Tuesday, May 12, 2009

Shin Splints Or Stress Fracture?



I've seen quite a few of my patients recently with shin pain so I thought I'd write about it. This condition can usually be caused by any activity that involves running, jumping or even extended periods of walking. Patients usually present with pain at the beginning of exercise. During the initial phase, the pain may disappear during the warmup or after 15-20 minutes of exercise, but returns for several hours after exercise. In the more severe cases, pain is usually present during training and aggravated during daily activities like walking, squatting or climbing stairs. There is often pain at rest as well. The pain is often described as a dull, aching discomfort of varying degrees of intensity.

Left untreated, it can progress to a stress fracture in your tibia (or shin bone). Which is exactly what happened to one of my patients.

The picture shown above is the x-ray of my patient's stress fracture. The arrow depicts the callus formation of thickening of the bone indicating a stress reaction in the bone. Usually a bone scan is needed to detect a stress fracture as an x-ray only picks up the callus formation (about a month later) as the bone is healing.

The term "shin splints" refers to pain along your tibia and this is usually caused by too much pulling of your muscles along their attachments along the bone. Research has shown that it is usually the tibialis posterior and soleus muscles that causes this condition. With repeated pulling (or stress), this causes the shin bone to be irritated and pain results. That is why this condition is also known as medial tibial stress syndrome. Milder cases are treated fairly easily. Most physiotherapists will ask their patients to rest, ice the painful area, change footwear and modify your training routine to prevent shin splints from recurring. The cause of your pain should be addressed rather than just treating the shin pain alone.

Most of the time shin splints occur from overuse. It is commonly seen in athletes who suddenly increase their duration or exercise intensity of training. Overpronation is often listed as one of the common causes of shin splints. Now if you've been following our blog article Pain Free Running or running with the Physio or Sports Solutions team, then you will be happy to know that you can run pain free and even avoid getting shin splints. Our athletes with shin splints or stress fractures often do their rehabilitation in the pool as well to maintain their fitness.

I have had stress fractures in both legs before, early in my racing days, when I was just competing in track and field events. This was before I started competing in triathlons of course. I know exactly how frustrating it can be not being able to run. Will be most willing to help if you need any advice on this.

Please read this for more on shin splints.

Reference
Thacker SB, Gilchrist J, Stroup DF and Kimsey CD (2002): The prevention of shin splints in sports: a systematic review of literature. Medicine and Science in Sports and Exercise 34: 32-40.

204 comments:

  1. Interesting case Gino.

    I am a PT currently having a patient with a stress fracture. How do you usually treat this conditon? How long before you start weightbearing exercises?
    thanks

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  2. If you treat your patient's pain, your patient will feel better for a while but the pain will return. Treating the cause will have a much better chance of eliminating the pain.

    Icing, stretching and even taping the area may help with treating the pain only. Hence you need to treat the cause of the pain and not just your patient's pain.

    Probably need to check your patient's running style, leg length, foot imbalances, hip muscle strength. Also check the lumbar spine and the sciatic nerve (tibial branch) for referred pain, how much your patient is running- is it too much too soon, or not enough rest, diet etc as all these can affect recovery.

    Wearing a rocker-bottom shoe may allow for immediate partial weight bearing depending on how serious the problem is.

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  3. How long is the average recovery time for a stress fracture? I've already taken 3 whole long weeks off from running and when I tried to jog a bit...I felt a dull ache.

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  4. It usually takes about 6 weeks for the shin bone (or tibial) to recover although some of my younger patients (under 15 years) can start running in 4-5 weeks without any pain.

    There is some evidence that low dose pulsed ultra sound can help accelerate bone healing (but you need to have the ultrasound done twice daily for 10 minutes each before it's effective).

    If you give me your email I can send you more details and also some forms of alternative training when you can't run.

    Hope this helps.

    ReplyDelete
  5. Gino,

    I got a quick question,

    i have been playing football and i got shinsplints in both legs after the 3rd week, and then after the 5th week i went to the Urgent care, and the doctor told me to ice and take 4 ibuprofin 3 times a day because my right leg's shin splint was extremely intense so i iced and used crutches for a week like he said.

    Then i continued to play football with the same pain, then after this weekends game i legit could barely walk on my foot and the pain is hurting horizontally not vertically like my left foot, but my left foot doesnt hurt much i just feel the pain mildly.

    would you say i have a stress fracture? Because my parents dont have health insurance on e and i cant get an X-Ray because it costs close to 350 dollars so i cant do an X ray.

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  6. Hi Gino
    I have a stress fracture in my shin. I've rested for 2 weeks and I do have Chicago marathon on sunday, I really want to run. Should I do it or not?. I am going crazy. Thanks+

    ReplyDelete
  7. Hi there,

    for the football player, I can't really tell whether you have a stress fracture or not unless I examine your shins. The x-ray may not be that useful anyway as it usually shows the callus formation only after a month after the stress fracture/ injury has occurred.

    Rule of thumb is if you only have pain while training or after and there is no resting pain, it is usually not a stress fracture yet (although sometimes it can be a stress fracture). I would definitely recommend some time off though with you doing other forms of training to keep your fitness.

    For the runner training for the Chicago marathon, like I mentioned in earlier reply, it takes about 6 weeks usually for the shin bone to heal. If you persist on running, you risk getting a full fracture which may mean even more healing time.

    I too had stress fractures in both my shins in my younger days (before I was a physical therapist) and I still tried to compete in a 800m race. I ended up with a lousy timing, worsened my condition and ended not being able to run for 6 months.

    My suggestion is to sit this race out, recover and come back stronger. As I mentioned above, if both of you send me your email I can send you more details and also some forms of alternative training when you can't run. Remember you need to treat what is causing your pain (or stress injury) not not just the pain, if not the pain will return. Treat the cause and you will not have the same injury again.

    Take care.

    ReplyDelete
  8. Hi.
    I was training all summer for marines marathon this OCtober 25th. 2 weeks ago during a long run I got posterior shin splints on my righ leg. I been 2 weeks off running , and I still feel pain, went to the doctor and gave me a treatmet of anti- inflamatory pills during 5 days. I lnow I caused my problem because I ran on old shoes, So I will replace them. My questions are:

    1) Righ now after 2 weeks off I feel a litlle pain on my leg ( I cant jump on it more than 5 times ), probably I have a stress fracture)

    2) Is it safe if I run the marathon with in 2 weeks? Im getting crazy not running my email is emorales@ec.rr.com

    ReplyDelete
  9. Hi emorales,

    what you are having may not be a stress fracture yet, it may just be a more severe case of shin splints. Of course I need to do a physical examination to be sure. Please see the 2nd comment to see what I will (or whoever is treating you) needs to check. Please also see above regarding pulsed ultrasound as there is some published evidence that it can help accelerate bone healing.

    If you persist on running, you may worsen your condition. I will send to your email some other way you can keep your fitness.

    Take care.

    ReplyDelete
  10. Thank you for listening~ I am training for the NY marathon on Nov 1 and have (I think) done all the right things -- in terms of increasing my mileage slowly and replacing my shoes frequently. In the last week or so I have this pain 4-6 inches above the top of my foot, but it doesn't seem high enough for a shin splint. I have been told that it might be a stress fracture, however it does not hurt at night and I can hop on it. It hurts mostly when I flex my foot or point my toes. I am completely devastated by the thought of not doing NY, as I trained and my trip is planned! I plan on icing, resting, and taking NSAIDS- until November 1 and then just taking it very slow on race day to just finish. my goal is 5 hours. Does this sound crazy or somewhat reasonable?

    thanks-
    Lara

    ReplyDelete
  11. Hi Lara,

    I will probably have to examine you before I am sure what injury you have. From what you describe, it may be a strain of the tibialis anterior muscle.

    I would suggest seeing a good sports physical therapist and treat what is causing your pain rather than just taking NSAIDs (and treating the pain. The NSAIDs may be masking some of your pain as well. You still have a couple of weeks to race day and if you get your injury treated correctly (assuming it is not a stress fracture) you should still be able to race in NY.

    Hope this helps and take care.

    ReplyDelete
  12. hello, i was wondering if i could get some help. in 7th grade track, i formed shin splints. 8th grade track, i had shin splints once again; now im doing cross-country and i began to feel shin splints forming again in both legs during beginning of the season and after summer conditioning.

    well ive been running on shin splints for quite a while now and ive never felt such an unbearable pain in my past years as much as now. whenever i sit, just relaxing, i get this sharp pain in my upper left shin. before this began to happen, i took two weeks off from running, and then ran a race that i felt absolutely fine in. (i beat my time by a minute surprisingly.) now the pain begins again. when i tried to run a cool-down, i noticed that my lower calf on my left leg hurt more than my shin does. i dont know if this had anything to do with my shin splints, but it definitely causes me to limp and even when i run, this sharp pain hurts so bad, it causes my leg to feel weak.

    ive been too afraid to go to a sports doctor, for i dont want them to tell me to stop running. especially since i only have about 3 weeks left of cross-country. ive been assuming that this was only shin splints in my legs, but now my left leg is very tender when i touch my shin and my left calf shoots up pain whenever i place pressure on my left foot. ive been starting to believe that this might be a stress fracture. however, i cant tell the difference between a shin splint and a stress fracture.. is there anything i can do other than visiting the doc?

    -thanks

    ReplyDelete
  13. Hi there,

    again I will have to assess you before I can really tell what is wrong. But from what you described, it sounds like both your tibialis posterior and soleus muscles (both commonly involved in shin splints) are affected, resulting in pain in your shin and lower calf.

    If you have read the post above and the comments, you'll know that you can ice, stretch soleus and tib posterior, change shoes, watch your diet, training etc. But bear in mind that all these are just treating the pain. You need to treat what is causing the shin splints. Especially so since this has been recurring for the past couple of seasons.

    It would be great if you can find a good physical therapist, athletic trainer etc who can treat your cause of pain (instead of just the pain) and allow you to train at the same time assuming it is not a stress fracture. If you send me your email, I will give you some suggestions for more training alternatives to keep your fitness while also resting the area.

    Take care.

    ReplyDelete
  14. thanks for the advice; actually today, i just gave in and visited my doctor. she told me that it was a possiblity that i have a stress fracture. However, the only way to find out is if i get an x-ray so now im making an appointment with a sports doctor. meanwhile, i have to visit a physical therapist 12 times.

    im happy to know that im getting help to heal my legs. i dont think i have been stretching my shins correctly; which could be a possibility of my shin splints every year.

    my e-mail is: venishhhgoboom@aim.com

    that reminds me.. instead of running, i have been biking to keep fit. but it's totally different than running. my coach told me to aqua-jog in the pool at our school, but other than those two options, theres nothing else i can think of.

    -thanks once again

    ReplyDelete
  15. The question I have is this: I was diagnosed with a stress fracture of my right foot after dropping a heavy glass pyrex pie plate on it, first just thought badly bruised.... but now having pain in the left shin/calf , think it might be a stress fracture there also... All I know is that it is very painful, and hurts to walk... by the middle of the afternoon, I am holding onto walls to walk because of the pain in my legs. Please advise.

    Lisa

    ReplyDelete
  16. Hi Lisa,

    I really need to have a bit more of your previous training, injury history etc and of course to examine you before I know what is wrong with your L shin/ calf.

    It may be just a strain. Try to ice it down about 20 mins and see if the pain subsides.

    You probably need to get it checked to be sure what it is. Hope this helps. Take care and keep me posted.

    ReplyDelete
  17. I have tried to run off and on for several years. I recently started again. Every time I do start, I end up with pain in my shin, approximately half way between my foot and knee. It hurts while running, although the pain generally lessens as I continue to run, and is painful if moderate pressure is applied to the affected area. I generally get the same effect on both legs. This has again reoccured with my latest attempt to get in shape.

    I am unconvinced it is a true shin splint, because it is not on the side of the shin nor is it near the foot. I have started to wonder if it is a bone injury. Is it something that needs to be checked, or is it more likely simply the pain associated with using muscles more accustomed to sitting around?

    Thanks!

    ReplyDelete
  18. Hi there,

    Shin splints can also occur on the same side and also on the other side of the shin. Sometimes pain on the other side of the shin can be attributed to a strain in the tibialis anterior muscle which dorsiflexes your foot.

    If the bone is involved, you will usually feel a deep sharp pain at rest as well as when you run.

    I really need to assess you to be sure, again as I mentioned before, you need to treat what is causing the pain and not the pain if not the pain will return. Have a look at the post pain free running, this will help to ensure you can run better.

    Take care.

    gino

    ReplyDelete
  19. Hi, lately I have been experiencing an unsual feeling in my left shin. There is no pain, but when I put pressure on my left leg it feels like all the pressure is at one point in my shin, not spread out or in my ankles like normally. When I am not putting pressure on my left leg it feels like everything below this point is going numb. I am not that concerned because it doesn't hurt except on rare occasions but it is getting kind of annoying. Some background on me if this helps out in anyway would be: I am a 17 year old male, I have an extremely high tolerance to pain (and from past experiences if I am hurting a lot its usually something serious), and I skateboard. Anything will help, thanks for your time!

    ReplyDelete
  20. Hi skateboard friend,

    from what you have described, it may be a shin problem or it may be a referred pain (or numbness) that is coming form your back. A sensation of pressure on exertion like running, jumping may mean an indication of "compartment syndrome", but I do not think this is your case. I will have to examine you to be sure.

    Ice, take a day of the skateboard and see if this helps. If the numbness gets worse, you'll need someone to have a look at your back as well.

    Hope this help, take care, keep me posted.

    ReplyDelete
  21. HI - I read your article and hoped I could also post a quick question.
    I am not a runner, however I am a dancer. For the past month, I've had what I had thought were bad shin splints in both legs. After each week of dance they get a bit worse, although I'm careful to ice after class, and warm up/stretch/cool down an extra 15 minutes before and after class.

    However none of that has been helping, and landing jumps has become more and more painful, to the point where I've had to stop before class is over, and have not been able to practice either. Walking, especially up and down stairs, is very painful. The pain is very sharp and stabbing, in the same spot on both my legs, inside of my shins, on the lower third of my legs.

    If you have any advice as to treatment (I hope to compete in 4 weeks), or if I can be sure these are shin splints and not stress fractures, I would appreciate it.

    Thank you so much.

    ReplyDelete
  22. Hi there,

    shin splints does affect dancers as well. I just treated an ice skater today in my clinic who had shin splints after increasing her jumping and landing practice on ice (oh, and she started running to help her fitness as well).

    I really need to assess you to be sure if you have a stress fracture. Again as I mentioned in earlier replies, you need to treat what is causing the pain and not the pain if not the pain will return.

    Please take a couple of days off training, ice the affected area 20 mins every hour the whole of today if possible. If it helps it is probably not a stress fracture. You'll need 1 rest day a week and make sure your diet is adequate. Please get a good physical therapist to treat what is causing your pain.

    Hope this helps, take care and keep me posted.

    ReplyDelete
  23. I have been training for a marathon, my second, and after a couple of months I developed a dull pain on the inside of my leg about 5 inches up from my ancle. The pain feels like it is almost directly behind bone in the muscle. I have not ran for about 7 weeks now and the pain is gone while I walk and or rest. However, when I start to jog or climb a lot of stairs it starts to hurt. It is not an extreme pain, but I do not want to have to take more time off if I begin training before the leg heals completely. I guess my question is, is it more likely that I have a stress fracture on the back inside of my shin or that it is a shin splint or something else? originally I thought it felt like a knot in the area and I bought a massage stick and pushed the knot out. It feels better now, but still after a few weeks of that it starts the dull pain almost immediately after I begin running and lasts for a few minutes after I quit. Should I train through this or should I keep resting? Will it heal on its own, or do I need to go to the doctor?

