Tabassum Ali, DC, CCSP, CCCN
A tibial fracture can be a result of those involved in a high impact, motor vehicle accident or in sports injuries such as falling while skiing or playing soccer. Anatomically, the calf portion of the lower extremity is composed of the tibia and the fibula with associated soft tissue and vasculature. The tibia is the larger and stronger of the two bones and more commonly known as the shinbone. The tibia connects the knee and the ankle through ligaments and soft tissue. A tibial fracture can have varying degrees of severity and should be consulted with a health care physician. Degrees of a tibial fracture include:
Stable- broken ends of bone stay aligned with minimal displacement
Displaced- broken ends of bone do not line up and are displaced; typically requires surgery
Oblique- break in the bone is at an angle and typically displaced and unstable
Transverse- break in the bone is horizontal, and can become increasingly unstable if the fibula is also fractured
Spiral- fracture caused by a torsional force causing a spiral break in the bone and can be unstable
Comminuted- bone has fractured in more than two places, and very unstable
Open- fractured bone protrudes through skin; will require surgical repair
Symptoms of a tibial fracture:
Pain radiating down into the lower leg
Inability to walk or bear weight on the leg
Deformity and instability of the leg
Protrusion of bone through the skin
Loss of feeling in the foot
When observing the tibial fracture, the clinician should first look for any obvious deformities or protrusions of the skin. Bruising and swelling may also be noted if some time has passed since the injury. The patient may experience pain and report instability of the leg, especially if the fibula is also involved. Further examination should be permitted with imaging, such as X-ray or CT to rule in/out a fracture. Muscle testing and nerve sensation can also be examined to further determine the severity of the tibial fracture. If a fracture is concluded, treatment will depend on the overall health of the patient and the nature of the fracture. With dislocations and breaks in the skin surgical repair is often the treatment of choice, along with casting. Healing time for a tibial fracture can be between 4-6 months and proper care should be rendered to ensure full recovery. Post-surgery or post-casting is the most important stage of recovery for a tibial fracture. During the healing phase scar tissue formation and muscle atrophy has developed and should be targeted. Possible therapy treatments for tibial fracture:
Addressing the soft tissue scar tissue formation in the lower extremity
Plasma Rich Protein injections
Rehabilitative strengthening and conditioning exercises with resistance bands
Approximately 10-12 weeks of therapy will be needed, depending on the severity of the injury, to decrease the pain and strengthen the muscles.
At Lone Star Sport & Spine, we approach injuries in a conservative manner that will give the patient the most weighted benefits. Our providers are board certified chiropractors and certified in full body Active Release Technique. We examine the patient and determine the most effective and fastest treatment plan for them. Our goal is not only to get the athlete back out on the field doing what they love to do, but to also enhance their athletic performance. We address the scar tissue that is formed from micro tears in the tissue due to overuse or previous injuries and develop a program to strengthen and train the muscles to be used functionally. Most all of our patients find results within a few treatments with decreased pain, and increased range of motion, strength, and balance. The second phase of therapy, strength and conditioning, is the most important aspect of the treatment to prevent future injuries.
In summary, to address a tibial fracture:
Address the scar tissue in associated soft tissue
Strengthen and condition the calf muscles to prevent future injury (sport specific functional training)
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