Training — Shin Splint or Stress Fracture?

running-advice-bugOne of my runners sent me an inquiry today that I get all too often. While suffering from pain in her shin, she asks if I think this is a stress fracture or a shin splint. Below was my reply to her, which others may find helpful. I use an analogy below to a pane of glass to help explain how a stress fracture forms and then what happens if with continued running on it. First, her question:

“….I have either a tibial stress fracture or a posterior shin splint… I’m hoping it’s just a shin splint, but my gut is telling me it’s a stress fracture… I have an x-ray scheduled for Friday… Running is unbearable right now. I tried it yesterday after taking a week long break and I felt like I was limping the whole time, so I figured I should stop. Instead, I did 30 minutes of intervals on the elliptical.

I don’t want to take 6-8 weeks off if she tells me that it is indeed a stress fracture. My dr’s a runner too so I think she’d understand my frustration. Is there anything you would suggest to speed recovery? How do I keep up with my current fitness level without running? This is the first time I’ve ever had anything like this…”

Oh, how often I’ve had this question. The first thing that I want everyone to read is that if you are in this situation, please go see your doctor. As I’ll explain below, although stress fractures are much less common than shin splints, they are very serious injuries. If you continue to run on a stress fracture, there is a strong possibility of doing permanent damage and there is no reason to inflict that on yourself. So now that you’ve all read my caution (go see your doctor!), I’ll answer the question.
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Training: Dealing with Shin Splints and Shin Pain

Coach Dean Hebert

Coach Dean Hebert

A reader named Angie poses a frequently asked question to us:


I have a question regarding shin splints. How bad should they hurt? I guess the better question is how much pain should one run through? And any quick fixes you know of? HELP!

Shin splints are caused for a reason. Most often it’s running too much or too fast, too soon. Rest alone rarely is the cure. It is a temporary relief.

Let’s address pain first. If they are very painful, you need to rule out a stress fracture. You should see your doctor and have them take x-rays of your legs if the pain is really bad. You should also watch out for pain in one very specific spot when touching your shin. With shin splints, the pain is usually fairly even across the whole shin. Often with stress fractures, the pain is located in one identifiable spot along the bone that you’ll feel with your finger.

Let’s assume you do not have a stress fracture for the sake of argument: If the pain hurts sufficiently to change your gait — meaning it makes you favor one leg over the other, limp, etc. — you are asking for lots more trouble than just shin splints because you will end up with compensatory injuries along with shin issues. Stop now. Get in to see your doctor or physical therapist. Get healed up and then get back to running.
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