    Any suggestions on why it persists would be helpful. I overpronate and wear shoes that are stability shoes and wear insoles for being somewhat flat footed. This is the second marathon I was training for.

    ReplyDelete
  24. I'd have have examine you to be really sure what you have, but from what you described, I don't think it is a stress fracture. If it was, it would take about 6 weeks for it to recover fully so you are definitely on track to start training.

    When you have shin splints it usually responds well when you rest it.

    However the pain will will return once you start training again. Especially so if you don't treat the cause of your shin pain. Even if you strengthen your muscles after resting, they may not be conditioned to take the loading.

    I will probably tweak your running style a little so you use your leg muscles (tibialis posterior-the muscle that causes shin splints) less.

    Most physical therapists will ask you to rest ice, stretch, strengthen, change shoes etc, they will all help but all these merely address your pain and not the cause of it. Hence the pain will return. You need to treat the cause of your shin splints.

    Please have a look at Pain Free Running (http://weloverunning.blogspot.com/2009/03/pain-free-running.html) on March 17 and Do High Tech Running Shoes Work (http://weloverunning.blogspot.com/2009/03/do-high-tech-running-shoes-work.html) on March 14.

    Take care, hope this helps.

    ReplyDelete
  25. hey so i started running cross country and then i found out i had a stress fracture on my tibia on my right leg so my doctor put me in to a walking boot for 6 weeks. then i started jogging on the treadmil for 30 mins.for a couple of days, and then i started running with the team again. when i started running, my right knee was hurting and i felt pain in my leg but it was like a sore pain and if i accidently hit or push on the area, it hurts. i dont know if i still have the stress fracture or that it may just be shin splints? but i want to make sure because i have been playing soccer now and i still have those pains and i dont want to have to sit out that season too. also when i try to sprint or open up my stride it hurts. if you know what is happening to me please tell me -thanks:)

    ReplyDelete
  26. You'll have to get it checked to be sure. It is probably not a stress fracture.

    It may be you're de-conditioned after sitting out 6 weeks. Ice the area after training and you need to treat what is causing your pain.

    Try not to over stride as it will load the shin even more. Take smaller strides but at a faster cadence. Please have a look at Pain Free Running (http://weloverunning.blogspot.com/2009/03/pain-free-running.html) on March 17.

    Hope this helps.

    ReplyDelete
  27. I recently discovered and fell in love with jumping rope for exercise. I have done a total of about 8 30-min workouts in the last 3 weeks. My last workout was 2 days ago, and I have been afraid to do any more because I have developed bilateral anterior tibial pain. It's minor- about a 1-2/10 at rest, but it can increase to a 3-/10 without any provocation. There is a tender 2-cm long region on the lateral edge of the tibia starting about 6-7 inches below the proximal end of the bone. There's no swelling or bruising. Two years ago I had a stress fracture in my foot (distal right 2nd metatarsal) that happened spontaneously - I was not exercising at all at the time. But I had had a baby about 8 months earlier, I was breastfeeding, and I was on the progesterone-only birth control pill - all of which I later learned can contribute to temporary bone loss.

    Could I have tibial stress fractures?

    ReplyDelete
  28. Hi there,

    I'd have have examine you to be really sure what you have, but from what you described, I don't think it is a stress fracture, it may be starting signs of one so good that you've rested.

    I'll suggest building up to your 30min blocks of skipping to prevent this. Start at 10 mins and build it up gradually.

    Take care.

    ReplyDelete
  29. I did not know what shin splints was until a few weeks ago, and I've been having pain in my lower left shin (about 5 inches from my ankle) for months. I had moderate shin splints tht went away after exercise for all of soccer season, and after a month of rest at the conclusion of the season, it was gone. My high school started indoor track season 3 weeks ago, and I am a long distance runner. Running 3+ miles is not a problem for me,but recently I have been getting really bad shin splints. I cannot go up stairs without sharp pains, and running on it is very painful. It is in a concentrated spot on my shin and this spot has been tender since the beginning of soccer, and even if I am not exercising, I have pain. About 2 days ago, I went to my school's trainer, and she said that I may be in danger of getting a stress fracture, as my shin splints are constant. I don't even need to have weight on my legs for them to hurt. I am worried to go to the orthopedist to get this checked out, but my mom does not want me to get hurt more. I do not want to have to stop running because of a stress fracture, but I don't know how much longer I can stand this pain.

    ReplyDelete
  30. Hi Missy,

    you probably need to get it checked to have a better end outcome. Treat what is causing the pain rather than treating the pain alone.

    Take care.

    ReplyDelete
  31. Hey there (:
    I am a football player, and considering I've been playing for 8 years (I'm 15 now), I've not had too many injuries.
    Around 4 weeks ago, I started getting shooting pains in my right shin. I thought I'd pulled a muscle or something, and just played on through the pain.
    I play twice a week, and it's now got to the stage where it hurts when I walk. It wasn't that bad before today, but this morning, I played a football match and was in tears by full time - the pain starts very severely in an area of about 2 inches.. as I play, that pain remains, but an ache also develops from my knee to my ankle. It aches when I rest, and every time I take a step I get shooting pains in the 2 inch area..
    Should I get it checked out by a doctor, or should I cease training for a while? I missed football training this week because of it, and thought I'd be fine playing today, but the pain was double that it was before.

    ReplyDelete
  32. Hi there,

    I think you should probably stop training, rest and ice it 20 minutes every couple of hours today and make an appointment to get it checked.

    Most physical therapists will ask you to rest ice, stretch, strengthen, change shoes etc, they will all help but all these merely address your pain and not the cause of it. Hence the pain will return. You need to treat the cause of your pain.

    Hope this helps. Take care.

    ReplyDelete
  33. I am an amateur runner who is beginning to train for a marathon - to date, I have never run more than 6 miles at one time - and no more than 4 days / week (usually max 4 miles trainig.) I am feeling some pain in both of my shins - however, I feel it most when I am not when running. The pain is usually right after I finish running...or after standing for a long time - when I shift my weight, the shin that I just took weight off gives me a little poke of pain. I've been stretching, strength training, icing and doing all that I can...should I be resting?

    ReplyDelete
  34. Hi Megan,

    When you have shin splints it usually responds well when you rest it. Your condition is such that if you rest you will definitely feel better. but as soon as you resume your running, the pain will probably recur.

    Especially so if you don't treat the cause of your shin pain. Even if you strengthen your muscles after resting, they may not be conditioned to take the loading.

    Most physical therapists will ask you to rest ice, stretch, strengthen, change shoes etc, they will all help but all these merely address your pain and not the cause of it. Hence the pain will return. You need to treat the cause of your shin splints.

    I will probably tweak your running style a little so you use your leg muscles (tibialis posterior-the muscle that causes shin splints) less.

    Try not to over stride as it will load the shin even more. Take smaller strides but at a faster cadence. Please have a look at Pain Free Running (http://weloverunning.blogspot.com/2009/03/pain-free-running.html) on March 17.

    Hope this helps. Take care.

    ReplyDelete
  35. Hi, I am a Division 1 track runner and I am not sure if have shin splints or a stress fracture. I took four weeks off of training and then about a week and a half back into training, the pain returned. It seems to be localized in several areas along the inside of my tibia, but the pain spreads vertically and at times, I feel some pain in the muscles and other regions of my leg. The pain increases as I workout, but after ice and sleep, I normally do not feel any pain the next morning. I am not sure what to do. I really dont want to miss 6 weeks because I am in the middle of my season but I want to treat this so that it doesn't become an ever worse injury.

    ReplyDelete
  36. Hi there,

    like I've mentioned before, I'll have to examine you before I can tell for sure if you have a stress fracture or just shin splints.

    With shin splints it usually responds well when you rest it. If you rest, ice etc you will definitely feel better. but as soon as you resume your running, the pain will probably recur. As such, you need to treat what is causing your pain.

    If you have read the posts above and the comments, you'll know that you can ice, stretch soleus and tib posterior, change shoes, watch your diet, training etc. But bear in mind that all these are just treating the pain. You need to treat what is causing the shin splints. You won't miss 6 weeks of your season unless it is a stress fracture.

    It would be great if you can find a good physical therapist, athletic trainer etc who can treat your cause of pain (instead of just the pain) and allow you to train at the same time assuming it is not a stress fracture. If you send me your email, I will give you some suggestions for more training alternatives to keep your fitness while also resting the area.

    Please also have a look at Pain Free Running (http://weloverunning.blogspot.com/2009/03/pain-free-running.html) on March 17 and Do High Tech Running Shoes Work (http://weloverunning.blogspot.com/2009/03/do-high-tech-running-shoes-work.html) on March 14.

    Take care.

    ReplyDelete
  37. Hi there,
    I just stumbled on your article...
    After almost 7 weeks of rest after the most horrible pain in my shins both during workouts and when just walking, I started running again yesterday.
    I only did 1 mile - and the shin pain returned. It hurts when I'm resting, it hurts when I walk - more than it hurts when I actually run? It is so bizarre...
    I've had shin splints off and on when I've run for the last 17 years (wow, that seems really long). But nothing like this, and definitely nothing that couldn't disappear after 6 weeks of rest.
    I'm going to call my general dr, and I guess an ortho?
    I noticed my feet are flapping, and over 6 miles my feet go completely numb. Great...
    I'll go back and re-read all your responses now... but any tips/advice would be great.
    I've tried switching shoes. I've tried changing the laces. I stretch my shins, ice them... Nothing seems to be working.
    Thanks for any help, because I'm pretty lost on this one!
    KD

    ReplyDelete
  38. Hi KD,

    I will have examine you to be really sure what you have, but from what you described, I don't think it is a stress fracture. If it was, it would take about 6 weeks for it to recover fully so you are definitely on track to start training anyway.

    Have a look at my post on Pain Free Running (http://weloverunning.blogspot.com/2009/03/pain-free-running.html) on March 17 coz' this is probably the way to go since you mentioned your legs "flapping" and if you send me your email I will email you some other stuff you can do to maintain your fitness.

    Take care, remember treat the cause of the pain and not the pain.

    ReplyDelete
  39. Hello - I have been running regularly for just over a year now. I run 3-5 days a week and have completed 3 half-marathons. I had problems with shin splints when I first started running but they went away when I replaced my shoes.

    Right now I don't have ANY pain in my legs WHEN I'm running. But my left shin is very tender (and has been for some time) to put pressure on. The same kind of feeling as when you put pressure on a bruise, it hurts a little but is not unbearable - just very tender to the touch/pressure.

    Do you have any advice/know what the problem is?

    My email is amber.yake@gmail.com

    Thank you.
    Amber Y

    ReplyDelete
  40. I am 52 years old, fairly athletic (PE degree, always active, no osteoporosis or osteopenia - good bone density per scan 2 years ago) good diet, 21 BMI. Developed bilateral stress fractures with minimal running of 4-6 miles/week, great shoes, compression tights, 2 miles/day - part of it walking, at least one day rest in between. Also dx with trochanteric bursitis. I want to be able to do 5k and the run at the end of a sprint triathlon, but keep getting sidelined by pain. Any suggestions on what to look at for the cause?? Kind of stumped, here...
    aquamom57@hotmail.com

    ReplyDelete
  41. Hi AquaMom,

    I hope I'm still as active as you when I reach your age. You're an inspiration to me to keep active.

    I really need to assess you to treat the cause of your pain and not treat your pain if not you will feel better for a while but the pain will return. From what you seem to describe, you seem to be doing all the right things already.

    I will probably need to check your running style, leg length, foot imbalances, hip muscle strength. Also need to check your lumbar spine and the sciatic nerve (tibial branch) for referred pain, - you don't seem to be running heaps and you seem to be resting and eating well too.

    Please also have a look at Pain Free Running (http://weloverunning.blogspot.com/2009/03/pain-free-running.html) on March 17 and Do High Tech Running Shoes Work (http://weloverunning.blogspot.com/2009/03/do-high-tech-running-shoes-work.html) on March 14.

    Hope this helps, will email you some other stuff as well.

    Take care.

    ReplyDelete
  42. Hi,

    I have just started running 2 miles a day after a year of no physical activity. The inside of my shin hurts when I press down on it with my thumb, it is approximately 4 inches above my ankle and the area is just about the top of my thumb. Is this a stress fracture?

    ReplyDelete
  43. Hi there,

    I will have examine you to be really sure what you have, but from what you described, I don't think it is a stress fracture. You haven't run for a while, its probably your tibialis posterior muscle "complaining".

    If it was, it would probably hurt a lot more at rest than what you described and not just when you press on it.

    Please have a look at the previous comments as well, you want to treat the cause and not just the pain.

    Take care.

    ReplyDelete
  44. Hi Gino,

    I recently started working out. Its been 2-3 weeks and ive been working out everyday. I usually do 3 miles at the gym a day. I get pain in both of my shins. It's an achy type of feeling. So i can't run for very long. Then when I stop running I walk fast and it still bothers me. It only bothers me while im working out. Not after or before. Im not sure if it's just my muscles that are weak or I do have shin splints. What do you think?

    ReplyDelete
  45. Hi there,

    again, I really need to be able to examine you to be sure. From what you described, it could be very early starting "signs" of shin splints or muscle fatigue in your tibialis posterior (muscle beside the shin bone since you have not rested in the last 2-3 weeks.

    With shin splints it usually responds well when you rest it. If you rest, ice etc you will definitely feel better. but as soon as you resume your running, the pain will probably recur. As such, you need to treat what is causing your pain.

    Please also have a look at Pain Free Running (http://weloverunning.blogspot.com/2009/03/pain-free-running.html) on March 17 and Do High Tech Running Shoes Work (http://weloverunning.blogspot.com/2009/03/do-high-tech-running-shoes-work.html) on March 14.

    Hope this helps. Take care.

    ReplyDelete
  46. Hey, Have been reading all the comments on this and nobody seems to have mentioned what I have done...

    I am a girl, an amateur boxer and a sports student, also training to be a gym instructor, been very fit and active for years, do loads of training almost every day, never usually have any complaints (apart from a skull fracture, concussion and muscle soreness from training)

    But recently at college we have started trampolining and they are really high off the ground, two weeks ago i jumped off and when i landed had a terrible shooting pain up my right shin. It was fine and i carried on how i usually do with my training, but i noticed i have the same pain when i begin exercise, then about half an hour in it seems to go away - or im not thinking about it, then as soon as i stop its agony, its like an aching, but its unbearable and it shoots up my shin. This will happen whatever type of exercise i do, even if its running up the road for 30 seconds, as soon as i stop it hurts like hell. Crouching is impossible, it hurts way too much.
    Obviously as a boxer we go through alot of pain and i am used to getting hurt, but this is begining to interfere with my training because the pain is getting worse and worse! The pain will last for a long time after the exercise. As a boxer i have to put alot of stress on it becuase of staying on my toes, especially my right leg, i cannot rest it and stop training becuase i need to keep up my boxing.

    Just wondering if you could tell me what i have done to my shin... I know jumping off the trampoline did it. And what can i do about it?

    Thanks,
    JC
    southpaw22@hotmail.co.uk

    ReplyDelete
  47. i'm a guy and i'm 16 but so ive been wrestling and playing soccer but during practice and after practice the pain on my shin bone (i know it's not shin splints) hurts to the point of tears. After practice i would sit on the field for about and hour before the pain to subside and i go home. I don't know what i should do it's highschool socer season and i dont want to get an x ray or anything because if it is like stress fractures or something i would be sitting out for the whole season. A whole season is a lot of time off to and it's really dissapointing. My email is, "itsquang@hotmail.com

    ReplyDelete
  48. Hi itsquang,

    have emailed you separately.

