Shin splints or stress fracture?

[Jose Jimenez]

I have had what I think are shin splints on my lower right leg for well over a month now.  The pain is most intense in the afternoons of the days after I run (I run every other day).  I feel it on the left side of my right shin about 4 to 5 inches above the ankle.  It is fairly well localized, which makes me think it could be a stress fracture.  However after my first 1/2 mile or so of running the pain goes away, which makes me think it is shin splints.  When should I bite the bullet and go to the doctor?  If it is shin splints I think I will keep following the advice I found today on this forum and hope things improve.  But I would like your opinion on when I should be seriously worried about the possibility of a stress fracture.

[Jeffrey McClellan]

I had a problem that seems very similar to what you have, except it was on my left leg.  I had localized pain and point tenderness on the ridge of the tibia about 4-6 inches directly above the ankle.  I ended up running with the pain for about 2 months (including a marathon about halfway through) before going to a doctor.  I did have a stress fracture, however the doctor told me that I had caught the problem early (after 2 months of running on it?) and that I just needed to take about 4 weeks off of running and I would be fine.  I got better, but then about midway through last year I began to have the same problem again.  This time I figured out what was causing the problem and I was able to avoid a stress fracture and a layoff from running.  Basically, the calf muscle in my leg was too tight and was pulling on the insertion point where the calf connects with the bone, thus causing the pain.  I ended up spending a lot of time massaging the calf and stretching it out.  I would kind of attack the spots where it was tender, and although it would be sore for a few days after that, it helped me to relieve the tension on the bone.  It is still a chronic problem for me, but as long as I stay on top of things I am fine.  I hope this helps.

[Jose Jimenez]

It sounds like what I have.  Massage on the spot actually helps it feel a lot better.  I think I will continue to massage it, stretch it, and do some of the shin splint exercises I have heard here and hopefully I can continue running on it.  I'll post an update with the results.  Thanks Jeff.

[James Winzenz]

In high school and over the years I have had the exact same thing - always on the inside of the leg.  Because the pain is on the posterior ridge of the tibia, it is called posterior shin splints.  Another to consider besides stretching and massage is the shoe you wear (both brand and type of shoe - i.e. motion control, stability, neutral).  Just another suggestion you may want to look at.  What shoes do you run in right now?

[Jose Jimenez]

I wear Brooks Trance 7 (stability) with custom orthotics.  I am a pancake flat overpronator.  However, every once in a while I use these old Asics (stability) that are half a size too short for me, which may be aggravating the situation.  I don't have that many miles on the Asics but they don't fit quite right and they don't hold my heel the way the Brooks do.  I'm not too heavy for my height (163 pounds on a 5'11" frame) so I don't think going to the motion control shoes is necessary.  What do you think?

[Dallen]

Most of what you describe sounds like shin splints: inside of shin, better with running. The concerning bit is that it is a single spot. Shin splints tend to be over a larger area, but there is a lot of overlap in the symptoms. If it gets worse, and hopefully someone else will pay for it, an MRI or bone scan will give you the answer. A normal x-ray usually will not. Good luck.

[Jeffrey McClellan]

One other thing that I just thought about.  Make sure to massage the entire muscle from bottom to top when you massage.  I found that the problem areas for me where the muscle was too tight were not always where I felt the most discomfort, but when I would rub the muscle out I was able to find these tight spots and work them out which helped alleviate the pain in areas other than where I was massaging.

[James Winzenz]

I concur with that.  I highly recommend using the "stick" or something else that will do a good job of working the knots out of your muscles.  Since you wear custom orthotics, I don't think that going to a motion control shoe is necessary, but I would definitely stick with the shoe(s) that work best for you.  Regardless of how much they cost you at the time, if you have a shoe that doesn't fit right, it will completely change your form and footstrike pattern.  Definitely continue to stretch your calves - both the gastrocnemius and soleus (you get a good stretch on the gastroc when you stretch with your knee straight, and get your soleus more when your knee is bent).  Good luck and like Dallen said, if it gets worse, you may want to consider an MRI or bone scan (if covered by your insurance).

[Jose Jimenez]

Thanks for all the advice.  I will expand my massage to include the whole lower leg.  I was able to run 13.1 miles today and felt pretty good.  I am 99% sure that I am just suffering from shin splints.  We'll see if the recovery continues.  I used one of those massage sticks when I did Ragnar Del Sol a few weeks ago and it was great.  It belonged to one of my teammates, so I'll have to get one of those.  Thanks again.

