The tibia is the bigger of the two shin bones and since it is a weight bearing bone, it is prone to stress fractures especially in the lower third region. This page will outline the symptoms, treatment and possible causes of tibia stress fractures.
Note: the material posted on this page on tibia stress fractures is for learning purposes only. To learn to recognize and manage fractures, bone, muscle and joint injuries sign up for first aid and CPR training with a provider near you.
The indications of a tibia stress fracture typically include pain, usually on the lower third region of the tibia that occurs after engaging in long distance running. There is tenderness and even swelling over the site of the fracture as well as pain when pressing into the shin.
An X-ray of the affected leg will not reveal any indication of a fracture. Due to this, another X-ray is taken 4 weeks after the first X-ray and often the new bone can be seen where it started to heal.
Close look on tibia stress fracture
The two bones in the lower leg are called the fibula and tibia. The tibia is bigger and responsible for load bearing. The fibula is smaller and responsible for muscle attachment. Either of these bones can end up with a stress fracture. The common site is 2-3 inches above the bony bit on the interior of the ankle on the tibia bone.
The possible causes include overloading the bone by continuous muscle contractions particularly when running. The distribution of stress in the bone changes due to continuous running when the muscles are tired. The muscles could not take some of the stress off, thus they depend more on the bone.
An abrupt change in the running surface such as from grass to road or track can increase the risk for developing a tibia stress fracture. Small impacts on the bone even though minimal can cause the build-up of a cumulative effect.
The individual should rest for around eight weeks as well as avoid weight bearing exercises particularly when running. It is recommended to substitute cycling or swimming if can be done without triggering pain or simply work out upper body strength in the gym. Even running in water with a buoyancy aid is a suitable substitute for running on the road.
Exercises to preserve flexibility and strength in the inferior leg such as gentle calf raises as long as pain is not triggered and wobble balance board training can be done. Training methods must be analyzed to identify if or how it contributed to the injury.
When to consult a doctor
An X-ray on the leg will be taken and the doctor will advise when it is safe to resume the training. Initially, the stress fracture will not show up on the X-ray; however some signs can be seen after 2-3 weeks. Gait analysis can determine any biomechanical issues of the foot that might increase the risk for injury. In most cases, orthotic inserts worn in the shoes can correct foot movement.