    Take care.

    gino

    ReplyDelete
  49. After a winter of intense cross country skiing, I started track in the spring. The first week I was sore in general, but no shin pain.

    The second week, we did hill repeats, and during that workout, I started to experience sharp pain in both of my shins. Every time my weight went over my leg, it felt like there was a crushing pressure on it. I iced a bit that night, and the next day at practice, it hurt a little at the beginning, but became unbearable after only a mile or two. I iced it again that night, but the next day even just walking (especially stairs) was incredibly painful.

    The next week, we were on vacation skiing (downhill). The first day, my shins hurt, but they felt much better after that, and by the end of the week, they didn't even hurt walking.

    When we got back, I went out to run, and very quickly (quarter mile) I had intense, excruciating pain in both shins. I walked back home, and even that was practically unbearable. The rest of the day, it was very painful, but I iced and took naproxen. The next day they felt much better but after running just 30 feet or so, they began to hurt again. I'm trying to rest them, but walking, and especially stairs, is so painful that I don't know how effective it is.

    The pain is in both shins, but much worse on the right. It is about 5 inches up from my ankle, slightly medial anterior, and I can feel some swelling along the tibia starting about 2" above and below. There is a point in the middle of the swelling at which it is extremely painful to the touch. Hopping on one foot hurts it, but is not unbearable.

    Thank you very much for any help or suggestions you can give me.
    -Rosy

    ReplyDelete
  50. Hi Rosy,

    I have to examine you to be sure what you have. But your pain that you described seems pretty nasty and intense, especially the swelling that you described.

    It may be that the change in activity from cross country skiing to track work was too sudden and rapid and much more weight bearing.

    With shin splints it usually responds well when you rest it. If you rest, ice etc you will definitely feel better. but as soon as you resume your running, the pain will probably recur. As such, you need to treat what is causing your pain.

    I will probably need to check your running style, leg length, foot imbalances, hip muscle strength. Also need to check your lumbar spine and the sciatic nerve (tibial branch) for referred pain. See if you can find a good physical therapist to do that for you. Remember treat the cause of the pain.

    Please also have a look at Pain Free Running (http://weloverunning.blogspot.com/2009/03/pain-free-running.html) on March 17 and Do High Tech Running Shoes Work (http://weloverunning.blogspot.com/2009/03/do-high-tech-running-shoes-work.html) on March 14.

    Deep water running will help you maintain your fitness too (http://weloverunning.blogspot.com/2009/04/aqua-based-rehabilitation-deep-water.html.

    Hope this helps. Take care.

    ReplyDelete
  51. Hi,

    I've been reading yours and other articles and would really like to get your opinion and/or advice on the pain I've been feeling in my shins as I'm not sure whether I have shin splints or more scarily a stress fracture :(

    I am a runner and footballer (soccer) though I had about 3 months out of sport due to lower back pain (lower disc and sciatic disc down to right leg). I have recovered from that and been running/cycling and playing football for over a month now. However, I started getting a painful ache all the way down the outside of my shins (particularly right leg) whilst running, which I tried stretching out and then would continue running. This also coincided with my getting new trainers (a different brand). The ache quickly turned to an ache/pain down the inside of my shins lower down near my ankle. This initially didn't affect my football but after about 2 weeks it did. I did try and continue running but realised it was causing too much pain and have decided to get a new pair of my 'old' trainers. for this last week I've hardly been able to play football and tonight at training I was in so much pain I was in tears. The pain is bad before/during and after and is localised in the lower part of my shin on my inside leg side - probably about 2 inches up from my ankle. The pain when it is at its worst (i.e. post training) is also apparent in my ankles too.

    The above has happened over about 5 to 6 weeks and I'm now worried I have a stress fracture. I've never suffered from shin splints before so not sure what I should be doing. I do ice/massage my shins but the pain now is even when I walk and especially bad going downstairs.

    I'd really appreciate any help and advice you can give as I'm really gutted that I cannot train after only recently getting over a back injury that prevented me training for over 3 months.

    If this is a stress fracture can you advise any other sports I can do while I rest? Is cycling ok? Any others?

    Thanks very much.
    Tamara.

    ReplyDelete
  52. Hi Tamara,

    Thank you for reading our blog,as I've said from previous posts, I'll have to examine you throughly before I can truly comment on what is wrong.

    From what you described, aside from shin splints causing your shin pain, your back pain can also refer pain to that same area and I will suggest getting a competent physical therapist to check your lumbar spine and the sciatic nerve (tibial branch) for referred pain. Should also probably check your running style, leg length, foot imbalances, hip muscle strength. Remember you need to treat the cause of your pain and not just your pain.

    The new trainers may be a contributing factor but I feel your pain may have also resulted from deconditioning from 3 months of sport because of your back pain.

    Please also have a look at Pain Free Running (http://weloverunning.blogspot.com/2009/03/pain-free-running.html) on March 17 and Do High Tech Running Shoes Work (http://weloverunning.blogspot.com/2009/03/do-high-tech-running-shoes-work.html) on March 14.

    Deep water running will help you maintain your fitness too (http://weloverunning.blogspot.com/2009/04/aqua-based-rehabilitation-deep-water.html.

    If you send me your email I can email you some other articles as well.

    Take care.

    gino

    ReplyDelete
  53. Hi Gino,
    Thank you for such an informative blog!

    I'm having terrible lower leg pain and I'd love your opinion about it. I was out for a run earlier this week and suddenly experienced pain in the lower part of the outside of my shin. It almost felt like a bruise. I finished that run, but have been in pain since. I do have an area of pain that I can pin point, and it hurts to flex and extend my foot, in addition to walk on it. I hadn't had any pain prior to that run.

    I haven't done anything, except a small amount of walking, for 4 days and the pain hasn't subsided at all. I really think it is a stress fracture. I'd love your thoughts.

    Thanks,
    Mary

    ReplyDelete
  54. Hi,
    I have been training for a 10 mile run. Last week we ran hills, and i could only complete a 3 mile run this week. I have been icing and resting completely this week, but today at the race, I could only complete 1.5 miles. My left leg now has no pain while resting, but I cannot put any pressure on it to walk without limping. When I put pressure on it, the pain is located between my foot and 3 inches up my leg...not quite where the shin pain was. It is not swollen and pressing on the area does not produce pain. Could this be a sprain or is it most likely part of the shin splints?

    ReplyDelete
  55. Hi!

    I think I've been battling shin splints for a while now, and hope it's not a stress fracture. Today I went for a 5 mile run and felt absolutely fine with no pain during the run or immediately after, but I felt a little soreness a few hours after after sitting down for a while. Is this more indicative of shin splints or a stress fracture?

    ReplyDelete
  56. Hey, do you mind if I ask a question? I'm in the 7th? week of track and in the best shape of my life. about 10 days ago, my shin started hurting, but it didn't feel like any shin splint's I've ever had before. When I had shin splints, the pain ran up and down my leg, but this is in one tiny spot. It feels like a bruise, but there's not any darkened skin. I put pressure on it to see if it felt like a bruise, but it hurt so much.. Contrary to shin splints before, I can flex my muscles without much pain. My coach said it's not likely that I have a stress fracture, and I went to our school's trainer and he told me it was shin splints, wrapped it, and sent me on my way. Wrapping it hurt worse than usual because there was more pressure on my shin. Oh, and I can walk around ok, but if I accidentally bang my shin on anything, it hurts wayy bad. Sometimes when I'm just sitting, I can feel it throb, but only a little. We have about 3 weeks left in the season, but I've read some terrible stories online and I'd rather not risk it for the long run. (no pun intended..) What do you think I should do?

    ReplyDelete
  57. Hi Mary,

    again, I probably have to examine you to be sure, but from what you said I don't think it is a stress fracture. Try and ice it and see if it settles. Stress fracture will usually hurt at rest and a lot more at night as well. Let me know how you go.

    ReplyDelete
  58. Hi Anonymous training for 10 mile run,

    Have to examine you, but I think its probably a strain of your tibialis posterior muscle (the muscle next to the shin bone).
    Please ice it and to solve your shin pain,
    please also have a look at Pain Free Running (http://weloverunning.blogspot.com/2009/03/pain-free-running.html) on March 17 and Do High Tech Running Shoes Work (http://weloverunning.blogspot.com/2009/03/do-high-tech-running-shoes-work.html) on March 14.

    ReplyDelete
  59. Hi Leisel and Halius,

    I probably need to examine both of you to be sure but I think you both have onset of shin splints or what is normally know is tibialis posterior strain. This is the muscle that usually causes shin splints.

    Need you both to check to see if you land on your heels when you run.

    If you do, that is not good as you will then pronate which means stress along your shin (tibialis posterior muscle), knee and ITB (vastus lateralis -or outer thigh muscle).

    After you land on your heels, you will then have what I will call "foot flat" which will cause you to pronate leading to the above chain of events that I mentioned. That causes your shin splints.

    So you need to treat the cause, icing, changing shoes, orthotics etc will only treat the pain, and not treat what is causing the pain.

    Please also have a look at Pain Free Running (http://weloverunning.blogspot.com/2009/03/pain-free-running.html) on March 17 and Do High Tech Running Shoes Work (http://weloverunning.blogspot.com/2009/03/do-high-tech-running-shoes-work.html) on March 14.

    Deep water running will help you maintain your fitness too (http://weloverunning.blogspot.com/2009/04/aqua-based-rehabilitation-deep-water.html.

    ReplyDelete
  60. Thanks for replying,

    I went to my school trainer and he said I didn't pronate very much at all. I can visualize what you mean about landing on the heels, though, and I do tend to be a heel striker. Will running on my toes more help it go away? I took two days off (which I didn't like very much)and it's starting to go away some. I only have two weeks left in the track season, and then it time for summer training. Summer training will be about 6 miles every day; would that be okay to do, or is it too much? I do about 5 miles a day currently.

    ReplyDelete
  61. Hi Halius,

    landing on your toes may create any problem, your calfs will get tight and sore from the extra work.

    Try and "fall from your ankles" while running and land on your whole foot. Practice it barefoot 1st and you'll be able to master it.

    Try and take 1 off day (meaning no exercise at all) to let your body recover.

    Take care.

    gino

    ReplyDelete
  62. Hi,

    Several weeks ago I started to develop pain in my shins when running. I let my shins relax for about a week by not running at all, then started back up again. I still felt pain, but continued to run maybe another time or two, until deciding to finally call it quits for a more extended amount of time. Besides pain in my shin, I also had pain on the inside lower part of my knees. It's been 7 weeks so far without running at all--only cycling in the gym for about an hour 2x a week. I haven't started running again because it still seems that when I walk (usually only longer distances and/or with weight, like a backpack or groceries) that the pain recurs, sometimes in both my shins and lower knee area. Right after I re-aggravated, I noticed the bone was very sensitive to pressure with my hand in certain parts. It doesn't seem as sensitive now, but still tender if I put pressure on the bone directly or on the sides near the muscles (there's also pain when touching in the knee area). I also noticed that when I flex my foot upward, as in walking up a hill, the muscles around the tibia seem to hurt. Just wanted to know your opinion on what you think is wrong. Also, if I should continue to use the bike (I use the one with the pedals in front not below you) in the gym as perhaps that may be adding to the long recovery process. Thanks for your help!


    P.S. From the best that I can tell by myself, I have a high arch and have a slightly overpronated gait, but nothing too severe I don't think. I haven't had shin splints in probably 2 years, running 10-15 miles a week.

    Thanks,
    Sam

    ReplyDelete
  63. I need some advice. I started a learn to run program back in march, I got some shin splints, or what felt like shin splints to me when I first started out, in both legs. I was able to run through the ones on my left leg, but my left leg has been progressively getting worse, I also did a 6km race, which may have been too much too soon. I haven't been running in 5 1/2 weeks now and have been having lots of active release therapy treatment on it, but nothing seems to be helping, just getting worse. I have the typical dull, nagging, nauseating ache on a small localized spot on the inside of my shin, there is a palpable bump there and it is very tender to the touch. I had and x-ray at the 4 week mark that showed nothing and then a bone scan 5 days later, the bone scan showed 2 "hot spots", one on my lower inside shin where I have been feeling all the pain and one on my old ankle fracture site, (I broke my navicular bone 3 years ago). My doctor phoned me today to tell me that it was just shin splints, but I am having a hard time believing that, I don't know what to do.

    ReplyDelete
  64. Hi,

    Good news from the bone scan that there is no fracture.

    You probably need to be treating what is causing the pain rather than treating the pain which is probably what active release is doing- just treating the pain. That's why it is not getting better.

    Active release, icing, changing shoes, orthotics etc will only treat the pain, and not treat what is causing the pain.

    Please also have a look at Pain Free Running (http://weloverunning.blogspot.com/2009/03/pain-free-running.html) on March 17 and Do High Tech Running Shoes Work (http://weloverunning.blogspot.com/2009/03/do-high-tech-running-shoes-work.html) on March 14.

    Deep water running will help you maintain your fitness too (http://weloverunning.blogspot.com/2009/04/aqua-based-rehabilitation-deep-water.html.

    ReplyDelete
  65. Hi Sam,

    will probably have to examine you to be sure of what is affecting you.

    The lower inside knee pain can be a strain on your pes anserinus (strain of either sartorius, gracilis or semitedinosus muscle) or it may be patello femoral joint pain which is an imbalance usually in the vastus lateralis or medialis muscle at the front of the knee. Both are easy to treat but again you want to treat what is causing it rather than just treat the pain.

    With your foot dorsiflexed upwards and feeling pain that is probably your tibialis anterior muscle hurting.

    Need you to check to see if you land on your heels when you run.

    If you do, that is not good as you will then pronate which means stress along your shin (tibialis posterior muscle), knee and ITB (vastus lateralis -or outer thigh muscle).

    After you land on your heels, you will then have what I will call "foot flat" which will cause you to pronate or overpronate leading to your shin and lower inside knee pain.

    Cycling on a reclined bike or normal upright stationary bike is fine.

    Again please have a look at Pain Free Running (http://weloverunning.blogspot.com/2009/03/pain-free-running.html) on March 17 and Do High Tech Running Shoes Work (http://weloverunning.blogspot.com/2009/03/do-high-tech-running-shoes-work.html) on March 14.

    Deep water running will help you maintain your fitness too (http://weloverunning.blogspot.com/2009/04/aqua-based-rehabilitation-deep-water.html.

    Hope this helps, take care.

    ReplyDelete
  66. Gino,
    Hello, my name is Joe.I am experienced runner, but I took 3 years off running due to work schedule. I started up in the winter, but started to get some leg pain so I stopped. I started up 6 weeks ago. I started at 3-4 miles per day 5-6 days a week. I increased to 5+ miles per day 5-6 days a week. I had a stressed fracture in 1992 & 1994. I feel some pain once in awhile after running in the same spot on my right leg. Just a dull slight pain. I can run w/o pain and can do the one leg jump over 30 times and no pain. Am I just being worrier and imagining this. I don't want to get hurt again. I started to incorporate some biking into my routine while I ice and rest my leg for the next week or so. Can you give me any advice? Anything would be appreciated. Please email me at runn4hisglory@altelco.net.

    ReplyDelete
  67. Hi Gino,

    I started experiencing pain on the bottom of my both legs (inner side) since more than a year ago. I have most of the shin splint symptoms as described on the net, including feeling the pain before the warm-up but disappearing after a while of workout, and then the intensive pain after the workout.

    I have already tamed down my routine exercise, like resting 1-2days before my next workout. I even tried resting for 2 weeks as I'm worried that it could be a shin fracture afterall and might take longer time to heal. The pain does go away as long as I rest, but apparently I still can't fully eradicate the problem.

