a lot.
    Two weeks back I felt that I am limping while running so I stopped playing completely.
    I don’t feel pain while walking, sitting or when on bed but running is still affected. I feel pain when I try to push my fingers into the leg (near bone) but its not unbearable when bone is touched.

    I read on certain forums that shin splint or stress fracture take about 4-6 weeks of rest so I am trying to do that. I am just walking around 5-6k steps a day for office / daily activities.

    Do you think it could be a serious injury even when I don’t feel pain while walking?
    Can I continue walking and wait for around a month to see my leg condition if it improves?
    What would you suggest about this from your vast experience?

    Thanks in advance.

  53. Hi, I am a high school cross country/track runner. In January I started experiencing leg pain in my left calf. I went to the doctor and nothing showed up on the x-ray, but he pressed on my leg, and it hurt a lot, so he told me I had a stress fracture in my left tibia. He told me to take a month off from running and didn’t put me in a boot because I didn’t hurt me to walk. I started to run a month later, and I had the same pain as before, but in my right leg. So I went to the doctor again and nothing showed up on the x-ray, but he pressed on my legs (both of them) and said I had both a right and left tibial stress fracture. Again, he did not put me in a boot because it didn’t hurt to walk. He told me to not run for 2 and a half months. Just recently, within the past week, I have been getting leg pains in both legs (still not running). I’m thinking about going back to the doctor, but I was wondering if it would be possible to be in two boots. If so, would two boots be pointless because my thought is that a boot, in general, is meant to put less pressure on ONE leg/foot and not two. Thanks.

  54. Dear sir,
    I have stress fracturein lower leg from last month when fist i take xray in 20 days ago then i saw my bone is very weak and major crack in two places and take medicine but after 20 days i again take xray and i saw my all cracks are fill but 1 is left and its the sign of tibia what i could do. Its very painfull and how much time i am going to running back.

  55. I am a 53 year old female. I had arthroscopic knee surgery and 3-4 weeks after the surgery started having pain in 1 spot directly below the knee.This pain made walking difficult. Xrays showed nothing, MRI showed stress fracture of medial tibial plateau. How common is this to have a fracture following surgery?

  56. Hi sir good morning, I had met with an accident about 16 months, tibial fracture happened,doctors did surgery and inserted 3 hole plate in right leg,now I am ok ,but not able to run, my question is shall I go for removing plate from my leg. Please give me answer

  57. I had a car accident last week. I live in a rural area and local hospital did an x-ray that shows a 1cm fracture on top of tibia. They gave me a knee brace and said I must use crutches for 6 weeks. Is this really necessary can’t I stop when the pain subsides? Is there any long term possible problems? Should I go to a big city hospital for better check up? Thanks

  58. I am a 67 year old woman with a stress fracture apparently caused by too much aerobic exercise (6 days a week). It happened in early April but was not diagnosed until May. I wore a boot for a month, which really helped but now, after 4 months I still have a swollen ankle and pain when I walk. Is that normal? Should I go back to wearing the boot?

  59. I rolled my ankle this week while running, it did hurt but I was able to finish my run. The next day I started feeling a pain in my lateral shin, which I guess it’s my tibia. I have a half marathon next week plus I have a full marathon coming up at the end of September. I am icing, compressing, resting from running. I’m swimming and will start biking so I keep active and I don’t lose form. woukd of think that what I’m doing is ok? I am not sure it is a stress fracture of if it is just my muscle that received a sudden strep check when I rolled my ankle. What do you think it might be?

  60. I am 14 years old, and do tumbling and acro. I’ve always had knee pain and I wear braces. It has recently gotten a lot worse and 6 days ago when i landed a flip, my tibial plateau just shattered. The doctor said it is a stable fracture and I don’t need surgery and I was given a brace from my thigh to my shin and no weight-bearing for 6-8 weeks. As of yesterday, using my crutches is absolutely agonizing. It feels like my leg is carrying too much weight on it. Do you think I pulled a muscle or my bones shifted? Also could I possibly be permanently affected by this injury?

  61. Broke my left tibia five months ago, metal rod was inserted to fix the bone and now i am walking with a limpness . My queastion is in how much time this limpness will go? Is it going to be permanent?

  62. Hi there, I was diagnosed with a stress fracture just below the left knee in May. With it being Sept now I am still feeling pain but I can walk on it. If I am on it for more then an hour or so I get pain and stiffness. Should this still be happening after 4 months?

  63. I dislocated my knee in January, it is now september, since I have returned to my gymnastics practices, on the top of my tibia almost to my knee, my leg hurts whenever I run, jump, or land anything on it. Could this be a possible stress fracture?

  64. Hi,
    I am a runner and after a race this past Saturday i have had this horrible pain in this one area on my tibia..I went to the trainer at my school and he thinks it is a stress fracture and that i should go to the Ortho. I know if the pain is in one general area that it is most likely a stress fracture and it is in one area. When somebody presses down on that one area its very painful.. Do you think it is a stress fracture? because i don’t want to pay to go to the doctor and then there be nothing wrong but i have had a stress fracture before, but this time it hurts worse so it most likely is. Will they put me in a boot or cast? i don’t know what to do ahh!!

  65. My 18 year old gymnast daughter has tibial dreaded black line in her left tibia. Has had this going on for almost 2 years. Is on a college gymnastics team. She recently had an xray and is back in a walking boot to get around campus. She is still training and conditioning with no real jumping or running. They are asking for blood work? in the past they were checking vitamin D deficiency. is there anything she can do at this point to aid in healing and or will this ever heal completely,Could this possibly be caused by an auto immune disease?

