Shin Splints or A Stress Fracture? How To Tell!

Updated: Oct 21, 2021

You're an avid runner. You've run multiple miles every single day for the past few years and you've had no issues. While on a run one morning, you start having sharp pain in the front of your shin. You ice it at home, take a day off running, and it feels great again... until you go for another run. The pain is still there and is getting a little worse the more you try to push through it. "Darn shin splints!" you yell as you finally have to take a day off. But is it really shin splints or something more sinister?


Stress fractures in the tibia, or shin bone, are one of the most common and serious injuries that sideline runners, and if misdiagnosed or left untreated, can sometimes PERMANENTLY affect your running routine!


It Can Be Difficult To Distinguish Between The Two!

Shin splints occur as a result of repetitive stress on the muscles, tendons, and bone tissues around the tibia causing them to become painfully inflamed. While they can occur anywhere in the sin, they are typically felt along the inside edge of the shin bone.


A stress fracture is a small crack in the shin bone. They are a common problem in high-impact or repetitive impact sports like running. They can be felt anywhere along the shin bone, not just the inside where shin splints are typically felt.


Patients with both injuries report the same symptoms: sharp throbbing pain in the shin with activity and may be aggravated even once the activity is stopped. The spot is extremely sore to the touch as well. There is usually a history of a sudden start of a new activity or a sudden increase in activity.


"While they are different medical conditions, shin splints and stress fractures share the same causes: an overload problem," says Laura Goldberg, MD, pediatric sports medicine specialist with University Hospitals Sports Medicine.


How To Tell Shin Splints From a Stress Fracture.


1) Shin splints typically IMPROVE with stretching and a proper warm-up. The pain may not be completely gone, but warming up the muscle and tissues properly can decrease the amount of stress on the tissues and lesser shin splints to an extent. A stress fracture in the bone will typically get worse with activity or not change after a warm-up.


2) Shin splints are usually BROADER and cover a larger area of the shin. Patients with shin splints will report pain that covers a larger area of the shin, usually radiating or shooting along the shin bone. Stress fractures tend to be in very precise, pinpoint areas. While it may radiate pain due to inflammation over an area, the area is usually much smaller than shin splints.


3) Shin splints will NOT show anything on an x-ray. If pain persists, your doctor may order an x-ray to assess for a possible stress fracture. Shin splints will not show a fracture or crack on an x-ray, while stress may show up! It's even possible that small stress fractures may be missed on an x-ray and your doctor may order more advanced imaging.