Can I trust the hop test and other self-tests to identify stress fractures?

[Eric Jeppsen]

About a week ago I had some pain in my lower right leg. It was the third time I've felt that pain since I started running, and the first two times the pain went away with a couple of days of rest, cross training or light running. This time, however, I started to worry that I might have a stress fracture, primarily because I had just read an article about Lance Armstrong doing too much running too soon and giving himself a stress fracture at the NY marathon a few years ago. Basically, his cardiovascular fitness allowed him to do more than his bones could handle, and he got hurt.

Armstrong's story hit close to home because I'm also a cyclist who recently switched to running. I started running in mid to late January. I've been running 40-60 miles per week, which feels pretty modest after 5 years of cycling 350-450 miles per week. But the conventional wisdom seems to suggest that I might be running too much.

The pain on my shin is about 5 inches above the ankle, and it comes and goes. I can run on it with out any real problems--I'm not forcing myself to run through pain; in fact, I can only feel the pain occasionally while I'm running. According to several articles, if I have a stress fracture I should be able to feel something when I press on the bone, and I shouldn't be able to hop on the injured leg without pain. I can hop without pain, and I can press the bone without pain, except for a very (very) slight sensation of bruising.

I can't get a bone scan on my current insurance, but I might be able to in a few weeks when I switch to my wife's health plan. For now, I want to know if I'm foolish to continue running, or if I should proceed as long as the pain doesn't become severe. If this is a minor stress fracture, I'll feel very stupid if I don't stop now and have to take some major time off in the future to let it heal. But if there's not a problem, I'll feel just as stupid taking time off and skipping races when I could have been out running.

Does anyone have any advice or relevant experience that could help me decide what to do?

[Scott]

I just got done icing my lower legs before I read this!  I have been running for a couple of years and have been part of this blog for a year (+).  I am training for a marathon in May and recently have had some pain in the area that you described.  My pain is in both legs, outer calves/calf area.  It's painful when I start running, but seems to ease as I get into my run (sometimes it takes awhile - 3 miles or so). 

Anyway, I could write forever, about my issues.  But, what I have found is that it is probably an overuse injury.  I don't think you have a stress fracture, but perhaps shin splints or compartment syndrome. 

I have been making sure to do alot of stretches (before and after) and TLC after my runs (Ice, Elevation, Compression).  I did take some days off.  The combination of these things seems to be making a difference.  I'm not entirely 100%, but feel I am heading in the right direction. 

If you've only been running two months and you're at 60 miles a week, that's quite a leap.  There are experts on here that are way more knowledgeable than I, but I would scale back a bit and let your body adjust to your running.  Again, I don't think you have a stress fracture if the pain "comes and goes" and you can "run on it without real problems".  I think you WILL get a stress fracture if you don't let your body 1) heal, and then 2) adjust to your miles (small increases).

Just my $.02.

[Scott]

Part 2 - There are other posts on here about stress fractures that may help you.  I didn't really answer your question my response above, but perhaps reading through the other posts will get you the information you need.

Good Luck!

[AndyBrowning]

Based on what you have said it doesn't sound like a stress fracture but that doesn't mean that it won't turn into one.  If it were a stress fracture you would definitely feel it when you run.  I had them in the same area and the pain was very pronounced.  Sounds like you are doing the right thing by backing off a bit. 

[Jason]

Hey, I am just slowly returning back to running after being out for 6 months with a stress fracture.  As people have noted, it is always best to listen to your body and get the extra rest before what you have becomes a stress fracture.  When I had mine, I knew it was a sfx even though the doc told me it was tendonitis or shin splints.  It hurt to walk  and it had a tremendous effect on my normal gait, as I was trying to put as little weight on it as possible when I ran.  I did the hop test for my doctor and I couldn't do it at all.  The pain was too much that I couldn't get off the ground without falling.  Be smart, rest it take care of it, believe me you will be happy to miss a week rather than several