shin splints or stress fracture?

How do know if you have shin splints or a stress fracture? Both cause pain in the shin bone at the front of the leg, and may be described as overuse injuries.

What is the difference?

Shin splints, medically known as Medial Tibial Stress Syndrome (MTSS), are one of the most common complaints of runners. The term shin splints describes pain along the front of your lower shin that gets worse when running or exercising. Shin splints are commonly developed from overuse, and can be diagnosed by a using a combination of your history and a clinical exam.

A stress fracture is also painful, and if it occurs in the tibia (shin bone) it is easy to believe it is shin splints. It is an area of bony weakness due to repeated stress (i.e. running). The most common site for a stress fracture in a runner is the lower part of the tibia. Typically the pain is well localised and the impact when your foot hits the ground is painful.

How can you tell?

There are a few signs that can help with the diagnosis.

  1. The pain is localised with a stress fracture, and tender over the site. Whereas shin splits cause a more diffuse pain and can be tender along the length of the bone.
  2. It is common to develop swelling with a stress fracture, but this is unlikely to develop if you have shin splints.
  3. If you have shin splints it is common to only experience pain when running or other high impact activities. A stress fracture may cause pain with even low level activities.
  4. Initially a stress fracture will not show on an x-ray, but changes may be visible after 2 weeks. The ideal diagnostic method is with an MRI scan.

Does the diagnosis matter?

Yes it does.

  • A stress fracture may be a sign of an underlying health problem. There may be nutritional deficiencies weakening the bony structure.
  • Continuing to run with a stress fracture will almost certainly make it worse, and lead to a complete fracture. Rest for a minimum of 6-8 weeks is essential.
  • Shin splints can be painful and uncomfortable – but you can manage them by following a few important tips.
    1. Stop running until your acute symptoms settle, this may vary from a few days to a few weeks.
    2. Reduce your running speed, distance and frequency, allow your body time to recover.
    3. Cross train to maintain fitness, cycling or going to the gym have far less impact than running.
    4. Monitor what you are doing. You may notice a particular trigger, such as running down a steep hill, or when you increase your speed. Use this as a warning to step back a level in your training.
    5. Use ice to cool the shin, it takes out the heat and reduces the pain
    6. Check your shoes. Old shoes may not give you support where you need it. Choosing a cushioned shoe may help.

If you are not sure it may be safest to presume that you have a stress fracture and train in the pool or on the bike for 6 weeks. Have your injury assessed by someone who understands running related injuries.

Whenever someone presents to clinic with shin pain we always assess their training load and footwear. Our clinics in Denbigh and Old Colwyn have treadmills so we can watch your running technique. There are many factors that can trigger shin pain. If you identify your triggers you may be free of shin splints forever.

Book your assessment on line or give us a call on 01745 434432.