Monday, April 29, 2024

“Thank goodness it’s just fractured, not broken”

 


Oh. My. Goodness. My kids know that is probably the easiest way to get me all worked up.

Broke is fractured is broke. No difference. The exception is a stress fracture, which is still a break but usually an incomplete break. In other words, it doesn’t go all the way across the bone. Unless it does, and then it is a fracture. Or a break. Whatever.

Think of a stress fracture this way—if your bone is a tree trunk, then a stress fracture could mean that it is a crack in the bark. Usually stress fractures are the result of repeated stress, hence the name.

If you hurt on the outside border of your foot, about midway down, then it is likely that you have a stress fracture. Or at least the beginnings of one. It’s common in runners and those that jump a lot.

It really isn’t just one thing that causes a stress fracture. It’s the accumulation of impacts that begins to break down the outer surface of the bone. The solution isn’t exactly what anyone wants to hear. You either have to rest or wear a boot. Either way, you’re out of your sport for a while.

But here’s the thing—the earlier you begin treatment (rest/boot), the sooner you will get back to your sport. If you try and run through it, it will get worse. Let me repeat that. It. Will. Get. Worse.

And that’s not what anyone wants to hear. The more you try to play through it, the longer it will be before you get back. Some of those even end up needing surgery. That’s what can happen when you ignore medical advice.

While I’m on it, let’s talk about shin splints a bit. I’ve seen all the “treatments” that are out there for treating shin splints. Icing. Rolling your foot on a soda can. Taping.

Here’s my (strongly held) opinion as a physical therapist and athletic trainer that has been treating athletes for almost 47 years:  If you don’t change the way the foot hits the ground, you are only treating symptoms.

Addressing the biomechanical issues of the foot is necessary to solve the problem, to treat the “why” of shin splints. I’m not saying that treating symptoms is unneeded. We do it all the time. But treating the cause is more important.

Most of the time we are addressing pronation of the foot. Those with flat feet especially have problems.

Shoes are a huge part of it. Because of the risk of litigation, I’ll not mention by name those big, cushy “shoes” that pretty much everybody has a pair of, but those things are terrible. Yes, they feel good when you put them on, but I don’t think they were ever meant to wear all day.  They just don’t give you enough support.

And slides. Sure, there are some slides that have a little bit of arch, but for the most part, they’re terrible. Running shoes, or what my generation calls “tennis” shoes, are the best. Running shoe technology has revolutionized shoe technology in general.

Hiking boots? Completely changed by employing running shoe technology. It used to be that you wore a pair of hiking boots for a couple of years before they were broken in enough to be even remotely comfortable. Now days, you can hike with them immediately off the shelf.

Even dress shoes have embraced some of the running shoe technology, building a better arch and more comfortable foot bed. Now, there are shoes for everything but it’s mostly the outside of the shoe—the inside is still basically a running shoe.

Whatever the problem, if the feet aren’t happy, nobody is happy. So see a professional (and not your local shoe store) for advice if there is a problem.

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