    I guess I don't have the pronation issue because I had never suffered shin splint in the past. The only reason I could think of is the long hiatus I took from my running 2 years ago. This could have resulted my body unable to adapt back to the previous running condition i was trained to.

    I'm pretty sure this is a shin splint but my concern here is that I do not know if my condition is still a shin splint or it has already aggravated to a shin fracture.

    I will be enlisting into the army for my national service 2 months later, and i'm worried that if i can't get rid of this in time, i will have to bear through it for 2 years in the army, which may worsen given the hectic training in army.

    As much as I would want my legs to heal, I would not want to stop running.

    Please advice! Your help is greatly appreciated! Perhaps you might to email your advice to me at international_king1990@msn.com

    Thanks!!!!!!

    ReplyDelete
  68. Hey Gino,

    I was just wondering if you could tell me if this sounds like a shin splint or a stress fracture. I have had shin splints for the past 6 months. I never thought anything really of it because after I got warmed up it was fine. Now I have a pain in my left shin down low but not that bad unless you touch it or continue to run on it. BUT my right leg is killing me. I am an excercise freak so I wont quit but it hurts so bad I cant walk. Like right now I am lying in bed and it really hurts. Its not aches anymore its shocking pain. I ran today and I hopfully will be able to grit it and run tomorrow. Just wondering if that sounds like a stress fracture or just a shin splint.

    Thanks!

    ReplyDelete
  69. Hi there,

    I really have to examine you to be sure, but resting pain (while lying in bed) is not good. You need to get it treated. Please treat the cause and not just the pain.

    Your physio should do a detailed history of your presenting symptoms and check on your running gait, your lumbar spine for referred pain and your glut medius strength.

    Also have a look at the following --Pain Free Running (http://weloverunning.blogspot.com/2009/03/pain-free-running.html) on March 17 and Do High Tech Running Shoes Work (http://weloverunning.blogspot.com/2009/03/do-high-tech-running-shoes-work.html) on March 14.

    Deep water running will help you maintain your fitness too (http://weloverunning.blogspot.com/2009/04/aqua-based-rehabilitation-deep-water.html.

    Hope this helps. Take care.

    ReplyDelete
  70. ...what about shin splints & basketball? my h.s. daughter had a really bad episode last year with shin splints turning into stress fractures-resulting in half the season on crutches to heal them. You say "to treat the cause", how do we do that so it doesn't happen again? She's just started daily practice after conditioning 2-3 times aweek, with the 1st game coming up Nov. 13th! Today she was in tears after practice because she's starting to feel the same pain as last year & doesn't want a repeat year, is she going to be able to play?

    ReplyDelete
  71. Hi there,

    "treat the cause" means finding exactly what is causing her shin pain. Whether she is doing too much too soon after a break or in preseason, whether her lumbar spine and the sciatic nerve (tibial branch) is referring pain to her shin. Should also probably check her running style, leg length, foot imbalances, glut medius muscle strength etc.

    I suggest you look for a competent physical therapist to do detailed history of your daughter's presenting symptoms and treat the cause and (not just treat the pain by icing stretching etc).

    Hope this helps.

    ReplyDelete
  72. Hi,

    My daughter is a cross country runner and has been told by her school physical therapist that she possibly has a stress fracture. We sent her to a doctor who said the only way to tell is to have a bone scan, but that she more than likely had shin splints.

    That was about 3 weeks ago. She is not any better. Yesterday we took her to another doctor who then referred her to a specialist and told her to take ibuprofen until the appointment.

    My problem is that she does not seem to be getting any better even though she has limited her running. The appointment is not until December 17th. I'm afraid that she will end up doing more damage to her leg if we wait any longer. But the doctors don't seem to be concerned and said she would be fine to wait. I think she needs to be seen ASAP.

    Am I being over protective?

    ReplyDelete
  73. Hi there,

    no you are acting like any concerned parent should. By taking Ibuprofen she may be masking her pain to allow her to run and this may worsen her condition.

    Limiting her running may not help. I will definitely need to examine your daughter to be sure but I think she has onset of shin splints or what is normally know is tibialis posterior strain. This is the muscle that usually causes shin splints.

    I need you to check and see if your daughter land on her heels when she runs.

    If she does, that is not good as she will then pronate which means stress along her shins (tibialis posterior muscle), knee and ITB (vastus lateralis -or outer thigh muscle).

    After she land on her heels, she will then have what I will call "foot flat" which will cause her to pronate leading to the above chain of events that I mentioned. That causes her shin splints.

    So you need to treat the cause of her shin pain (which in her case may be her landing on her heels), icing, changing shoes, taking medication, orthotics etc will only treat the pain, and not treat what is causing the pain.

    Please also have a look at Pain Free Running (http://weloverunning.blogspot.com/2009/03/pain-free-running.html) on March 17 and Do High Tech Running Shoes Work (http://weloverunning.blogspot.com/2009/03/do-high-tech-running-shoes-work.html) on March 14.

    Deep water running will help you maintain her fitness too (http://weloverunning.blogspot.com/2009/04/aqua-based-rehabilitation-deep-water.html.

    Hope this helps. If you send me your email I will send you some other articles. Take care.

    ReplyDelete
  74. how do i know if i have gotten a stress fracture or shin-splints. the doctor whom i first consulted with said that i have shin splints, and told me to ice the shin area and take rest. i did that for nearly 4 months, but still i have little pain when i run and this will definitely increase if i run more. so i consulted with another doctor who told me that it is stress fracture and gave me some calcium tablets for 45 days. now its has been nearly 4 months and i can still fell that slight pain near my shin area. what should i do ?? should i take more rest or should i gradually start to run again ???

    ReplyDelete
  75. Hi VJ,

    I have to examine you to be sure what you have. But from what you described, you most likely have shin splints or what is normally know as tibialis posterior strain. This is the muscle that usually causes shin splints.

    The doctors you saw haven't sent you for any scans so there is no confirmation of what your condition is like now.

    I need you to check and see if you land on your heels when running.

    If you do, that is not good as you will then pronate which means stress along your shin (tibialis posterior muscle), knee and ITB (vastus lateralis -or outer thigh muscle).

    After landing on your heels, you will then have what I will call "foot flat" which will cause pronation leading to the above chain of events that I mentioned. That causes your shin splints.

    So you need to treat the cause of your shin pain (which in your case may be landing on your heels).

    Icing, changing shoes, taking calcium or medication, orthotics etc will only treat the pain, and not treat what is causing the pain.

    Please also have a look at Pain Free Running (http://weloverunning.blogspot.com/2009/03/pain-free-running.html) on March 17 and Do High Tech Running Shoes Work (http://weloverunning.blogspot.com/2009/03/do-high-tech-running-shoes-work.html) on March 14.

    Deep water running will help you maintain her fitness too (http://weloverunning.blogspot.com/2009/04/aqua-based-rehabilitation-deep-water.html.

    Hope this helps VJ, take care.

    ReplyDelete
  76. I had stress fractures on both of my femurs when i was practicing in football, what you stated is very accurate, it took me a long time to recover, but im playing football next year.

    ReplyDelete
  77. I don't know if I have a stress fracture or a shin splint! I ran a 10k about 2 weeks ago. I'd been training for it on a treadmill by running about 8-8.5k, so running the full 10k distance on a hard road was a first for me. Consequently, I now have a dull pain in my right leg, on the upper inside tibia, just below the knee.

    At first I thought it was just a minor shin splint, so after resting for 3 days after the 10k, I ran 7.5-8k two more times. But the pain didn't get better, so now I'm worried I've worsened a stress fracture! The pain is mild but hurts if I run or put weight on my leg (like going downstairs). I've taken no medication and haven't applied ice.

    Now that I've researched and read up on shin splints and stress fractures, I realize I was stupid and shouldn't have resumed running after I felt pain. What should I do? Continue to rest the leg and wait for it to heal? Is it a fracture or a shin splint?

    thanks,
    DG

    ReplyDelete
  78. Hi DG,

    I need to assess you to be sure, but I don't think it is a stress fracture. If it is, chances are you will have some swelling and definitely tenderness over the area all the time. Night pain is also present, all of which you do not seem to have.

    Please ice it, read some of the comments above about how you should be running and it will definitely help.

    Take care.

    ReplyDelete
  79. I have a question. I had a 2nd metatarsal stress fracture diagnosed by an MRI the end of Dec. I had the pain, swelling, edema and redness. I was put in an aircast for 2 months. So far my x-rays have not shown any callous formation, most recent one yesterday. One of my doctors is very concerned and the other is not worried. He says symptoms at this point, are what is important. I do not have any pain above the 2nd metatarsal unless I push on it. I still have that red circle above the area and at the end of the day I do have some swelling. But I am really concerned about not having any callous formation at this point. I am worried that it is not healing and that at any point it will become a displaced fracture. I am afraid to do anything. Does everyone develop callous formation??

    ReplyDelete
  80. Hi, so I had pretty bad pain in my shins and over the past week I stopped running and went on a stationary bike instead. Since then pain has been subsiding quite a bit and I recently found out that a part of the problem may be that I am flat footed and I will be wearing insoles from now on. I am thinking that with this subsiding pain and laying of the running, it shouldn't be anything really serious right? What would indicate to a person that it might be a stress fracture?

    Sara

    ReplyDelete
  81. Hi there,

    yes callus formation is indicative of bone formation. It's a good thing not to have pain on the fracture site, but we do want callous formation as that will be indication that healing is taking place. May want to consider ESWT (extracorporeal shock wave therapy).

    Please check with your doctor or seek 2nd opinion.

    ReplyDelete
  82. Hi Sara,

    I need to assess you to be sure, but from what you described, it is probably not a stress fracture.

    You probably need to be treating what is causing the pain rather than treating the pain.

    Active release, icing, changing shoes, orthotics etc will only treat the pain, and not treat what is causing the pain.

    Please also have a look at Pain Free Running (http://weloverunning.blogspot.com/2009/03/pain-free-running.html) on March 17 and Do High Tech Running Shoes Work (http://weloverunning.blogspot.com/2009/03/do-high-tech-running-shoes-work.html) on March 14.

    Deep water running will help you maintain your fitness too (http://weloverunning.blogspot.com/2009/04/aqua-based-rehabilitation-deep-water.html.

    Hope this helps, take care.

    ReplyDelete
  83. Hi. I've had shin splints for about two years now. I got them last year during track season and I kept running throughout the whole season while having PE that semester, too. I iced them every night and took aleve on days I had practice and I tried new insoles in my shoes. But they ended up getting pretty bad. They hurt before, during, and after running. A dull aching pain to a sharp localized pain on the inside of my shin. It hurt when I walked and when I didn't. After the season was over, I only went on runs every once in awhile. They started to feel better but the pain would come back every once in awhile when I ran or jumped on hard surfaces. Now, I'm in track again. The pain is back just as bad as last year. I've never seen a doctor about it because I don't want to quit but on the other hand, I want them to heal before it gets too serious. I'm 15 and a pretty athletic person and I hate how my legs have held me back on becoming a better athlete. If you have any advice, it'd be greatly appreciated. thanks,
    renee

    ReplyDelete
  84. Hello. I had shin splints when i started spring track this year and i visited my school trainer. He told me to rest and i restest for 5 days. Actually it got better and im sure it was completely healed. Then i started workout. It was fine when i did 3mile loop but my shins are killing me after sprint workout (im distance runner). Since then my right shin hurts really bad. I cant even walk nor walk up and down stairs for 2-3 days now. I know how it feels when your body is sore but its like different pain. for My lower right leg, its like more bone is hurting but upper right leg is like muscle is aching. I tried eveyrthing ice, streches, recovery drills for shin splints. It wont get any better but worse. So my question is are these symptoms related to shin splints? or stress fracture? BTw my left leg is only the lower part. It doesnt really hurt when i run compare to other leg. but when i press, it hurts. the pain is like on the bone. thanks for reading!

    ReplyDelete
  85. Hi,
    Need you to check to see if you land on your heels when you run.

    If you do, that is not good as you will then pronate which means stress along your shin (tibialis posterior muscle), knee and ITB (vastus lateralis -or outer thigh muscle).

    After you land on your heels, you will then have what I will call "foot flat" which will cause you to pronate leading to the above chain of events that I mentioned. That causes your shin splints.

    So you need to treat the cause, icing, changing shoes, orthotics etc will only treat the pain, and not treat what is causing the pain.

    Please also have a look at Pain Free Running (http://weloverunning.blogspot.com/2009/03/pain-free-running.html) on March 17 and Do High Tech Running Shoes Work (http://weloverunning.blogspot.com/2009/03/do-high-tech-running-shoes-work.html) on March 14.

    Deep water running will help you maintain your fitness too (http://weloverunning.blogspot.com/2009/04/aqua-based-rehabilitation-deep-water.html.

    Hope this helps. Take care

    ReplyDelete
  86. Hi,

    I have had shin splints for the past 7 months, during basketball season, and was only recently able to rest starting mid-March. I took two weeks off completely from running but that didn't really help as I tried to run one day and developed pain. Now I'm receiving, ultrasound and stim once a day, in addition to stretching and calf raises and no running. I've been wearing custom made orthodics as well for the past 4 months. I last had an MRI in December and was wondering whether I should get another one? My concern is that I now get pain after walking which used to never happen. Also how do I figure what the cause of the shin splints were in the first place and prevent this in the future? Thank you.

    ReplyDelete
  87. hi. i have been having this pain in my left leg, on the inner side above my ankle but below my gastrocnemius. i do not feel the pain all the time the i walk. i run both cross country and track. i took a week off after school ended and then i began to run again. but after 6 days of running my left leg began to hurt in the area i just described. i have stopped running for a week now and usually no longer feel the pain when i walk. i usually only feel it after i poke the area to test and see if the pain has gone away. but sometimes it will start to randomly hurt. or it begins to hurt after i jump or land hard at the bottom of the stairs. i am worried i have a stress fracture because this does not feel like shin splints, and is in such a strange specific spot. i do not want to go to the doctor because if it is a stress fracture they will put me in a boot. i cannot be in a boot because this summer i have many active plans and am going on a 5 day 50 mile backpacking trip in the adirondack mountains as well as many other physical activities. how can i get the pain to go away completely? is it even a stress fracture? what should i do? should i go to the doctor? i am really freaking out about this and am so worried. one of my friends who had a stress fracture said she is pretty sure i do not have one. but then again she is not a doctor. please help advise as much as you can. i would really appreciate it. thanks so much.

    ReplyDelete
  88. Hi There,


    I need to assess you to be sure, but from what you described, it is probably not a stress fracture.

    You probably need to be treating what is causing the pain rather than treating the pain.

    Active release, icing, changing shoes, orthotics etc will only treat the pain, and not treat what is causing the pain.

    Need you to check to see if you land on your heels when you run.

    If you do, that is not good as you will then pronate which means stress along your shin (tibialis posterior muscle), knee and ITB (vastus lateralis -or outer thigh muscle).

    After you land on your heels, you will then have what I will call "foot flat" which will cause you to pronate leading to the above chain of events that I mentioned. That causes your shin splints.

    Please also have a look at Pain Free Running (http://weloverunning.blogspot.com/2009/03/pain-free-running.html) on March 17 and Do High Tech Running Shoes Work (http://weloverunning.blogspot.com/2009/03/do-high-tech-running-shoes-work.html) on March 14.

    Deep water running will help you maintain your fitness too (http://weloverunning.blogspot.com/2009/04/aqua-based-rehabilitation-deep-water.html.

