Shin Splint or Stress Fracture?

One of the common issues we see is shin pain, and people often assume that pain is the result of a shin splint, formally known as medial tibial stress syndrome. Shin splints are most common in runners, dancers and athletes engaged in repetitive stress activities, but they can also happen when an athlete changes up his or her training.

But sometimes the pain that patients feel isn’t a shin splint at all. It could be a stress fracture. The difference is really in the injury. A true shin splint is the pain caused by overworking the connective tissues and muscles surrounding the tibia, whereas a stress fracture is an incomplete break in the tibia itself.

“We recently had a patient who felt sharp pain every time he put his foot down,” said MMT’s Dr. Jeff Sergent. “Stairs were a particularly painful experience for the patient. It wasn’t a shin splint; it was actually a stress fracture.”

Our bodies have an interesting irony to them. The way to build muscle and strong bones is to actually stress the body. Your body actually gets stronger as it repairs itself and builds up tolerance to the activity that stresses it.

Sometimes, however, the body is unable to positively respond to that stress, especially if we introduce an activity that the body either hasn’t done or hasn’t built up some tolerance to over time. This is why people who try running after a long absence (or for the first time) often find that their shins cause them problems. “Stress fractures definitely do occur in athletes, but they also tend to happen as we age,” said Dr. Sergent. “It’s possible to develop a stress fracture by taking a long walk, particularly if its not a regular activity for you.”

The good news is that, generally speaking, both shin splints and stress fractures do get better with rest.

“If it presents itself as a severe stress fracture, then we would refer the patient on to a podiatrist or other specialist to see if it should be booted, for example,” said Dr. Sergent. “But in general, both of these situations do get better if you give them time to heal.”