While my daughter currently doesn’t ride, she does run track and just recently was diagnosed with a grade 3 stress fracture in her right shin. She is going to have to have surgery to insert a plate with some screws to stabilize the leg. Has anyone had this surgery? How was recovery and rehab? I figured that those in the horse community have a pretty good chance of having suffered some sort of fracture similar to this, and I’m just wondering what we are really looking at in terms of recovery, from people who have actually gone through it (not just what the surgeon is telling us). Thanks in advance!
Hmm. Horses get these perhaps.
Riders are more likely to get fractures from impact, either falling off or getting kicked. Not stress fractures like runners.
2 Likes
Ouch. I personally have not dealt with stress fractures. But both my sister-in-law and my brother have. They were both professional classical ballet dancers into their mid 30’s. (Both principal soloists for the major Canadian ballet company) Because of their jobs, they kind of worked through them. (I know, BAD idea). They will pay for the rest of their lives.
Because of that, I would strongly advise that you and your daughter look at it at a broken leg. Because it is. Take the time for it to heal. She is young, four to six weeks or even eight to twelve is not the end of the world. Evaluate her diet (often a factor for stress fractures). Also her shoes. No shoe, no horse. Same thing for people.
7 Likes
Wow, ouch. I’ve never known anyone to need surgery for a stress fracture - is it displaced? Most people I know who have had them did not have serious fractures and were able to recover by taking time off from running, getting PT and doing things like swimming in the meantime.
Once healed I would definitely re-evaluate the training program as they are almost always an overuse injury. And make sure diet is appropriate for the sport. Also, I had a run gait analysis done last year and I wish I had done it 20 years ago. My run form is not bad but over time even small imbalances can lead to injury. Proper run form and well fitted shoes make you faster and greatly reduce the chance of injury. A good physical therapist can do this with video and a treadmill. Sometimes it needs to be in slow motion to see minor imbalances.
Good luck and hope it heals well!
7 Likes
Stress fracture in runners can be a result of overtraining or a too rapid change in protocol .
Diet and hormones can be a factor. Shoes can be a vital part prevention.
Get the best rehab coaching possible.
Wow, has conservative treatment already been attempted, and failed?
Given the relatively high complication rate, it would be worth pursuing a few opinions here:
Here’s some more useful info, there are some labs to check and consider her vitamin d and calcium intake:
3 Likes
Maybe I’m just sheltered, but I have never heard of someone getting surgery for a stress fracture. Rest, PT, and swimming were the ticket.
Is your daughter on hormone medication, or anything related to transitioning, that could be a contributing factor to the rapid decision for surgery? Seems a little “from the hip” to me?
1 Like
No this is isn’t my trans daughter. She WAS low on vitamin d about 6 months ago but has been on doctor prescribed supplements for it.
I was told that the stress fracture is severe enough that they expect there to be complications with healing if we try to heal without surgery. Apparently, she has less chance of reoccurring issues with it if we go with surgery.
Basically what happened is she had a shin splint, and she didn’t tell any of us how much pain she was in and was just taking ibuprofen and using bio freeze to mask her pain. She runs and does hurdles. The last race she ran in (100 meter dash), she had a severe pain and about went down. We ended up in the ER that night, but we didn’t find out it was a stress fracture until about a week later when the specialist ordered an MRI.
I worry about rushing to surgery but from what I’m being told (by the doctor), is that this is our best option. I tried getting her into a second Ortho but it’s a long wait to get in, and in the meantime my daughter is in pretty severe pain. I did call her doctor and she said with a a grade 3 fracture, if the doctor suggested surgery more than likely she needs surgery. But she’s obviously not a specialist.
2 Likes
Take some time on pubmed and read the literature. Absolutely get a second opinion or two. Even with plating, return to sport looks to be 12 + weeks out… Attempting conservative therapy seems prudent.
Surgeons vary, often a lot, in how aggressively they treat. They’re surgeons because they like surgery. And they’re selling something.
No one is as concerned about your daughter’s recovery and long term outcomes as you are (and her, but you’re better positioned to make rational decisions!) Pause here, speak to a few other doctors, including non surgeons, (a sports med person would be great) and make a truly informed choice on moving forward.
