All About Stress Fractures of the Shin

Overuse and minor injuries can result in a stress reaction or deep bone bruise. If you start to feel shin pain, ease off your exercise routine to allow for healing. Continued pressure on the bone can make it start to crack, resulting in a stress fracture.

While the word “fracture” sounds less severe than “broken bone,” the two terms mean the same thing. The bone has cracked to some degree.

Any bone can fracture, but you’re most likely to develop a stress fracture of the shin bone.

A stress fracture may cause tenderness or swelling of the shin. It can also cause pain that:

• increases when you touch your shin or put weight on it
• is less severe when you rest your leg
• is persistent

If you have shin tenderness or pain, raise and rest your legs and apply an ice pack to see if it gets better.

See your doctor if:

• you have noticeable swelling
• you can’t walk without pain
• pain is persistent or worsening

Without treatment, a small crack can turn into a major one or the bone can move out of alignment. The result will likely be more pain, additional treatments, and a longer recovery period.

At the first sign of injury, it can be difficult to tell if you have a stress fracture or shin splints. Both are caused by overtraining, or a sudden increase in training or weight-bearing exercise. Both are common among runners and dancers.

Stress fracture

A stress fracture of the shin means there’s a crack in your shin bone. Pain may be confined to a small area, and is likely to increase when you put weight on your legs, walk, or run. Pain may persist even when you’re at rest.

Shin splints

Shin splints involve inflammation of muscles, tendons, and bone tissue, but the bone is unbroken. They can cause tenderness and pain over a larger portion of the shin bone. You may not have much pain at rest or with low-impact activities like walking, but pain increases sharply with high-impact exercise.

Shin splints can improve with home-care measures like icing, rest, and avoiding high-impact activities until it improves. However, if you try to keep up with your normal activity level, you may end up with a bone fracture as well.

See a doctor for a diagnosis

If you’re not sure whether you have shin splints or a stress fracture, it’s worth having it checked out by a doctor. Your doctor may be able to make the diagnosis visually, but imaging tests can confirm it.

There are many factors that can contribute to stress fractures of the shin. Some can be managed to a certain degree and others are not within your control. Causes of stress fractures of the shin include:

• repetitive movements in high-intensity activities, such as:
  • long-distance running, track and field
  • basketball, soccer
  • gymnastics
  • dance
• improper athletic technique
• increasing training or weight-bearing exercises too quickly
• not getting enough rest between workouts
• working out on a different type of surface than usual
• running on a sloped surface
• inadequate footwear

Other things that can increase your risk of stress fractures are:

• drinking more than 10 alcoholic beverages a week
• smoking
• infrequent exercise
• being underweight or overweight
• osteoporosis
• eating disorders
• low vitamin D levels
• not taking in enough calories to match your activity level

It can be tempting to push through the pain, but if you don’t take care of a stress fracture, it can get considerably worse. You could even end up with chronic shin problems.

Immediate steps

Your doctor may recommend a combination of treatments and lifestyle changes, such as:

• taking a break from high-impact activity until you’re fully healed
• elevating your leg and applying ice for 10 minutes to ease pain and swelling
• taking over-the-counter (OTC) anti-inflammatory medicine
• using crutches to keep weight off your shin while you heal
• physical therapy

Severe stress fractures may require a cast or surgery to ensure proper healing.

Long-term recovery

As you recover, it’s important to increase your activity slowly and get plenty of rest between workouts. A sports medicine specialist or qualified trainer can help redesign your routine to protect your shin fracture while you maintain fitness.

Stress fractures can take anywhere from 4 to 12 weeks — and sometimes longer — to heal. If you still have bone pain, you haven’t completely healed. Keep in mind that increasing activity too quickly can lead to re-injury.

There are some things you can do to help prevent recurrence. First, make sure you’re treating conditions such as osteoporosis and vitamin deficiencies. Ask your doctor if you should take calcium and vitamin D supplements for bone health and, if so, in what amounts.

Additional tips for healing

Here are a few other tips for lowering the risk of shin fractures:

• Rest. Allow shins time to recover between high-intensity workouts.
• Start cross-training. Stay in good shape while resting your shins between workouts.
• Invest in proper footwear. Support your feet, ankles, legs, hips, and back while you exercise.
• Elevate and ice. Address shin discomfort before it worsens. Elevate your legs above heart level and apply ice for 10 minutes at a time.
• Maintain a healthy diet. Vitamin deficiencies can affect bone health, so eat a balanced diet.
• Manage your weight. Lose extra pounds that put added strain on bones and joints.
• Work with an experienced trainer. Use good techniques for optimal physical performance and bone health.

A stress fracture of the shin is a thin break caused by repetitive, high-impact exercise. Treatment includes getting adequate rest and backing off intense exercise until it heals.

Severe or hard-to-heal fractures may require using crutches, wearing a cast, or surgery. Full recovery can take 4 to 12 weeks.

If you love high-impact activities, there are some steps you can take now to lower the chances of stress fractures of the shin. When shin pain and swelling strikes, see your doctor for diagnosis and treatment.