    Hope this helps. Take care

    ReplyDelete
  89. Hi,
    I walked/ran a half marathon 3 weeks ago and have had pain in my shins since. It starts off with the main minimul in the morning and worsens during the day. I had an appointment to see a doctor in 2 days but they just called to cancel and moved it out another 2.5 weeks. I dont think I can wait that long for pain, and wondering if going to an urgent care is going to help any. I ice it a few times a day, keep it elevated when possible and I have a desk job so I am not standing on it a lot. Do you think I should go to an urgent care or wait it out?
    Thanks, C

    ReplyDelete
  90. Hi Gino

    Great blog, thanks for posting replies. Very informative.

    Perhaps you can help me. I've got pain along the front of my tibia (both legs although my left is worse) and I'm worried it's a stress fracture.

    I am recovering from an Achilles injury and have undergone a running style readjustment so I now land on the front of my foot more. I recently increased my mileage as my Achilles has been feeling much better, but now I'm feeling pain in my shins and in the bone (tibia?) above my shin. It is sore to touch up and down the bone (even lightly) and today I felt it a bit throughout the run. Usually once I get running and after about 10minutes it goes. I run for approximately 40minutes at a time, but last Saturday I did an hour and that was when I noticed some pain in my tibia. I gave it two days rest and ran today but the pain was a bit more noticeable during the run.

    Does this sound like a stress fracture? I'm also wondering if running too much on the front of my foot can cause stress fractures as well? You mention hitting the heel is bad, but what about the front of the foot? Also, any help for strengthening muscles around that area etc so I can prevent stress fractures or pain would be greatly appreciated as well.

    Kind regards
    KF

    ReplyDelete
  91. Hi KF,

    as I written before, I need to assess you to be really sure, but from what you described, you probably do not have a stress fracture.

    Landing on your toes are not good either (try walking up and down your hall on tip toes, after a short while your calf muscles start to get sore).

    Landing on the whole foot and "picking" it up with your hip flexor muscles would be best as you then do not tax the leg and foot muscles much at all.

    Hope this helps. Take care.

    ReplyDelete
  92. Hi Claire,

    great job on finishing your race. If the pain persists, I would suggest looking for a good physical therapist/ athletic trainer to take a look at it first.

    Unless it is really a very bad stress fracture, the doctors will probably not have you use crutches.

    Try to "pick" your leg off the ground while walking by using your hip flexor muscles and land on the whole foot to take some impact of the lower leg.

    Take care.

    gino

    ReplyDelete
  93. Hello,

    Very informative post. I have a few questions regarding my personal situation if you could be of any help! I run marathons. About 4-5 weeks ago, I experienced pain in my right tibia (bottom/inner right leg) while running. The pain was not intense but was definitely noticeable. I continued to run on this. After about 2 weeks of running, the pain did not increase, but the pain did not go away either so therefore I decided to stop running. I stopped running for about 2.5 weeks. I went on a few runs after 2.5 weeks off of running and I experienced no pain. However, after running, when I pressed on the area, I did feel some tenderness in one area. I went on a couple of more runs and then my leg hurt slightly when running again. Not as intense as before, but noticeable. What do you think this could be? Stress Fracture? Some type of Shin Splint? What do you recommend that I do? Is icing/stretching/ibuprofen helpful? Thank you so much!!

    ReplyDelete
  94. Hi Gino,
    I experienced this 5cm above my ankle at the side of the lower leg there is a slight swell and tenderness in the area. Being there for more than a year. I can still undergo physical exercise, running, biking,etc. So didnt sought treatment. Pain when pressure is applied. Until recently, even during rest, there is a on and off throbbing pain.
    I went consultation last year and given Fastum gel to apply. But does not help. Had X rays and no abnormality. Is this a problem of Shin Splints? Please advice. Thanks

    ReplyDelete
  95. Hi Mary,

    I can only tell for sure I examine your leg, but from what you described it is probably not a stress fracture.

    Probably early stages of shin splints of strain over your tibialis posterior muscle.

    Icing, meds etc helps the pain bu does not treat the cause of your pain.

    Active release, icing, changing shoes, orthotics etc will only treat the pain, and not treat what is causing the pain.

    Need you to check to see if you land on your heels when you run.

    If you do, that is not good as you will then pronate which means stress along your shin (tibialis posterior muscle), knee and ITB (vastus lateralis -or outer thigh muscle).

    After you land on your heels, you will then have what I will call "foot flat" which will cause you to pronate leading to the above chain of events that I mentioned. That causes your shin splints.

    Please also have a look at Pain Free Running (http://weloverunning.blogspot.com/2009/03/pain-free-running.html) on March 17 and Do High Tech Running Shoes Work (http://weloverunning.blogspot.com/2009/03/do-high-tech-running-shoes-work.html) on March 14.

    Hope this helps, take care.

    ReplyDelete
  96. Fastum gel will probably not help as it normally works superficially.

    As mentioned above you need to address the way you run, please see the comments above.

    ReplyDelete
  97. Hello thank you for your posts, reading them has been really helpful. I am a 27 year old athlete on crutches with swelling around the neck of my right femur. I have been on crutches for 3 weeks and will be on crutches for 5 more according to my doctor. Now I have developed a dull pain in my tibia 2 inches below my knee that occasionally turns into a sharp pain when I stand on it. I suspect I may have developed a stress fracture. I have a doctors appointment in two days to address both injuries. Any advice on what might help my recovery. My doctor has recommended rest for the femur, but I was wondering if there is something more I could be doing?

    Thank you

    ReplyDelete
  98. Hi there,

    If you have not been weight bearing fully, chances are that it is not a stress fracture. It is probably a compensatory pain from using your crutches.

    If you can find a kinesio tape practitioner to tape you, it can help with the swelling in the femur and also to relieve your shin pain. Probably it would be best to find out what exactly is causing the shin pain to solve the problem.

    Deep water running is best to maintain your fitness and the hydrostatic pressure in the water can also alleviate your swelling (http://weloverunning.blogspot.com/2009/04/aqua-based-rehabilitation-deep-water.html.

    If you give me your email, I can email you specific programs.

    Take care.

    ReplyDelete
  99. Hi Gino,

    I am currently using Adidas Response Cushion Shoe for my running. I experienced pain in my lower inner right leg after the run. The place feel tenderness on touch/pressure. Could this be a sign of shin splints?

    Does kinesiotaping reduce the shin pain? Is your course free for all to attend? And how much is consultation at your clinic?

    -Shi Ting

    ReplyDelete
  100. Hi, I'm 43, female, and have been running 3-5 days a week for about 1 year. Until last week, I was running 5 to 7 miles 3 or more times a week with no increase in distance in about 2 months.
    Over the past couple of weeks, I have had numbness in my right shin and in the fourth & fifth metatarsals, as well as mild pain just below the top of my tibia when going up stairs or when my heel strikes as I walk.
    I am not a heel-striker when I run, have a fairly neutral gait, and don't experience pain when I'm running.
    The numbness is a really strange feeling, rather warm and heavy. I have no swelling, and NSAID's don't seem to lessen the sensation. Massaging the area doesn't hurt, although when I extend my leg straight out in front of me while sitting, I feel a pain vertically along the top of my tibia.
    I have taken ten days off running, and am extremely frustrated. I would keep running, but worry that I will worsen whatever this is. I don't have insurance, and would appreciate any advice re: what this might be and whether I would benefit from seeing a physician.

    ReplyDelete
  101. hello, i have no pain while training but after i have finished and rested for awhile i get a sharp pain in my upper tibia when i stand up and then it starts aching unless i sit down, any idea what this might be?

    ReplyDelete
  102. oh, and the pain is in my left leg and it started after i went for a run with my friend for about 3k including a steep hill, this was my first run in about 4 weeks, i play soccer too but that hasnt had any affect on it until it started aching after i had rested.

    ReplyDelete
  103. Hi Shi Ting,

    I have to Examine you to be sure, could be starting signs of a shin splint.

    Kinesio taping helps the pain but not what is causing your pain, so still need to treat what is causing your pain.

    I teach the course, but it is organized by Progress Healthcare www.progress.com.sg

    ReplyDelete
  104. Hi Connor,

    have to examine you to be sure, but probably not a stress fracture. Ice it and it should settle down.

    ReplyDelete
  105. Hi Castiza,

    what you describe seems to be a nerve root irritation--i.e. coming from your back, of course I need to assess you to be sure.

    Please see good physical therapist to treat the cause.

    ReplyDelete
  106. Hi, First off, thank you so much for this blog- it's very helpful and informative. I am a 23 year old female runner. I have been running for over 7 years now and started preparing for my 5th marathon this summer. I've had consistent increase in mileage, am always aware of repalcing my shoes when they're getting to accumulate over 500 miles and I wear orthotics (super feet). I also am very conscious about stretching and taking calcium. Recently, while running 10 miles, I felt a dull but persistent pain in my right lower shin towards the side. I ran through it because I tend to always be tight in my side shin area. The next day, in the morning, it hurt a lot, like a bruise. I ran that evening and the pain didn't entirely subside while running but wasn't unbearable either. Not until I stopped to grab a drink and then started up again. At that point there was a brief intense pain. I decided not to run since then and the pain hasn't really gone away. It's worse in the morning and tends to subside as I walk around a bit and also a little bit when I ice it. What worries me to think it's a stress fracture is that there is a definite specific point of pain when I press along the side of my shin bone. The pain does not go up and down all of my shin but rather is in one specific area on the bone. Also, when I press along the back of my ankle (achilles tendon) I feel the pain in that exact spot. I have pretty good mobility of the leg, moving it up, down, flexing and pointing doesn't hurt much, just a dull pain.
    I have a marathon Nov. 27th and it's heart breaking to think I might not be able to run it. What are your thoughts? forget the marathon?

    ReplyDelete
  107. Hi there,

    I need to examine you to be sure, but from what you described, it probably isn't a stress fracture.It probably starting signs of shin splints.

    Your calf/ Achilles is probably tightening up as a result as well.

    Please read my previous comments about treating the cause of your pain and not just the pain.

    Need you to check to see if you land on your heels when you run.

    If you do, that is not good as you will then pronate which means stress along your shin (tibialis posterior muscle), knee and ITB (vastus lateralis -or outer thigh muscle).

    After you land on your heels, you will then have what I will call "foot flat" which will cause you to pronate leading to the above chain of events that I mentioned. That causes your shin splints.

    Please also have a look at Pain Free Running (http://weloverunning.blogspot.com/2009/03/pain-free-running.html) on March 17 and Do High Tech Running Shoes Work (http://weloverunning.blogspot.com/2009/03/do-high-tech-running-shoes-work.html) on March 14.

    All the best.

    gino

    ReplyDelete
  108. Hello, I've had bones scans on my shins a few months ago now and was originally diagnosed with shin splints. however now 4 weeks later after competing at sport aerobic nationals i have constant shin pain in both legs (particularly in right). I constantly experience night pain, and pain generally 24/7 with very few exceptions. If it turns out to be a stress fracture, will i have to wear a boot? And will i be able o continue with aerobics?

    ReplyDelete
  109. Hi there,

    in serious cases, you may need a rocker boot or may even have to use crutches to take some loading off your legs.

    Time off training/ aerobics is usually 6 weeks before full recovery.

    Hence better not to get to that stage.

    Low dose pulsed ultrasound can help bone healing if done correctly.

    Take care,

    gino

    ReplyDelete
  110. Hi! I'm a dancer and I do ballet, tap, kickline, and hip hop. I also have hypertension in my ankle which my PT said give me a weak ankle. I started having pain on the inside of my ankle but about 2-3 inches above the ankle. It started out with just dull pain, but now it's really bad and its starting to hurt when I go downstairs as well. Is it just hin splints or a stress fracture? Also, it hurts A LOT when I press down on the area.
    thanks!

    ReplyDelete
  111. Hello,
    After training/running progressively more intense over a 10 week period I took a week off. I had some shin pain during my last week of training, but I usually ice after running and not a big deal. Towards the end of my 1 week rest I noticed bruising on the outside shin area from just below the knee to almost my ankle. No specific pain while walking, just pain to the touch. I also had tingling in my foot. Sport physician had not seen this before and could not explain why I had no pain while walking or when manipulating foot/ankle, which apparently should have been present with shin splints. After 3 weeks of rest still sore to the touch, bruising and tingling gone, and dull resting pain or throbbing intermittently throughout day. Any thoughts?

    ReplyDelete
  112. Hey...

    A question if this is still an active forum...I play basketball 3 times a week and seems no matter how slow i start out as far as duration is concerned, i always develop shin splints. I already have them from playing for the last 3 months and my adult leagues are just now starting this month.

    I have been getting them on and off playing basketball for the last ten years, and im sure at times have developed stress fractures although have had enough off time during certain times of the year i would hope that is currently not an issue..as i mostly feel the pain while playing and only during certain movements on days i dont play.

    anyways, aside from rest, once my shins have recovered, what are some things i can look in to, to see what may actually be causing my shin splints? should i be doing certain exercises or lifting weights to strengthen these muscles prior to getting back to basketball? i just dont know how to eliminate this problem, im ready to be done with shin splints they cause so much pain when im active which is very often, thanks.

    ReplyDelete
  113. Hi there,

    I will need to assess you to tell for sure what is causing your shin splints. If you've read some of the comments above, we like to treat the cause of your shin splints and not just your pain so it doesn't come back.

    You probably don't have stress fractures, if not there will usually be pain at rest as well.

    ReplyDelete
  114. Hi

    I'am 13 years old and have osgood schlatter disease and play football 2 times a week. last weekend i played football for the first time in two months on rubber crumb astroturf for one hour and a half. by the end my knee's were caning and had aching pane worser than usual. This monday as hurrying to next lesson at school my leg just got a sudden stabbing pain on my shin (right dominant leg).

    The it aches but pain hurts when i walk or lift my toes up or squat down or put all weight on it. I havent tried running on it yet but guess its gonna hurt along with my knee's.

    What do you think i have shin splint or stress fracture? What shall i do?

    ReplyDelete
  115. I'll have to examine you to be sure, but probably not stress fracture, please ice and get it checked.

    You're probably going through a growth spurt and your bones may be growing faster than your muscles and the muscles may take a while to "catch up".

    Read some of the previous comments to treat what is causing your pain.

    Take care,

    gino

    ReplyDelete
  116. Hi. I am a marathon runner, and I am training for Boston. I live in an area with hills and mountains, and train mostly outside. I am using a treadmill for the bad weather days, but prefer to run outside. Recently, I have had problems with posterior shin splints. I went to my running store, and they had put me in shoes for overpronation and I actually supinate. So, I changed my shoes immediately. I am using compression calf sleeves when running, and compression socks for recovery. Icing, elevation, and taking ibuprofen. My problem is that I can't seem to find a shoe that helps this. The place where I go is a store specifically for runners, but each shoe makes it worse. I evaluate my stride, my form, use kinetic tape, etc. I'm doing stretches for my calves and shins, etc. my next Marathon is March 4, and I can't take time off right now. Any suggestions?

    ReplyDelete
  117. Hi there,

    as I've written from previous comments it's you running form that truly matters. Please have a look at the previous comments.

