Shin Splint or Stress Fracture?

Severe shin fractures

Someone dear to me who shall remain nameless (Bobby G) has been struggling with what he called a “shin splint” for 3 weeks now. After some research, I think we have both come to the conclusion he has a stress fracture. He is obviously pretty bummed, but knows he needs to get better as soon as possible.

Shin Splint or Stress Fracture?

  • Is the pain in a large area down the outside/inside of your shin? Yes = Shin splint.
  • Is the pain just in a little area smaller than a quarter? Yes = Stress fracture.
  • Does the area have just a dull ache and does NOT hurt when pressed on? Yes = Shin splint.
  • Does the area hurt when you press on it, with a sharp pain? Yes = Stress fracture.
  • Stand on the affected foot and hop on it; does this hurt? Yes = Stress fracture.

Having my own experience with a possible stress fracture on the top of my foot (See “Das Boot“), there are several things I have learned:

  • A specialist (Orthopedist) will probably cost a little bit more co-pay if you have insurance.
  • If you decide to go to a doctor, realize that when in doubt, they will tell you not to run. This is good advice anyway.
  • X-rays are usually cheap/free if you have insurance.
  • Often, even if you have a stress fracture, the X-ray will not show it. This could be because by nature stress fractures are very small or because it hasn’t started healing yet (once healing began it would show a callus on the bone).
  • If they suggest an MRI, bone scan, fancy-pants ultrasound, etc, slap them in the face and hobble away! Even with insurance these can be $2,000+! Bobby got an MRI for his shoulder in 2009 we just finally paid it off a month ago.
  • You can get a boot (usually free with insurance) and wear if you want, but if walking doesn’t hurt I wouldn’t bother. Just wear comfy and supportive shoes.

Things you can do while recovering:

  • Don’t run.
  • Apply a baggie of ice water to the area daily.
  • Ride your bike as a pace bike or along side friends in races/group runs.
  • Don’t run.
  • Practice your swimming.
  • Go shopping at your favorite local running store and buy a perfect new pair of supportive running shoes; old shoes or non-supportive shoes (racing flats, Vibrams, etc) could have been the cause.
  • Don’t run.
  • Walk any races you had already signed up for. Sure, you may be almost DFL, but at least you won’t be a DNF.
  • When you are ready to gradually start running again, run with your slower friends in races/group runs.
  • Think about some triathlons you’d like to sign up for now that you have improved your biking and swimming.

Das Boot

Walking boot

I went to a doc at Campbell Clinic Friday before last. They did 3 xrays of my foot and…no fracture! Nothing, nada. Not even a little.So after poking and proding my foot she decided that, “Maybe it was on its way to becoming a stress fracture” and suggested I not run for a month. Oh, and wear this giant boot all day long. WHAT?!

Needless to say I thought the boot was a little overkill. In fact, as I was being fitted for it I heard a nurse say, “When you come into this office you’re either leaving with a cast or a boot”. So I think she was just playing it safe. I showed it to Bobby and he asked me several times, “How much did you have to pay for that?!”. I had to keep telling him nothing.

So I haven’t wore the boot at all. But I HAVE wore only tennis shoes and I haven’t run at all. I’ve done some stationary biking. It was a really good workout and I think I’ll keep it up even after I start running again as cross training.

Last night was the first time I tried running in 2 weeks. Didn’t hurt it all on the top of my foot during. Was a tiny sore the next day. I’m going to keep running; gradually work back into it. I’m going to go back to my old Adidas shoes for one thing…I have a theory my newer, 2-month old ASICS pair may have been the problem all along. I’ll let you know if that theory turns out correct! *fingers crossed*