    • Some athletes with the dreaded black line on x-rays of a tibial stress fracture actually undergo surgery to treat it. I have never heard of an autoimmune disease causing a stress fracture, but I suppose it’s possible. Usually it is related to too much stress or poor bone density from not eating enough or having irregular menstrual cycles.

  66. I am a Military veteran and I was diagnosed with stress fractures in the left tibia, right foot and right leg during my time in service. They would heel and come back. Had a cast put on my left leg but after it was taken off the pain returned x-rays showed it was consistent with healing but the pain persists now I am having problems with my hip and lower bag is this normal from years of walking transferring weight from one leg to the other because of the pain in legs and feet

  67. I was diagnosed with a tibial stress fracture about 8 years ago… and was only told to use crutches if it hurt and avoid exercise. Over time the pain greatly lessened. Over the last several years, the pain has increased to where , at times it feels like my leg could just split if I step further. The extreme pain is not constant, however… it happens even if I am just walking in a store. I am limping in no time. I also feel gnawing, burning pain when resting. I cannot exercise anymore. I must also note … I was a former athlete… and I do have bone on bone in that knee and will eventually need a knee replacement… but this tibia area gives me more pain and trouble than the knee. I have had a new… negative X-ray…

  68. My son runs Cross Country and began having pain in his tibia a few weeks ago. The pain is very localized and is on the inner side of his leg. We have seen two different doctors. Xrays were negative for a stress fracture. He was given Mobic and told to cross train along with tape. The pain has gotten worse over the last couple of weeks. There is pain even with walking. He has flat feet, so we added insoles as well. Could this very well be a stress fracture?

    • I just went to the sports Doctor today, and I have the same symptoms. I am a high level competitive gymnast though. My doctor said to back off and cut my repetitions way down because I have a meet coming up. He said if I wasn’t about to start my competition season, he would say, no pounding or running at all. I was diagnosed with a “pre-stress fracture”. If I do too much, I will end up with a fracture. Also don’t take pain medication to make the pain go away. He recommends me feeling my pain so I know when to stop. Hope this helps:)

      • I have a double stress facture but my xrays came back negative for a stress fracture. it wasnt until i had an mri that the stress fracture was seen. if an mri is a possiblity i highly suggest you go for one

  69. I have had 2 stress fractures in the past 3 years years all caused from track. The first one was understandable…happened at the end of my track season and we thought it was shin splints but turned out to be stress fracture so I was in a walking boot for 4 weeks and did no physical activity during that period. Then in decmeber of that year i got another stress fracture which i did not expect because I had taken the time to come back slowly form my injury so wondering what is causing this? Continuing to have pain in shin a year after stress fractures happen. Have tried physical therapy and claf sleeves and custom insoles for shoes.

  70. Do you ever see cases of tibia nonunion stress fractures (from over use) that are able to heal on their own to the point that the person returns to running? My Ortho admits he has limited experience with this type of [rare?] injury.

  71. I was diagnosed with a stress fracture a couple months ago. My doctor said no activity for 5 weeks and I complied. I play basketball and have been released for about a month now and pain is starting to come back. At first, it was just slight pain every once in awhile when I landed hard or stepped hard. Now it is every time I jump or land on it and pain has been starting to show during jogging as well. If I go back to the Dr. what do you think they might say?

  72. My son was running track and x-country in college on a track scholarship. He recently suffered his 5th stress fracture to the same tibia in 4 years. His college running days are over but he would like to run for recreaction. He been to numerous doctors. Do you have any recommendations for a specialist in stress fractures of the tibia? We live in Colorado. Thank you

  73. My name is Ricardo. I am a 16 year old basketball player. When I was 14 i broke my tibia straight through. Screws were planted in my leg. After a year and a half they took them out because the doctor said it was no point in the screws staying if my bone is healed. I recently got a stress fracture in my tibia same leg on December 14th of 2016. My doctor said no weightbaring for 5 weeks so he put me on crutches. I listened to him I came back after 5 weeks and it was not healed. They then asked me to proceed with a surgery which required a plate going into my left outer part of my tibia to relieve the stress off the right side because that is where the fracture is. Its been a month now since I got the plate inserted my doctor told me stay on crutches but I have 0 pain no pain walking around the house of course i use the crutches when i go outside but I feel as if I don’t need them and my appt is 2 weeks away. What would u suggest? If it is not hurting does that mean I am healed? Thanks doc I really want to go back to sports

  74. Over the past two months, I have had very bad pain from my left tibia. I went to my orthopedic doctor and when he pressed on my shin I about came off the table. He gave me a boot and I wore it for 2 weeks. He told me to start easing out of it but I still had terrible pain. I had an MRI done 4 days ago, and it turns out there are multiple stress fractures/stress injuries still. He wants me to keep wearing the boot, but I feel the boot is not working. The pressure is only applied to my ankle area and not my tibial area. I asked if crutches would be better but he said the boot heals it faster. Do you think I should be using crutches? It hurts in the boot a lot and I feel not putting weight on it all would be best.

  75. I am slightly overweight and just diagnosed with upper tibia stress fracture just below the inside right knee. They will be putting me in a walking boot or air cast soon, or perhaps crutches. It will be extremely hard for me to do crutches. Will I be able to work during the healing process? I do have a few stairs I have to climb during my work day.

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