    ReplyDelete
  118. Hi Gino,

    I am uttterly frustrated! Shin splint started after some overtraining with running. It wasn't gradual onset, it was sudden after the run. It started as mild pain. Anterior-lateral tibia. I immediately stopped running. Saw an orthopaedic doctor. He did an xray which didn't show anything, he didn't want to do other imaging. He said that I could bike or use elliptical machines. Mostly, I biked. I saw a physical therapist twice per week for four weeks, ultrasound, massage, ice, and strengthening exercises with an elastic band. About a week after ending physical therapy the pain got much worse. I had done some short bike rides three days in a row and then 30 minutes on an elliptical machine. Saw the ortho guy. He did another xray, he said that if I had a stress fracture it would show by now. He did see some rough tissue on the anterior part of the shin that he said could be the irritated periosteum. He put me in a walking boot. I am doing no biking and no cardio exercise for a month. It hurts to walk in the boot, but I think it hurts more without it. I'm icing it and using diclofenac, topical. Advice would be appreciated. I was first injured two weeks before Thanksgiving. I have been in the boot for about 5 days.

    ReplyDelete
    Replies
    1. Hi Rick,
      sorry to hear about your condition. A stress fracture will usually show up on x-ray a month later.

      Please read the comments on changing running style above and treating what is causing your shin pain rather than just treating the pain.

      Deep water running will also help (http://weloverunning.blogspot.com/2009/04/aqua-based-rehabilitation-deep-water.html).

      If you email me I can send you more information.

      Take care and hope this helps.

      gino

      Delete
  119. Hi, I've had shin splints since freshman year since I joined basketball, I am now 21 and have been going on and off from running or anything to prevent severe shin splints. I have a physical exam in 1-3 months and I need to get in shape, I started running again to get condition but the shin splints have gotten the best of me, I know I need rest but this exam is important, so how else can I get stamina, endurance, and condition with out running so my legs can heal.

    ReplyDelete
    Replies
    1. Deep water running (http://weloverunning.blogspot.com/2009/04/aqua-based-rehabilitation-deep-water.html)& intervals on a stationary bike will help.

      Remember what I mentioned above, treat the cause and not just the pain.

      Delete
  120. Hey, i've been having shin splints starting from i think about two months ago in both my legs due to soccer. my coach told me that i could rest until it got better, but since soccer requires running, i should basically suck it up. he also said if i visited the doctor, all they would tell me to do is ice it down and rest. but since soccer requires a lot of running and i dint want to get out of shape, i havent been resting it much. now, i only feel the pain in my right shin and i feel a slight bump near the area and i dont know if it has developed into a fracture thing yet. i wanna keep running on it since my season just started, but i dont know if it'll get worse..what do i do?

    ReplyDelete
    Replies
    1. You can do deep water running to keep your fitness levels up
      http://weloverunning.blogspot.com/2009/04/aqua-based-rehabilitation-deep-water.html

      Get a competent physical therapist to check and see if you land on her heels when you run.

      If you do, that is not good as you will then pronate which means stress along your shins (tibialis posterior muscle), knee and ITB (vastus lateralis -or outer thigh muscle).

      After landing on your heels, you will then have what I will call "foot flat" which will cause you to pronate leading to the above chain of events that I mentioned. That causes your shin splints.

      So like I wrote in the comments above you need to treat what is causing your pain and not just treat your pain.

      Hope this helps.

      gino

      Delete
  121. Hello. I have been having some pain in my left lower leg- about 2/3rds up on the inner side of the tibia. It started about a month ago. 2 weeks ago I only ran twice for 11 miles total and then I have been only biking & swimming for the last 8 days. It had been hurting most at the start of runs and as I ran longer the pain would lessen, and the last 2 runs I did it actually felt a bit better as I was running faster rather than slower. Also, the pain was highest in the mornings when I first started walking on it but then got better as the day went on. I have also been taking Motrin, icing several times a day, and stretching as well as trying toe lifts to strengthen some of the other muscles around there. The last 2 days I have been able to walk again without trying to compensate/alter my stride. And, although I know it is probably not recommended I have been able to carry my 30-40lb kids up/down the stairs without really feeling anything different. I have been doing 1 marathon/yr for the past 8 years and my typical goal is to run about 100-120 miles/month. However, last month I was feeling so good for awhile that I went 147 miles as I am trying to get ready to run Boston again in 6 weeks. So, I know you are most likely going to say I should just skip the race and rest some more but my hubby is in the military and will be deploying soon. He was deployed the only other time I ran Boston 6 yrs ago and this time it is a full family vacation for us, our 3 kids, my parents and brother. SO, I would like to know how you can help guide me in trying to run safely, what types of pains or symptoms I should watch for in order to know when I need to rest more before I hurt myself worse, and any basic tips on things that will help me to get through these next 6 weeks so I can run Boston since I know I will 100% rest after that race and let it fully recover then. My email is denisetennison@yahoo.com in case it works better to contact me that way. Thank you.

    ReplyDelete
  122. Hi Gino,
    May name is Scott and I have been running for just a year now. When I first started out I did get a case of the shin splints, but was able to adjust my running, etc. and worked them through to painless runs and after runs. HOWEVER, recently I ramped up my runs to a longer distance and inclines in my runs, also I ran through the cold season (winter). I am not 100% sure but I am thinking the three caused a sever case of splints or maybe even a fracture. I read through your posts dated May 12, 2009 and seen your suggestions of ice, rest, stretching and changing the style of running (treat the problem causing the paint, not just the pain).

    When you say rest, do you mean no running at (i have done this). But do you also mean to get a "boot" to use, or crutches, and no weight baring on the bad leg/shin? Please explain what you mean by "rest".

    The only time I have pain is when I first get up in the mornings, walking a long distance, or if I bump the area. There is no swelling or bruising in the area.

    THANKS!

    Scott

    ReplyDelete
    Replies
    1. I have emailed you separately since you emailed me as well Scott, hope that helps.

      Delete
  123. Hi Gino,

    I'm a 26 year runner turned triathlete. Previously ran half marathons, but kept my mileage relatively low as I have severe knee arthritis. Last spring while starting up I had suspected shin splints, so stopped running. Spent most of the year off with the occasional attempt, which usually ended up with the same recurring pain on the medial shin area. I never run more than 3 days a week, and cross train with low impact sports.

    This year I turned to triathlon to force myself to cross train, and finally saw a registered massage therapist with a sports med clinic to check out my legs. My gastroc an soleus were unbelievably tight and painful, but after 5 weeks of treatment and constant stretching, I've started short intervals on the track, a mile total, 2-3 times a week. There's one spot on the right shin that feels less like muscle pain and more like bone when getting massaged (we're constantly probing to try to determine if it's muscular, the muscle attachments, the periosteum, or perhaps a fracture at the one spot that's particularly painful). My return to running has been pretty good. I land forefoot, ice bath, have appropriate shoes, and did aqua jogging during the several months I was off, and sometimes continue to replace a track jog with an aqua jog.


    Do out have any suggestions for me? The hop test reveals no pain.

    Is it possible to have a stress fracture even after te many months of rest, since during that time my MTSS wasn't treated?
    Thanks

    ReplyDelete
  124. Hi Katie,

    I need to assess you to be sure, but from what you described, it seems like the periosteum is still a little irritated and reacting to your running. Certainly doesn't seem to be a stress fracture if you can do intervals.

    Read some of the comments above & try on land on the whole foot and not the forefoot as forefoot landing uses your gastroc & soleus to absorb the shock which leads to it tightening up.

    If you land on your whole foot & use your hip flexors to pick up your foot then the smaller muscles from below the knees all get a rest.

    Keep up with the biking & deep water running. All the best.

    gino

    ReplyDelete
  125. Hey Gino,

    About two weeks ago I began running and only ran for about two miles but the pain in my shins afterwards was horrible. For about a week I couldn't even walk without pain. I just assumed they were shin splints and didn't stop my daily exercise. Recently, the pain in my left has gone away but the pain in my right hasn't. I can barely run without my leg hurting and I can't jump without pain. Should I get my leg checked out?

    Thanks, AJ

    ReplyDelete
    Replies
    1. Yes, please do AJ,

      read some of the comments above and get your Doctor/ Physio/ Trainer to check your lumbar spine and the sciatic nerve (tibial branch) for referred pain.

      Should also probably check your running style, leg length, foot imbalances, hip muscle strength. Remember you need to treat the cause of your pain and not just your pain.

      Delete
  126. Hi Gino,

    I have had shin splints for about a year now and they only seem to be getting worse. I have chondromalacia in both of my knees also so I took 3 months off to help heal the shin splints and help with my knees. However, now my shin splints are back again and getting a lot worse. The pain has intensified and I have trouble walking and going up and down stairs, even when just moving my foot or sitting down my shins ache very badly. I just started lacrosse season and cannot afford to loose amy spot on the team. Do you think I have a stress fracture? or is there anything else I can do to help them other than not running and icing them?
    Thank You!!

    ReplyDelete
    Replies
    1. I have to assess you to be sure, but pain at sitting or at rest doesen't sound so good. Please get it checked.

      Deep water running will help maintain your fitness while not aggravating your condition. (http://weloverunning.blogspot.com/2009/04/aqua-based-rehabilitation-deep-water.html).

      Intervals on a stationary bike will help.

      Treat the cause of the pain always.

      Delete
  127. Hi

    I've been told numerous times from my boyfriend that I more than likely have shin splints. but the pains are located more in the inside of my lower, Shin?, its right above he ankle, I figured it was just the muscle so I stretched it out as best I could, but my weightlifting teacher had us run for our midterms and now it just seems that the pain isnt going away at all and I can now feel it from below the knee and down, I cant squat, I cant jump, I cant even run, Im stuck at a slow jog if I try to run. I've even been icing, but its only a temporary fix for the pain, and the pain is worse in my right leg than it is in my left. This has been going on and progessing acouple weeks after I joined weightlifting, which was in January if I remember correctly. I'm 18 female and in highschool.

    ReplyDelete
  128. From what you described, you probably do.

    Please read my previous comments about treating the cause of your pain and not just the pain.

    Need you to check to see if you land on your heels when you run.

    If you do, that is not good as you will then pronate which means stress along your shin (tibialis posterior muscle), knee and ITB (vastus lateralis -or outer thigh muscle).

    After you land on your heels, you will then have what I will call "foot flat" which will cause you to pronate leading to the above chain of events that I mentioned. That causes your shin splints.

    Please also have a look at Pain Free Running (http://weloverunning.blogspot.com/2009/03/pain-free-running.html).

    Hope this helps, Take care.

    ReplyDelete
  129. Track season started 2 weeks ago and my shin hurt. It sometimes hurts to walk on it and usually hurts to go up the stairs. It started out just hurting when i would put all of my weight on my left leg and bend it but now it is hurting more often than just that. It is slightly swollen and bruises pretty easily. I talked to our athletic trainer at my school and he didnt know what was wrong (it was less than a week after it had started to hurt) it used to start hurting maybe 800meters into practice, but now it even hurts durring the warm up. I ran cross country with no problems what so ever earlier this year, but i didnt run at all over the winter. Any idea what is wrong wuth my shin? Thanks!

    ReplyDelete
  130. Hi there,

    I will need to assess you to tell for sure what is causing your pain. If you've read some of the comments above, we like to treat the cause of your pain and not just your pain so it doesn't come back.

    The swelling / bruising doesn't sound good, please get it checked.

    Take care.

    You probably don't have stress fractures, if not there will usually be pain at rest as well.

    ReplyDelete
  131. Hi, I am a highschool track and cross country runner and I have suffered from shin splints for the last 2 or 3 years. I take at least a month off of runner after each season and work up my mileage slowly but my shin splints still come back with a vengeance. I have tried different shoes, orthodics and streaches but none of them work. Not only do they husrt when I run as well as after my work out for while and i can feel them at different times of the day just doing normal things. But now this season I have noticed that it hurts to touch certain spots on my shins. I was wondering what your opinion was. Thank you.

    ReplyDelete
    Replies
    1. Please read my previous comments about treating the cause of your pain and not just the pain.

      Need you to check to see if you land on your heels when you run.

      If you do, that is not good as you will then pronate which means stress along your shin (tibialis posterior muscle), knee and ITB (vastus lateralis -or outer thigh muscle).

      After you land on your heels, you will then have what I will call "foot flat" which will cause you to pronate leading to the above chain of events that I mentioned. That causes your shin splints.

      Please also have a look at Pain Free Running (http://weloverunning.blogspot.com/2009/03/pain-free-running.html).

      Hope this helps, Take care.

      Delete
  132. hi,
    i just joined my high school track team and have been having pains in my lower legs. i didn't prep myself very well before the season, but i was in the school's marching band over the fall season. basically i went from no physical activity to running 2-3 miles a day. my muscles hurt for a few days, but that quickly went away. about a week ago, the inside of my right ankle began to bother me. that shifted to the outside of my ankle. my school's athletic trainer taped it up, and it helped for the first 2 days. i started running with a different form because of my ankle pain, and the pain spread to my knee. from the knee, it went into my shins, and now my entire lower right leg hurts. when i push through the pain while running, i feel fine. as soon as i stop the pain catches up with me and i can barely walk and am on the verge of tears. i'm noticing the same pattern is starting to occur in my left leg. at the beginning of the week i had the trainer and my doctor check it out, and they said it was just sore from me getting back into shape. they both told me to ice the ankle and elevate it, and i have been doing that, but the pain just keeps getting worse and worse. do you think this could be a stress fracture?

    ReplyDelete
  133. Need to assess you to be sure, but probably not.
    Please see my comments about treating the cause of your pain and not just the pain.

    ReplyDelete
  134. Hi gino, I'm a 17 year old high school athlete, I recently started track after taking off basketball season. We started the season doing lots of sprints and jump boxes, after two weeks I started feeling pain in my left AND right shins! I went to the town chiropractor/sports therapist and he told me I have awful shin splints (you can feel the swollen attachment points) he told me not to do sprints and do long jogs like miles. So I am on my second week of trying this and the pain is horrid. It's mostly in the left leg now and tonight was our first track meet. I'm overweight and I ran the mile. I went as hard as my leg would allow. Right after the mile I could not stand and it was a Sharp pain going horizontally acrossed my left shin in two places. It's been roughly 7 hours since the run and my leg still hurts(deep throbbing pain) what is the probability that its a stress fracture and who should I see about it. My email is matherjustin12@gmail.com can you respond to my question there because the probability of me being on this site again soon is slim. Thanks

    ReplyDelete
  135. Hi Gino. I read your comments about the cause: Well I know what caused my pain in my lower legs, I ran on concrete with shoes that I bought 8 years ago, and run too much in too little time (didn't run for four years and practiced recently for a month and a half: prepared myself for 10K). Week before the 10K race I didn't run and pain went away. After finishing the 10 K ( I ran it in 52 minutes) I felt tired but ok. In the following days, I had muscle pain, in legs and it went away, but the shin pain despite running on new shoes, came back. Now I haven't run in 12 days, and still have a bit of a pain (its not very painful but I feel my shins) if I start to run a bit (I stop immediately). I have registered myself for a new run in two days, precisely two weeks after last run. If in two days time, I hardly feel any pain more: do you advice me to go ahead, or do I risk a shin fracture by running another 10K. Or can I run it on a slow pace? I can use pain relieving creams such as Bengay?

    ReplyDelete
  136. You can probably run if there is no pain, although you may risk getting the pain again.

    When I say the causes, I meant landing on your heels. If you do, that is not good as you will then pronate which means stress along your shin (tibialis posterior muscle), knee and ITB (vastus lateralis -or outer thigh muscle).

    After you land on your heels, you will then have what I will call "foot flat" which will cause you to pronate leading to the above chain of events that I mentioned. That causes your shin splints.

    So you probably need to change your running technique to solve your problem.

