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Shin Splints or Stress Fracture? How to Tell the Difference
Shin splints or stress fracture? Understand the key differences, spot warning signs and find out when to seek physiotherapy or podiatry assessment.
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If you’ve started running more and your shins have started to hurt, you’re certainly not alone. Shin pain is something we see regularly in runners, especially when training ramps up for an event or people get back into running after some time off.
But is it just shin splints, or could it be something more?
Two common causes of shin pain are medial tibial stress syndrome (MTSS), often called shin splints, and bone stress injuries such as a stress fracture. While they can feel similar, there are some important differences.
Shin Splints or Stress Fracture?
1. Medial tibial stress syndrome is a common running-related injury that causes pain along the inside edge of the shin.
2. It often comes on when your training changes. You might have increased your weekly kilometres, added some hills, started doing more speed work or simply gone from not running much to running regularly.
3. The important thing is that it isn’t necessarily about doing something “wrong”. Sometimes your body just needs more time to adapt to the amount of load you’re putting through it.
4. A stress fracture is a bone stress injury that develops when the bone is repeatedly loaded without enough time to recover. The tricky part is that early symptoms can feel similar to shin splints.
5. One thing we look at is where the pain is. Shin splints tend to cause pain over a broader section of the shin, while a bone stress injury can be much more localised.
6. There isn’t always a simple test you can do at home to tell the difference. Your symptoms, training history and physical assessment all help build the picture.
If your shin pain started after a big increase in running and settles when you stop, it may be consistent with shin splints. If the pain is becoming more localised, getting worse, affecting your walking, or occurring when you’re resting or at night, it’s worth getting it checked.
How Can Physiotherapy Help?
Physiotherapy at PEAK can help work out what may be contributing to your shin pain and, importantly, what you can do about it.
Depending on what we find, this might include strength and rehabilitation exercises, modifying your training, improving mobility and working out how to gradually build your running back up.
At PEAK, we look at the bigger picture. Your training, strength, running mechanics and recovery can all play a role in how your body responds to running.
The aim isn’t just to get the pain down. We want to get you back to doing what you enjoy and make sure your body is ready for the demands you’re putting on it.
Could Your Feet or Running Technique Be Part of the Problem?
Sometimes it’s useful to look beyond the shin itself.
Our Podiatry team can assess your feet, footwear and running mechanics and, when appropriate, use a Running Biomechanics Assessment to look at how you move when you run.
For some runners, footwear changes or custom orthotics may be useful. For others, they may not be necessary. It really depends on what we find during your assessment.
Another common mistake is resting until the pain disappears and then going straight back to the same amount of running. Your symptoms might be gone, but your capacity hasn’t necessarily caught up.
PEAK’s Running Program can help runners gradually build their training back up using a combination of load management, strength work and a progressive return to running.
When Should You Get Your Shin Pain Checked?
Consider getting your shin pain assessed if:
- It’s getting worse rather than better
- You have a very specific, tender spot on the shin
- It hurts when you’re walking
- The pain continues after you’ve stopped running
- You’re getting pain at rest or during the night
- You’ve recently made a big jump in your training
The good news is that most running injuries don’t mean you have to give up running altogether. The key is understanding what’s going on and finding the right level of load while you recover.
Don't Ignore Persistent Shin Pain
Shin pain can have different causes. Get the right assessment to understand your symptoms, guide your recovery and help you return to running safely.
Frequently Asked Questions
Can I keep running with shin splints?
Sometimes. It depends on your symptoms and how they respond to running. You may be able to continue at a reduced level, but if your pain is getting worse or affecting everyday activities, it’s worth getting assessed.
How long do shin splints take to settle?
It varies from person to person. How long you’ve had the problem, how much you’re training and how you manage your load can all influence recovery.
How do I know if I have a stress fracture?
You can’t always tell from symptoms alone. Increasingly localised pain, pain when walking, or pain at rest or at night are good reasons to have your shin pain assessed.
Get Back to Running with Confidence