As Spring inches its way ever closer to Bentonville, Arkansas, our running community seems to be clamoring to be outdoors whenever the weather permits (which hasn’t been often lately.) With the huge influx of running that is coming in preparation for the Bentonville half marathon, I have already had several people come to my clinic for shin splints or Plantar Fasciitis. While neither is fun, I wanted to take a quick opportunity to talk about another injury that is commonly mistaken for shin splints and that is stress fractures.
Stress fractures can masquerade as shin splints because symptoms usually presents in the same fashion – pain that occurs in the front of the lower leg that increases in intensity when the athlete runs. Sometimes there may be swelling. Differentiating between the two can be tricky.
Here is what I have seen that points to a stress fracture instead of shin splints. Usually the pain comes on the inside of the shin bone (Tibia.) At the site of the most pain, there is usually a palpable lump. This may feel like a trigger point or spasm. In all likelihood, it is swelling at the site of the fracture. Some old school tricks for diagnosing the fracture are to place a tuning fork over the bone. I have done this in the past without reproducing symptoms (the test was a false negative for fracture.)
The only way to truly diagnose the stress fracture is to have your doctor take an x-ray. Now here comes the bad news – you will probably have to wear a walking boot for some period of time like 4-8 weeks and worst of all NO RUNNING. This is a death sentence for many but your body needs time to let that bone heal. Once it has, you will be free to pound the pavement once more.
If you suspect you might have a fracture, don’t hesitate to have your doctor to take an x-ray. If it comes back clear, check out my other blog post on how to quickly treat shin splints.