    ReplyDelete
  137. Hi Gino,

    I read your comments and you seem to have a good amount of experience with shin splints.
    I have tries almost everything over the past 1.5-2 yrs which is when I started experiencing pain in my shins. It started with pain in my lower leg (from my ankle joint in the front to 4 inches aboves). I have rested, iced, rolled (which helped a little), wear insoles (arch support. I have changed my shoes, gait (to kick my foot back more and hop less), been to physio, chiro. My xrays last year showed nothing. I ran a few events last summer, but havent been running much since then. But now, I cant even run for more than 5 min cont. My shins throb, with my entire shin (from ankle joint to knee) swollen with knots near the middle of the leg. I am at my wit's end and really want to run in the summer. Please advise!

    PS: I have been cross training by swimming and cycling (for triathlons)

    ReplyDelete
    Replies
    1. It's good your x-rays are clear, although even with x-rays stress fractures tend to only show up a month after they occur.

      Like I said in previous comments, you need to change your landing (please see my previous comment).

      You can do deep water running as well
      http://weloverunning.blogspot.com/2009/04/aqua-based-rehabilitation-deep-water.html

      Delete
  138. Hi. I was training for the cleveland half marathon, and was running a lot of miles back a few weeks ago. I started to feel like I was getting shin splints in my right leg after running for 3 days in a row, when I usually would take off a day in between because I was running at least 8 miles every other day. well on that 3rd day I felt crazy pain in my right leg and had to stop. It would hurt to even walk for the next week. I even had to limp just walking. It is almost 4 weeks now and I still have some pain, but just not nearly as bad. I think it was more than shin splints because it has lasted this long and I haven't ran for almost 4 weeks noe. The race is in about 6 and a half weeks and I really wanted to run in it, but having taken 4 weeks off and it being only 6 weeks away, do you think I will be able to run in it? I cannot go to the doctors as I do not have health insurance at the moment. But I really wish I knew more about it. And if it would be wise to run in the half or not. ANy advice would be greatly appreciated! Thanks!

    ReplyDelete
    Replies
    1. I would need to assess you to be really sure, but resting pain is not a good sign. Good news is that you are feeling less pain now.

      If it is really a stress fracture it usually takes 6 weeks to recover. So in the worse case scenario, you are almost there in terms of recovery.


      You can still run your race, but will have to adjust your expectations and bearing in mind you need to build again slowly if not you may be more prone to getting injured again.

      To maintain your fitness, you can do deep water running as well
      http://weloverunning.blogspot.com/2009/04/aqua-based-rehabilitation-deep-water.html.

      Hope this helps.

      Delete
  139. Hi Gino,

    I am 25 years old and am training for an ultra-marathon (148km race). I have been running around 80-100km a week with no problems for the last 3 months. Last week I ran a 25km run and pushed myself a bit to hard. I ran it at a pace of about 1.5 minutes faster per km. I did not feel pain right after the run.

    The next day I did notice a slight discomfort in my left shin while on my 12km run and then again the day after on a 13km run felt more discomfort. I took the day after that off and then on the Friday was suppose to complete a 40km run but stopped and walked back after 5 km.

    I had this problem once before a couple years ago and after 3 weeks of rest felt fine. Since the friday off I have not ran for 9 days. I need to get back running but am still feeling a bit of discomfort in the left shin.

    I have tried the jump test and can do 10 jumps. I do notice the spot it is sore but it doesn't bring me to my knees. I also have touched around my shin and there is no major pain spots along the bone.

    I am wondering if I should take an additional time off or if I can try and get back to my training. Does this sound more like shin splints or a stress fracture?

    I really appreciate your help.

    Thanks,

    Adam

    ReplyDelete
  140. Hi Adam,

    need to assess you to be sure, but no painful spots along the shin is a good sign.

    You can probably resume training, but please gradually rebuild you distance. If no pain then you can increase again, but please increase conservatively.

    Hope this helps, all the best for your race.

    gino

    ReplyDelete
  141. Gino,

    I have recently started to play softball more for my team and have had a pain vertically in both shins for about a month. I am also a 15 year old teenage girl. They both hurt all the time, whether relaxing or playing softball. I don't run that much in softball (I'm an outfielder) but I would like to know if I have shin splints or something worse. This is my first time experiencing any pain like this and it's driving me crazy.

    Also, I drink a lot of milk around 50 ounces per day and want to make sure that this is healthy (I like milk.) I've heard that this might link to osteoporious and want to make sure that this pain is not premature osteoporious. Could you help?

    Thanks so much!

    Danielle

    ReplyDelete
    Replies
    1. Hi Danielle,

      I need to assess you to be sure what you have. Your pain is probably linked to your increase in activity as you suggested.

      Try icing them after training/ games and use a compression garment after to see if they help. If they do, it's a good sign, if they don't please see a competent physiotherapist to get it checked.

      You're probably too young to have osteoporosis. Drinking milk and doing weight bearing exercises (like what you're doing now) are excellent for your peak bone mass (which we look out for in osteoporosis).

      Hope this helps, take care.

      gino

      Delete
  142. Dear Gino,

    I recently developed shin splints and have not been able to run for 2 weeks now. I am training for a half marathon and using the Galloway method.

    Can you please send me the further information you speak of on what to do while I am resting.

    I am also quite overweight. Should I be running at all? Is it okay to run if you are overweight? I have really enjoyed my training and have lost a little weight. A better response than other exercise methods I have used.

    Also, how do I become a faster walker? I get so frustrated trying to speed walk because I can't seem to increase my pace, unless I start running.

    Thanks

    Laura

    My email is : otforpeds@live.com

    ReplyDelete
    Replies
    1. Have emailed you separately Laura.

      Delete
  143. Wow Gino you do a wonderful job responding to all of your readers comments. I have read through several of them (but not all) so hopefully this question is not repetitive. I understand you cannot diagnose without an in person assessment, but here is my question. Is it possible to have the onset of a stress fracture and there be little to no pain present when running or jumping? I ask because I have an extremely sore localized spot on my tibia (run several miles/wk but have stopped out of concern that I may worsen the condition and to decrease the heal time). Thank you! Krista

    ReplyDelete
    Replies
    1. Thanks Krista,

      I do my best.

      In the very early stages of shin splints, there may not be any pain while running or jumping. In a more acute stage, pain would be present even at rest.

      So to answer your question, if you have a stress fracture, the area will usually hurt while running or even while walking or even at rest.

      You may have onset of shin splints with the localized pain on palpation, so do be careful.

      Please ice the area, and try taking smaller steps while running and land on the whole foot and not the rear foot.

      Take care.

      gino

      Delete
  144. Hi,
    first I wanna tell that I relly liked this article. I also have a question. I had shin splits, because I started with track.I have never done track before, so it was really hard to my legs. A just run through pain, but like 3 weeks ago one of my leghs started hurting much more, and I had to stop running for more than 2 weeks.Now I started running again, but my right leg still hurts, even when I am walking. So I am just wondering, if you think that its just shinsplints, or if it can be stress fracture. I am really worried about it. How can I find out if its stress fracture?Thank you very much!

    ReplyDelete
    Replies
    1. Probably early stage of stressing your tib posterior tendon- the muscle that causes shin splints. But I have to check to be sure.

      Please get someone competent to check, doubt it is a stress fracture

      Delete
  145. Hello, out of the many articles and sites on the issue, this one tops them all. And with the numerous questions/responses, I decided to ask my own. I am currently training for the NYC marathon in Nov (5 month plan), have been running for almost 2 years (twice/thrice a week), and atleast a half marathon distance every sunday for the long run. I've had shin splints many many times, the type of splints in which you can feel the bumbs on the shin and try to run them down to the ankle. I am now having some intense pain where the source is 6 inches below the knee on the inside shin. When I apply any sort of weight to the right leg, the pain goes through the whole bone. Forget stairs, the pain occurs going down steps and even walking (I am limping now). Is this a stress fracture or something else? Should I just not try to run for a week or 2? Thanks in advance

    ReplyDelete
    Replies
    1. I have to assess you to be sure Jon.

      It may be starting signs of a stress injury or it can also be a more serious strain on your tibialis posterior muscle- the muscle that caused the shin pain.

      Please ice it and get a competent person to check it for you.

      Please see some of the above comments to treat what is causing your shin pain and not just treat the pain.

      Take care.

      gino

      Delete
  146. Hi, I'm not sure if I have shin splints or stress fracture. Last fall my doctor said I have shin splints. I had pain on the outside of my left calf. It started at my ankle and went all the way to my knee. I rested and cut down on soccer and running.

    Now it's summer and the pain is back. But, this time it hurts right above the bone on the outside of my left ankle/calf. It hurts 3 times as much. I can barely run. I can jump on it maybe a few times before the pain is too much to bare. It hurts when I put any pressure on it and it hurts when I wake up in the morning and at night when I try to fall asleep.

    I have a big swollen bump on the spot that hurts. It fells a little better with RICE and that's about it.

    I would really like to know if I have a stress fracture or not.

    Ps. I'm an 8th grader that swims, runs and plays soccer!

    Thanks!:)

    ReplyDelete
    Replies
    1. Like I wrote before, pain at rest is not a good sign. The swollen bump doesn't sound too good either.

      Need you to really get it checked please before it gets worse.

      Delete
  147. About two months ago I started training for my first 1/2 marathon, getting my body used to running more frequently. I worked my way up to running 3 miles and kept running 3 miles every other day or every other 2 days. Long story short - my doctor said I have a tibial stress fracture and I've haven't ran in 3 weeks. He gave me resistant bands to help work out the area and a guide to "return to training." Lately I've been interchanging jogging and walking every minute but found that once I start jogging pain would occur around the fracture area but would leave after 5 seconds. Is that normal?

    I've been doing this for a couple of days and found that after jogging 2 minutes, I felt no pain. Is that a good sign as well?

    ReplyDelete
    Replies
    1. I have to assess you to be sure, but a stress fracture generally takes about 6 weeks for the bone to heal (a little quicker if you are younger, especially if you are still in your teens).

      It's a very good sign, but pace yourself this time and don't train too much too soon. Try to make sure your running technique is sound (please read some of the comments above).

      Hope this helps, take care.

      gino

      Delete
  148. In January, I started training for a half marathon. I am 30 yrs old and have been running off/on since I was 15.
    In the middle of Feb., I was up to 4 miles and did 16 miles one week. During my run, I started to have severe pain in my right shin on the inside. I stopped running and did the ice/rest thing. I also continued to cross train. The pain was so severe that it hurt just to walk for about 2 weeks. I gave it exactly 8 weeks of no running and tried again. I could only run 1 mile before I felt the same pain.
    The pain to this day is still there with no running since April. The spot that hurts actually hurts to touch it on the outside. I've had xrays, and a bone scan and was told today by my DR. that there really isn't anyting I can do for it and that it's a bad shin splint.
    I don't understand how that could be if I'm not even running. I'm so frustrated. Any help?

    ReplyDelete
    Replies
    1. Try deep water running http://weloverunning.blogspot.sg/2009/04/aqua-based-rehabilitation-deep-water.html

      Delete
  149. Leslie the inpatient runnerJuly 27, 2012 at 9:35 AM

    Hi Gino!
    I have to agree with some previous posters in that you do an excellent job in responding. I have a question on my own that I can't figure out (sorry if it’s long post, But I wanted to paint a picture). I am a competitive runner and have plenty cases of shin splints. And it is usually on my Left leg which is my problem leg (I get all my overuse LE injuries on that leg due to my overpronation) but this time it’s my good leg (R leg which never gets inuried). I haven't had any shin complaints in 3 years as I finally found a way to avoid them (proper orthotics/shoes, eccentric strengthening, stretching…I also have really good running mechanics so no heel stricking for me). I was in the best running shape I have ever been 4 weeks ago with no problems, then got a concussion and was basically completely bed rested for 2 weeks. Stupid me, I didn’t stretch, didn’t use my muscles in anyway except for basic ADL’s and once I was allowed to run again I took 3-4 days easying back into it (as in no hard runs, but I would keep the length of my runs to about 75% prior to concussion) and then did a short interval workout. The next day I did a short run and was completely fine, but by that evening (after sitting down for a few hours), I got up and had pain in the medial/border of my tibia. I thought this was odd as I'd always get shin splint pain during runs which would progressively get worse as I didn't rest. So, I have taken 4 days off running (biking, elpitical, swimming instead), been icing about 10xday, massaging, stretching, doing eccentric exercises. Today feels worse than the first day (maybe I massaged to hard along the shins). I'm wondering what I might have done. I don't have swelling but I do have very tender tibia, tight @ tibialis posterior & soleous, having resting pain (more a slight throbbing discomfort) and pain going down the stairs (but not up and I don’t have pain if I walk on the heel of my foot). I noticed it is worse after icing (on the re-warming phase), first thing in the morning, and I also think swimming causes the most discomfort (haven’t been running of course). I’m confused because it doesn’t sound like the typical way shin splints present (sudden onset of pain after rest) and rest pain. It also doesn’t completely sound like a stress fracture (swimming shouldn’t bother it I think and I don’t think 2 weeks of not exercising then running for 6 days( at ~ 75% pre-concussion) would give me a stress fracture. Overuse muscular/tendon injury, yes, but bones take a little more time to break down I would think . I’ve never had a stress fracture before (and I have ran through some serious shin splints before) and I have been consistently running for the past 10 years. Do you it could be a stress fracture, shin splints or a strained tibialis posterior? Does deep massage help this or hinder it?
    Sorry for the long post, but I’m really getting disheartened. The concussions were a huge setback for me (in all areas of my life) and running is one of the biggest positive outlets for me. I’m hoping I can be running again in a few days (at least 20-30min runs), but not sure if that is a reasonable thought.
    Thanks so much for your help! Leslie

    ReplyDelete
    Replies
    1. Hi Leslie,

      sorry about the late reply, I have read thru' your long post, from what you described you probably don't have a stress fracture. You probably had some de-conditioning after your 2 weeks off and your tibialis posterior muscle is adjusting to you running again.

      Pace yourself gradually and you will definitely be better. Biking, deep water running should ease you back into running as well.

      Take care.

      gino

      Delete
  150. Hi Gino,
    I've had shin pains for almost three months now and have gone to several doctors and they just said it was shin splints, but I've stopped running for these three months but the pain is still there no matter what i am doing, walking or just sitting relaxing and I'm only 16 years old, I'm not sure where to go from here any advice? thanks for your help!

    ReplyDelete
  151. Hi Gino,
    I am a freshman and I have had shin splints since january of 2012. I run 4-5 days a week with a club. When I realized I had shin splints it was from sprinting down hill a couple of times during school practice. later in the season I took a week off and the pain was gone. But it gradually came back. For one week I could not run at all. I tried jogging but I was limping pretty bad so I stopped. My Coach has been rubbing them out every night after practice. He starts from my ankle with his thumb and goes up my shin bone and both sides of the shin. We are beginning to run hills now and they are very sore. I ice them three times a day. Before I go running I heat them. And after I run I ice. After I begin my workout they don't hurt. When I finish though they begin hurting again. I was just wondering if this sounds like a stress fracture or just shin splints? If you have any ideas I would be glad to know. Thank you.

    ReplyDelete
    Replies
    1. I can't tell for sure unless I examine you, but sounds like a case of shin splints that is worsening.

      You need to be careful before it progresses to a stress fracture.

      I will probably tweak your running style a little so you use your leg muscles (tibialis posterior-the muscle that causes shin splints) less.

      Try not to over stride as it will load the shin even more. Take smaller strides but at a faster cadence. Please have a look at Pain Free Running (http://weloverunning.blogspot.com/2009/03/pain-free-running.html) on March 17.

      Kinesio taping can help alleviate some of the pain, but you want to r=treat what is causing your pain.

      To maintain your fitness, you can do deep water running as well
      http://weloverunning.blogspot.com/2009/04/aqua-based-rehabilitation-deep-water.html.

      Hope this helps. Take care.

