Chronic stress fractures and skates

[texspeleo 0]

An early Happy New Year to all of you.

I am about to get out a boot cast for the second time due to a stress fracture in my right fibula. I'm skating in Bauer Vapor XXVs and coming from XXXs. I purchased the XXVs this past summer after my big toe and the one next to it were amputated in an accident at work, and my XXXs began to give me bad Haglund's bumps on the heel of my right foot once I started skating again. My recurrent stress fracture is exactly at the very top of my right boot, just above the outside ankle. I'm 36 years old, 180lbs (probably closer to 185 now that I've been off for 6 weeks) and in decent shape, and 6'0", and just play beer league and pick up games with the local college's club team, totaling 3-4 games a week + 1 practice. I 'm usually a left wing, occasionally center. My inclination is to go buy a new pair of skates with more ankle flex, such as Graf 707s, or Mission AG-X, to take the stress off the bone and put it more on the ankle. I have never had an ankle sprain, and think the ankles are plenty strong for the bigger load. I have a good LHS here with a single owner/operator whose opinion I value very much, to whom I usually take all of my business, and from whom I purchased these XXVs. He is of the opinion that there is no way that the XXVs are causing the fracture, and gets pretty angry with my podiatrist, who also plays hockey, telling me that my stress fractures are most likely from skating. Normally, I would trust my LHS guy first, but my doc seems to know a thing or two as well. I'd sure appreciate some opinions from in the know folks who don't have a dog in this fight. Is my thought process correct in going with the more flexible boot, and are there any other models I should be looking at? Not playing is not an option, BTW. The leg would have to fall off, and there's still sled hockey after that happens.

Cheers, Chris

[duch 0]

I'm neither a doctor or hockey equipment expert but I'd like to help you if I can. My thoughts are you should first allow your stress fracture to heel a bit, back off a little on the hockey as hard as it may be to do. Your body can only take so much and you need to give it a bit of healing time, to shore itself up as it where. Otherwise you may be looking to not being able to play at all when your older, which judging from how much you play is almost unthinkable.

Secondly, yes I would try switching skates. The formation of bumps on your heel indicates to me there is a fit problem with them, perhaps due to the loss of your toes and you need to look into something diffferent or go for a custom fit. The Graf 707 is a good choice because it was designed for players who have had ankle injuries and allows a bit more flexability in that region of the foot. I don't know if the extra flexabilty is preferable to a stiffer ankle to avoid a reoccurance of the stress fracture, you may want to throw that question to your podiatrist. If that is the case the Mission line of skates might also be an option. Otherwise you may need a custom fit done on the foot missing the toes which is a bit time consuming but might also help solve the problem. Keep working close with your doctor and heed his advice. Your health should be your number one concern because its your future. Work with your LHS to maybe find an alternative skate if needed. It sounds like he is pretty informed and can probably fit you into a suitable alternative if need be.

[texspeleo 0]

Thanks Duch. I have dutifully taken my six weeks off in the cast (again), and plan to gradually work back into playing over a couple weeks. My gut feeling is that the repetitive fractures are caused by a stiffer skate boot creating a fulcrum against which my body weight is applied repeated to a short portion fairly thin bone. I'm hoping that the greater ankle flex/lower cut boot will relieve this. I wanted to hear someone else think the same way to reaffirm that I have not lost my mind, as sitting still doesn't seem to be very good for it. I'm still suspicious that there is some angle I'm not considering...

Cheers, Chris

[MLSman 22]

I will have to agree with duch. Primarily due to the loss of two of your toes, I don't believe that any retail hockey boot will help you. It is very possible that your issues may be related to the negative space in the boot and affecting your lateral stability, thus causing your stress fractures on the fibula. Those two digits are very important for stability and load bearing, so the overcompensation to lateral support for load bearing weight would be my guess for your injuries.

My suggestion: if you can, find a good physical therapist that specializes in sports medicine. I would first work on general strengthening for normal load bearing (walking and back to normal use). Once the injury has healed, I would then start weight training to focus on accelerating the lateral compensation. Let's face it, if the fibula cant support the extra weight with properly performed weight training, then it will not be able to support the stress that hockey can produce. A bone is not like a tendon or a ligament that can be supported by a brace, but all of the muscles around the bone can be strengthened to support it.

[fatwabbit 93]

Sorry to hear about the mishap at work Chris, hoping that you heal up really quick. As someone who works in the safety side, I cringe everytime I get a call from one of the managers telling me about something that happened to one of their guys, esp if its an apprentice.

Rest up, and then strengthen up again. It would be difficult to get away from hockey for the rehab time, but keep telling yourself that without the rehab, you might get a reoccuring injury.

Is there a way to get a second opinion from another doctor who knows something about hockey? I'm lucky enough that one of my team mates is a doctor, and he give pretty sound advice. He's a GP, and would give a quick assessment, but normally tells you to get another opinion from an expert in the field or something.

[texspeleo 0]

Again, happy 2009 hockey fans! Everybody ready for the Classic today? As my favorite teams are the North Stars and the Avs, I'm not sure who to cheer for, but I'll sure be watching.

Thanks for some excellent insight, gents. I have an excellent physical therapist who's been helping me with the toe thing since June, and at least prior to the cast and instructions to sit on my butt, stayed pretty active in the weight room. I think maybe i should find a real hockey doc, and see what opinions are given as far a custom skates go. I wonder if I might be able to have a friend put me in contact with a doc associated with USA Hockey, since they're close by, and I may have an "in" or two. My wife is already thrilled with the prospect of my buying another (really expensive) pair of skates this year. Thank goodness she's a good sport.

Cheers all!

Chris