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Shin Splints vs. Stress Fracture: Why It's Tough to Tell Them Apart

Shin Splints vs. Stress Fracture: Why It's Tough to Tell Them Apart
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Shin splints and stress fractures both affect the lower leg and have similar symptoms. Learn the difference between these common sports injuries.

You took up running a few months ago, and now you log a few miles – usually on a paved trail in a local park – most evenings. Lately, you've noticed lower leg pain during your runs, but it mostly goes away when you rest. What's going on? You might have shin splints or a stress fracture. Determining which it is can be tricky without a medical provider's help.
Shin splints and stress fractures have a lot in common. Both are frequent injuries among people who participate in high-impact, weight-bearing physical activities, such as running. Shin splints and stress fractures are overuse injuries that can occur if you increase your workout intensity too quickly or exercise too much without allowing enough time to recover. These two injuries even have similar symptoms. So how can you tell them apart?

Defining Shin Splints and Stress Fractures

When you place too much stress on the muscles, tendons, and shin bone, inflammation can occur. This can lead to pain in the front of your lower leg, a.k.a. shin splints. You're more likely to get shin splints if you run on hills, are new to running, have flat feet, run frequently on hard surfaces, or wear old running shoes that have lost much of their shock absorption.

Like shin splints, stress fractures – small cracks in bones – often affect the lower leg, although they can also occur elsewhere in the body. If a bone's neighboring muscle can no longer handle the shock of activity, the bone has to bear it. Over time, this repeated stress can cause the bone to crack. Running, tennis, basketball, and other high-intensity activities that involve your feet repeatedly striking the ground can increase your stress fracture risk.

Similar Symptoms

Shin splints can feel like a stress fracture and vice versa. That's because the main symptom of both is lower leg pain. In addition, with both injuries, the pain may get worse during exercise and better when you're not active.

One sign that may help you distinguish between shin splints and a stress fracture is to push on your shin. If you feel pain, shin splints may be the cause. However, pain concentrated in the shin isn't always a definitive indicator of shin splints – stress fractures can also form in the shin.

Don't try to wait out persistent lower leg pain. If shin splints grow severe, walking may become painful. Letting a stress fracture go without treatment or returning to activity before it heals can lead to a more serious bone break. See your medical provider to get a definitive diagnosis and a treatment plan.

How to Treat Shin Splints and Stress Fractures

For shin splints and stress fractures, the key to treatment is rest. Stop running or any other activity that may have led to your injury. You don't need to give up the activity permanently – just take a break. Find a different, pain-free activity to enjoy for the time being.

Shin splints can take three to six months to heal, according to the National Institutes of Health, but you may return to full activity as soon as you're pain-free. Be sure to take things slow and increase your activity level gradually. Most stress fractures heal within two months, according to the American Academy of Orthopaedic Surgeons.

Adding extra shock absorption to your shoes in the form of arch supports can be helpful for both shin splints and stress fractures. For additional relief from shin splints, you can ice your shin and perform leg stretches. You may need to use crutches or wear a cast to give a stress fracture a better chance to heal.

Preventing Shin Splints and Stress Fractures

You can reduce your risk of shin splints and stress fractures by following exercise best practices. Start by ensuring you have the proper equipment. For runners, this means well-fitting shoes with plenty of support.

Other steps you can take to protect the bones and soft tissues of your lower legs include:
  • Avoid running or playing sports on hard surfaces, such as concrete and asphalt, when possible.
  • Be sure to warm up before physical activity and cool down afterward.
  • Stop exercising and rest if you experience pain.
  • Vary your activities throughout the week instead of devoting yourself to one form of exercise.
  • Work with professionals at a sports medicine center to help you develop a proper technique for your sport and reduce your injury risk.
With preparation and commitment to healthy practices, you can reduce the risk of shin splints or stress fractures taking you off the field, trail, or court.




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