It’s incredibly valuable and important to be able to tell the difference between a stress fracture and shin splints, especially for athletes in season who are typical sufferers of both diagnoses. These injuries are often confused for each other and can lead to delayed healing and worse problems in the future if misdiagnosed.
Both injuries typically occur in the lower limb right along the shin bone, or tibia. They will also both typically occur in athletes who place repetitive trauma on one area of the body such as running, jumping, cutting, etc.
The most important reason to understand the difference is because with shin splints, the athlete is often able to play through the injury if it is being treated properly, whereas with a stress fracture, a period of rest or immobilization is required to heal the injury.
By understanding the signs and symptoms of each, it can help you make the decision to seek imaging (MRI/x-ray) of the area, or if it can be put off for a while.
Shin splints are more of an inflammation of the muscles in the shin region that sit next to and attach onto the tibia. They will often cause diffuse discomfort up and down the shin bone that is greater than 5cm in length. Another main indicator of shin splints vs a stress fracture is that with shin splints pain will typically improve with activity. As the muscles and tendons get increased blood flow and are working, they feel better, whereas at rest or first thing in the morning, pain will be worse. As mentioned above you can often play through a shin splint and they do not usually require imaging to diagnose. Lastly, shin splints can often be felt on both sides (bilaterally).
Stress fractures are tiny microfractures/cracks in the tibia, and are diagnosed by MRI or X-ray. They are small, focalized specific areas of pain that are often less than 5cm in length. With activity, stress fractures will get worse. Often with every increased step, the pain will intensify, whereas they feel best first thing in the morning or following periods of rest. It is also possible to experience a constant pain with a stress fracture depending on severity. Lastly, it is rare for a stress fracture to occur on both sides, they are often unilateral.
Check out these lists below for a quick reference to determine whether you have shin splints or a stress fracture.
Shin splints:
  • Can play through it (as long as it’s being treated properly)
  • Inflammation of muscles in shin region that sit next to and attach to Tibia
  • Diffuse discomfort up and down the shin (>5cm length)
  • With activity: Diffuse pain up and down the shin bone, warm-up phenomenon, better with activity, worse when resting
  • Bilateral typically
Stress fx:
  • Need to stop playing sports for a period of time
  • Small crack typically in the shin bone, diagnosed by MRI or X-ray
  • Focalized, small, specific area of pain (<5cm length)
  • With activity: worse with every step you take, better at rest or first thing in the morning, OR constant pain
  • Unilateral typically
Are you an active adult or athlete living in Roswell, Johns Creek, or Alpharetta, and experiencing shin pain or another issue that is holding you back? Since 2008 our proven 3 step plan has helped people stay in the game and keep doing all the awesome activities they love. Please give us a call or text at 678-400-0300.