[breanna cobler]

Ok, I'm really frustrated with my shins. They are making every workout depressing and painful. They have been hurting for about a year now and I've tried almost everything I can think of. Here is what I have tried: ice, massage, accupuncture, shoes for pronation, chiropractor, stem machine, DMSO, prednisone, ibuprofen, rest with cross training (1 month), rest without cross training (1 month), taping, strengthening muscles in lower legs. What else is there? Track season is just starting up and I really want to do well, but my shins are making that difficult. Does anyone have any ideas?

[Jeff Linger]

I have tried: ice, massage, accupuncture, shoes for pronation, chiropractor, stem machine, DMSO, prednisone, ibuprofen, rest with cross training (1 month), rest without cross training (1 month), taping, strengthening muscles in lower legs. What else is there?

Don't know what DMSO is, but .... have you gone to a doctor? I'm no expert on gait, but is it possible that your stride form is connected to this issue?

[David S]

I have been fighting some sort of shin splint pain for the 2 years that I have been running. It seems to come a go and I have always been able to run through it until recently.  My right leg became so painful that I had to stop running for 10 days.  For me it was a combination of adding too many miles and running in the wrong shoes for that amount of mileage.  Getting treatment - ART, stretching and electro stimulation helped a lot.  I also switched to much more cushioned shoe which made a huge difference.  I am also seeing a PT is helping strengthen some specific muscles to help prevent shin splints in the future.  But you should seek professional help - a Dr. to rule out a stress fracture - and a PT or other sports rehab professional for specific guidance.

[Jose Jimenez]

Update - I am feeling much better.  I did the following: 

1. Massaged my lower legs from the knee down about two times a day
2. Did strength exercises twice a day:  stood on my toes (NOT the tippy toes like a ballerina, but on ball of my feet) for about 30 seconds at a time for about three reps.
3. Stretched my legs by sitting (gently) on my feet (once or twice a day)
4. Started using my newer shoes more than my older ones.  I use the Brooks Trance 7 but I think I am going to try the Nike Equalon's.  I tried them at the store and they felt great.  We'll see how they do on a long run.  I think the right shoes can make a big difference.

Thanks to all who have provided advice.  I felt good enough to PR on the Riverton Half Marathon.

[Michelle Nelson]

I have got the same issue right now and have never had any issue like this. I recently switched from using Asic Nimbus to Asic Cumulus and the doc thinks that was most likely the cause. Anyway, your tiabialis posterior connects right about where your pain is. He told me there are 3 stages of this injury. 1st being pain and inflammation (basic shin splint), 2nd the same as 1st but where it connects to the bone it starts to get inflammation and the bone enamel will start to break down (which mine has done) and 3rd is obviously the stress fracture. I went in 2 days ago and he told me I was very close to a stess fracture but hopefully I haven't gotten one yet. I've been on prednisone and haven't been running and have noticed a pretty big difference in the past 2 days. I am supposed to be running Boston but who knows at this point. I went to Dr. Russ Toronto and I thought he was great. He is up in Sandy. Good luck. I hope yours doesn't end up as bad as mine has.
BTW, you said you pronate. That would definitely be the cause because you tend to push more off your inside toe.

[Ryan Shaul]

I am experiencing shin splints as well, have always had a problem with them. I did go to a friend who happened to be a retired MD and he said two things, one, could be stress fracture, which it was not, and two, ice, ice, ice, and stretch! Nothing you can do about them other than ice even on the days they don't hurt. If you are currently running ice 3xs a day and stretch. It helps, but does not take away the pain on some days. I have also read in an article that the muscles that run the back of your leg get too tight and put additional pressure on your shins thus causing inflamation and pain. So, I guess we are all just doomed hu? Ice, stretch, elevate your legs when you can cause it will help with the inflamation, what else is there to do? Anyone have any suggestions let me know! My mom told me that in HS her track coach had her rub ben gay on her legs and them wrap them really tight with ace bandage every day and she said it helped. I don't know! I do know that they can get really painful, and I do not want to have to take any time off from running, so if anyone has any other ideas I am game!  Thank you!