5 Likes
Well I called around to the same orthos I tried to get a second opinion with last week and was able to find one that had a cancellation tomorrow! Previously no one had any openings for over a month. And they are willing to give a second opinion. If nothing else at least it will just put my mind at ease that what I’m doing is the right thing (or not).
12 Likes
Oh that’s great news. I would definitely agree that if possible, having two orthos give opinions on this is better than just one.
I’m sure it’s still painful, but not sure whether the surgery will be less painful or not. Is she on crutches? Anything else right now (brace, ice, meds)?
4 Likes
She has been on crutches since the initial visit to the ER on April 20th. She is not supposed to put any weight on it. She is keeping it wrapped when not sleeping, and we are icing and doing ibuprofen, keeping it elevated as much as possible. Unfortunately nothing seems to alleviate the throbbing pain though, she’s had a hard time sleeping and she’s pretty grouchy at this point (even grouchier than your typical 15 year old). But this is all the ortho said we could really do for it right now. It is bruised and swollen still, too. Poor girl is tough though!
I’m also questioning the school’s training methods. I think their conditioning of the girls is severely lacking, and they don’t have an actual track so they have just been conditioning on a concrete parking lot. Of the ten girls who started the season in February, only 4 are not injured and not out of the season at this point, for various injuries. I’m sure track and field injuries are somewhat common, but to have more than 50% out injured to me just seems like a pretty high number?
My daughter started hurdles over barrels because they had to find someone they could get hurdles from. They only trained my daughter on the barrels for one day before they sent her into a competition to run the 300m hurdles. She has only had half a dozen training sessions over the hurdles, but has been competing on them. My daughter has smoked the competition but I have no idea if she’s doing it with proper form or not…which could have very well led to this fracture (along with her being stubborn and running on shin splints and not telling anyone). The coaches are both very young, and I’m sort of questioning their methods if all of these girls are getting injured.
4 Likes
NSAIDs actually interfere with bone healing, increasing the risk of non union, which is exactly the opposite of what you’re looking for here. Did her team rx the Advil?
I would be really concerned with it, since you already have a chronic non healing bone issue.
That’s FAB you’re getting in to see someone else!
5 Likes
The ortho himself said to take Ibuprofen for the pain…wow! Well, it’s not really been helping either.
Yikes. Tylenol does not carry that same risk (it’s not an NSAID) and may provide better pain relief.
For adults, there’s a max dose of 4 grams/day, not sure where teens sit, but def don’t exceed that. Hope it helps more than the Advil!
1 Like
Here’s another NSAID study specific to stress fractures:
Use during training def could have contributed to where she is now 
1 Like
Ouch that makes my shins hurt just reading it.
Was she running hurdles on concrete?
I belong to a beginner triathlon group on Facebook and spend about 50% of the time telling people they are risking injury because they are a) ramping up too quickly; b) not cross training properly; or c) a + b. School sports seasons are so short, they are all ramping up quickly, which is even more reason for proper warmup, cross training, stretching/mobility, etc.
But yeah - lots of other variables - surface is a big one. Asphalt is better than concrete, so when I have the option to run on the road versus the sidewalk, I usually do. It adds up over time.
It’s frustrating and these are adults who should know better. Schools have coaches (in part) to protect their athletes.
5 Likes
Yeah they only “conditioned” for four days before the first track meet. My daughter is pretty fit, but only gym fit. She wasn’t doing running/cardio in the gym, mostly upper body and things like the leg press, squats, etc in the gym. When they train hurdles they train on the concrete as well. Because my daughter is one of the quickest on the team he also entered her in quite a few more events than some of the others…she was running in anything from 3-5 events per meet (usually two hurdle events out of those…she’s the only hurdler on the team).
The week she got injured they went from their typical 1 track meet a week to 3 track meets in 4 days. So the girls had a lot more stress on them than they did in a typical week, as well.
This is nuts, and totally irresponsible.
Do they have “travelling track teams” the way they have other sports, so that maybe you can get her under a competent coach?
5 Likes