      Delete
  152. Hello gino, i have a 14 yr old son started playing football for highschool he needed to get his hr. In conditioning he ran and walked on the track field for 2 hr straight after that day his front lower legs hurt he said its his bone hurting on the sides witch sound to me like it is his shins. It hurts him when he goes up stairs,runs and does anything physical. He says it fells like they are kicking his shins. I have been puting icyhot and wraping them at night till the morning and been giving him advil to take before practice. I hear from the other p?ayers that if you rest your pain will just come back and you wont heal because you stop then start again they said it sound like shin splin because same thing happened to them. I took him to get xray last week and it came back normal. My question to you is does this sound like shin splin and am i doing the right thing for treatment? Thank you for your time

    ReplyDelete
  153. From what you described, it is probably shin splints. He should not be doing too much too soon in terms of any training.

    Icing is probably good.

    Need you to check to see if he lands on his heels when he runs.

    If he does, that is not good as he will then pronate which means stress along his shin (tibialis posterior muscle), knee and ITB (vastus lateralis -or outer thigh muscle).

    After he lands on his heels, he will then have what I will call "foot flat" which will cause him to pronate leading to the above chain of events that I mentioned. That causes his shin splints.

    So you need to treat the cause, icing, changing shoes, orthotics etc will only treat the pain, and not treat what is causing the pain.

    Please also have a look at Pain Free Running (http://weloverunning.blogspot.com/2009/03/pain-free-running.html) on March 17 and Do High Tech Running Shoes Work (http://weloverunning.blogspot.com/2009/03/do-high-tech-running-shoes-work.html) on March 14.

    Hope this helps.

    ReplyDelete
  154. Wow thats great that you answer to all these people! I just recently started experiencing shin splints today... it didnt hurt during the run but after it hurt extremely bad... i still have like 2 months left of school cross country... do you think they will go away? should I ice? and they hurt all day today.... I have a 6 mile run tomorrow.. thanks!

    -anonperson

    ReplyDelete
  155. Gino,

    In early 2011, I trained for my 1st half marathon and shut it down for 7 weeks after increasing mileage too fast and developing serious pain a few inches above my left ankle. I trained smarter and ran a great half marathon in February. Now, I'm training for a full marathon in November, and stupidly ramped up a little to fast and the pain came back after my first 30 mile week. I've rested for a week and the pain is gone. Should I forget about the marathon and rest for an additional 6 weeks, or start training again and lower expectations for my performance in the marathon?
    Thanks,
    Jack

    ReplyDelete
  156. Hi. I have really bad shin splinter in both legs. One leg for over a year. The other for about 2 months. I am seeing a doctor on Thursday but I was wondering about your opinion. I personally think both legs have shin splinta because even though they are both super sore there are some points in my leg that are sharper and hurt more than others. It also continues after rest. I play volleyball and basketball. Two high impact sports. Do you think I have stress fractures. Also If I do have stress fractures or Heyy really bad shin splinter how would the doctor treat them because they are in both legs. A wheelchair? I'm not sure. I would be grateful if you replied! Thanks (:

    ReplyDelete
    Replies
    1. The doctor will probably ask you to rest.

      I can't tell for sure what you have without assessing you though. Sounds like a chronic case of shin splints from what you described.

      You need to be careful before it progresses to a stress fracture.

      I will probably tweak your running style a little so you use your leg muscles (tibialis posterior-the muscle that causes shin splints) less.

      Try not to over stride as it will load the shin even more. Take smaller strides but at a faster cadence. Please have a look at Pain Free Running (http://weloverunning.blogspot.com/2009/03/pain-free-running.html) on March 17.

      Kinesio taping can help alleviate some of the pain, but you want to r=treat what is causing your pain.

      To maintain your fitness, you can do deep water running as well
      http://weloverunning.blogspot.com/2009/04/aqua-based-rehabilitation-deep-water.html.

      Hope this helps. Take care.

      Delete
  157. Hi I am not sure how to describe my problem, but I will try. I'm a 27 year old male and I've been in the army for the past 4 years. I have already had shin splints multiple times with the amount of running we do. They even had me with shin sleeves for a while. Well I worked through them and haven't had any pain during or after a run in over 2 years. However there is another problem that started after this. We have to do push ups with our legs on someones back sometimes. As soon as that pressure of their back against my shins happened it felt like someone was ripping the muscles from my shins. If i press on my muscles two inches below the knee my whole shin knee to ankle hurts terribly. Also the same goes for the bone side. Which if i rub my finger along the bone there is these small lumps that i know aren't part of the bone because they move. I have no clue what's going on with my shins. But again no pain what's so ever with physical activities. Just pain when pressure is applied.
    Thank you for your time.
    Chase

    ReplyDelete
    Replies
    1. Try not to over stride while running as it will load the shin even more.

      Take smaller strides but at a faster cadence. Please have a look at Pain Free Running (http://weloverunning.blogspot.com/2009/03/pain-free-running.html) on March 17.

      Will need to ice the area to help with the pain.

      Delete
  158. I am in the military and have had issues with my shins. I finally got them checked and was told by the military doctor that i have stress fractures. I was put pn light duty for 21 days and have to take an exhorbent amount of pills. Because of my job being always on the go what can I do for it to heal? Should I wrap it, ice it, have an operation? The pain is becoming unberable. Should I get a second opinion?

    ReplyDelete
    Replies
    1. Try taking smaller steps while walking. Kinesio taping can help alleviate some of the pain, but you want to treat what is causing your pain.

      To maintain your fitness, you can do deep water running as well
      http://weloverunning.blogspot.com/2009/04/aqua-based-rehabilitation-deep-water.html.

      Hope this helps. Take care.

      Delete
  159. Hi Gino,

    I'm due to run the London marathon (My first) in April, and training was going excellent for the first month, but i've now had to stop due to a painful right tibia, hopefully this is not a fracture but it's been 7 weeks and is not getting better, even whilst sitting at my desk at work I can feel it burning and is painful, it does however feel fine when I walk. I know without seeing me it's impossible to know exactly what's wrong but i'm worrying that I won't make this Marathon! I think that seeing a Dr he'll just say to rest so i've not seen him as yet, but it's very frustrating not being able to run. How long can it take to heel??

    ReplyDelete
    Replies
    1. Can be 2-6 weeks depending on what you do.Please read some of the above comments.

      Try taking smaller steps while running. Kinesio taping can help alleviate some of the pain, but you want to treat what is causing your pain.

      Take smaller strides but at a faster cadence. Please have a look at Pain Free Running (http://weloverunning.blogspot.com/2009/03/pain-free-running.html) on March 17.

      Will need to ice the area to help with the pain.

      Delete
  160. Hello!
    I have always had problems with shin splints, but they usually come and go in spurts. I am currently training for a half marathon in march and I am worried I won't be able to do it because the pain in my shins has worsened tremendously. After running 5mi today, the pain in my tibia was so bad I could hardly hold myself up to walk. The most severe pain occurs when I flex and the pain shoots up all the way to my hip. Hopefully Im not beating a dead horse on this blog, but any insight/advice would be much appreciated.
    Julia

    ReplyDelete
    Replies
    1. Have a look at some of the comments above Julia.
      Need you to check to see if you land on your heels when you run.

      If you do, that is not good as you will then pronate which means stress along your shin (tibialis posterior muscle), knee and ITB (vastus lateralis -or outer thigh muscle).

      After landing on your heels, you will then have what I will call "foot flat" which will cause you to pronate leading to the above chain of events that I mentioned. That causes your shin pain.

      So you need to treat the cause, icing, changing shoes, orthotics etc will only treat the pain, and not treat what is causing the pain.

      Please also have a look at Pain Free Running (http://weloverunning.blogspot.com/2009/03/pain-free-running.html) on March 17 and Do High Tech Running Shoes Work (http://weloverunning.blogspot.com/2009/03/do-high-tech-running-shoes-work.html) on March 14.

      To maintain your fitness, you can do deep water running as well
      http://weloverunning.blogspot.com/2009/04/aqua-based-rehabilitation-deep-water.html.

      Hope this helps. Take care.

      Delete
  161. Hi,

    I had just started training for a half marathon after taking to months of when my shin started hurting. It was probably from over training because I was running everyday on sore legs. I don't know if this would matter but there was about a half inch of packed snow on the road I was running on the day I started feeling the pain. After the run I felt the pain when I put any extra weight on my leg. It hurt bad when I tried to run, a little when I held my son, and I had no pain when I walked. Over the past two weeks the pain has pretty much gone away but I still feel something there when I put weight on my leg. I have not tried to jog more than 50 yards and that was today. I feel it in one spot. If anything it is more horizontal. I read that pain more like to be a stress fracture but would the pain from a stress fracture go away this fast with no running?

    ReplyDelete
  162. Hi, I am a track runner in high school. During the indoor track season, I am pretty sure I had shin splints and they were pretty bad because I wasn't used to running to the extent that we did at practice. We also ran insidee on the hard floor so that could have been part of it too. I thought I could power through the pain, but towards the end of the season, this bump of bone on the inside of my shin developed. It is very painful to the touch, and is a localized area. Very painful to run on, and the pain stays constant throughout the running. When I am not running, it is a dull ache, but only in the small area where the bump is. Walking, going up stairs, and jumping hurts very bad, all in the spot where the bump is. I does not feel muscular, it feels like it is bone. The outdoor track season just started and I am worried I might have a stress fracture or shin splints? I need to know asap because the pain is really bad, but I don't want to have to sit the season out!
    Thanks for the help
    -nervousrunner

    ReplyDelete
  163. HI Gino,

    I'm also a track runner who last year got a stress fracture and had to sit out most of the track season until MAC which is the last race of the season. the stress fracture was in my left shin towards the front. after i fully healed i took the entire year off and didn't do cross county to try and fully heal for track. i started doing everything i could to be fully prepared for when the season came. i started getting my neck adjusted with the treatment called nunca. later the doctors discovered my hips were uneven by half an inch but since ive been getting adjusted they are even. I also got new shoes that fit my body bcause i have extremely flat feet so i have arch inserts in my running shoes. and i did a program called acceleration to get me in shape a few weeks before track started. now track has been going on for 5 weeks and outdoor seasons about to start. ive been extremely careful not to pound my feet on the indoor floor and to ice after every practice. ive also been taking epsomsalt baths. but just yesterday i got done running 4 150s at 80 percent and where my stress fracture was killled! you could hardly touch it without it hurting. so i iced it and even a couple hours later the pain was very dulled. today i took the day off and use the elliptical but it hardly hurts just if i put a fair amount of pressure on it... is this just my leg remembering the pain? or is it my stress fracture coming back? i cant decide if i should be worrying or not..

    ReplyDelete
  164. Hi Gino,

    thank you for ur informative post!:) would like to consult u on whether my injury is a shin splint or a stress fracture?

    the pain I'm feeling on the side of the tibia bone sometimes at the upper 2/5 of my leg( measuring frm the knee to the ankle). sometimes it hurts while walking but sometimes it don't hurt at all. the pain is localized on one area & when I press the bone of the affected area, it hurts badly. At first, I could still run but after a week of the pain, I cannot run now anymore as the pain is quite bad the moment I run.

    with regards to this, I have a few other burning qns that I hope u can enlighten me with as I really need to get back to running ASAP.

    1) how long do I need to recover (I.e: to completely stay away from running)

    2) to still work out without running, can I do brisk walks/ elliptical trainer/ swimming?

    3) how should I treat this myself because I do not have the financial means to visit a doctor.

    4) how can I prevent future relapses & when recovered, how shld I ease myself back to running?

    here's my email address: shimin249@gmail.com
    thank you! (:

    Regards,
    Esther

    ReplyDelete
  165. Hello,

    I am in high school and recently joined track after many years of dancing ballet. I started running track in January and was doing pretty well (or so I thought) and I had shin splints on and off, I'd ice them and there was not too much pain but then after maybe 3 weeks with zero pain they came back only on my left leg and bad! A million times worse than before and I've been resting my leg for about 3 weeks now and I'd love to get back to running but my left leg still really hurts! Even when I walk and try and jump on it. My coach says my stride is kind of short compared to what it could be and also that my posture when I run is too straight so I take too many extra steps. Also, I have never ran before this year, never this intense and I probably did too much too soon? I just wanted another opinion because maybe I have a stress fracture I don't know if I should be concerned that after 3 weeks of rest it still hurts like this? Anyway, thank you so much for posting this, it was quite informative.

    ReplyDelete
  166. Hi Gino,

    I am a 32 year old male who started running seriously just last year. I trained up to 20 miles but stopped most of my running when it got to be winter. I have just started back up and worked up to 10 miles over a period of a month and a half. I am having pain now in the inside of my left leg about 6" up from my ankle. I can feel a spot which is roughly an inch in diameter if I feel along the inside of my posterior tibia which is the source of the pain. At this point it has been just under a week and the pain seems worse now then it was the first day. It is not unbearable but I am "feeling" it most of the time. Also, I am having pain which shoots up my shin towards my knee and also wraps around to my calf and my ankle. I do not have insurance so I am just wresting it by not running. I am trying to figure out if I should go get an x-ray as it could be a stress fracture - or just give it some more time before I go seek medical attention. I have been icing it at night. Any advice you might offer up would be very much appreciated. You could email me directly:

    paul.meco@gmail.com

    Thank you

    ReplyDelete
  167. Hello, I have been running in cross country for almost three months now, and have been having pain on both of my shins. My left started earlier and feels better while walking, but my right still hurts a lot while walking and training. When I walk down the stairs, it starts shaking and cant bend and move forward. Also in the back of my right thigh hurts, but the stretching of the hamstring doesn't do any good. I dont know what they are or what i should do. Could you help me please?

    ReplyDelete
    Replies
    1. Have a look at some of the comments above about treating the cause of your shin pain and not just treating pain.

      Delete
  168. Hello,
    Within the past week and a half I have developed a pain on the inside portion of my left tibia about midway up. It doesn't hurt much when I am running, but during the day when I walk downhill or downstairs I feel pain--also, when I press on the spot. I currently run 3 miles 6 days a week on asphalt. I have run for years and have not ramped up my mileage or anything. However, I never used to run on asphalt before March 2013. Also, I overpronate and wear posted running shoes. I'm 135lbs and 5'6". I know I should probably take a rest from running, but I want to keep in running shape. I am scheduled to attend the Police Academy in January. They conduct a military style boot camp and I DO NOT want to have a stress fracture. If I already have one, I want it to be healed in time. Please give me some advice on what I should do.

    ReplyDelete
  169. I believe my chiropractor worsened my stress fracture. I have a tibial stress fracture...causing pain I thought was my knee. The chiropractor said my leg was out of alignment, pulled my leg and whacked the sides of my knee to put things back. I told him this was hurting...but he didn't stop. The pain got worse, and I had an MRI from the sports doctor and found a severe stress fracture. No more chiropractor for me.
    metatarsal stress fracture

    ReplyDelete
  170. Hey Gino. So I feel like I may have had (and still have) shin splints for a long time. I have this dull aching pain in about the middle of the inside of my shin bones. (both legs). I'm wondering what the cause is, because I've converted to being a toe striker, which I'm in love with now, although I used to heal strike. When running down stairs however I've always done toe first. Can you get shin splints from running properly? I've read Born To Run and watched many youtube videos so I'm 100% certain my form is correct. Also, I usually run down to the college everyday, and I run down these very long stairs. could the constant impact every other day even from toe first be causing my pain? Again, I've basically had this for months. What's your suggestions? I hate the though of not running but I feel like that's what you'll tell me :/

    ReplyDelete
    Replies
    1. Hi Cory,

      land on your whole foot is better, not on your toes.

      Delete