Oct 9, 2011 7:42 AM
Stumped: Shin splints or stress fracture?
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After scouring the internet for a couple days about the differences between shin splits and a stress fracture (which, admittedly, are very minimal), I am completely stumped about which injury is causing the pain in my right shin. I could use whatever insight y'all could give me!
The pain started 2-3 weeks ago as a combination of minimal pain the middle of my shin (the inner part, closest to my right leg) AND a soreness in the small "bulb" part of the bone that's to the right side of where my shin bones and calf bones meet. I didn't think much of it, and was able to run without any pain for a week. After that week of no pain while running, I experienced pain in my shin at the beginning of my runs, which subsided after about a mile (which led me to believe that the pain was shin splints). After my runs, the shin pain would return with a vengeance--so much so that I began to worry that the injury could be something more serious. My shin hurts while walking up and down stairs, and sometimes just while walking (it's not a shooting pain, but it's enough for me to be aware of it), which is more suggestive of a stress fracture (I think, yes?). I've also tried the "jump test" I've read about, where one jumps off of the toe, landing toe to heel: if one experiences pain while doing so, it's indicative of a stress fracture. (If there's no pain, the injury is most likely shin splints.) I experience pain while jumping.
I'll also note that, rather than a dull pain along all of my shin, the pain seems to be more localized to a spot about an inch wide right in the middle and inside of my shin (which I think is more characteristic of a stress fracture). It's almost like the pain is located behind/underneath my bone, on a tendon of muscle--it's very tender to the touch.
(As I'm typing this, I'm realizing that my symptoms look more like a stress fractuce, but I stil definitely welcome opinions! I'll take all of the advice I can get.)
Anywho, I didn't run at all last week (I did about an hour Tuesday-Friday on the elliptical, which felt fine on my shin), and have an appt. with a sports doctor on Saturday. I was supposed to run a half marathon on Saturday, but I think it would be wisest to sit it out. (As must at I'm itching to race it!) Thoughts on this? If the pain is better by, say, Wednesday, could I run the half? Or is this too risky?
Thanks in advance for your help and advice!
I think you've done a pretty good job of self-diagnosis, which may be difficult for a physician to confirm conclusively until there is enough calcium build-up around the probable stress fracture to become visible in a scan.
However, what worries me is that equipped with all this information, you doubt your own credibility enough to even think about running that Half. Give yourself some credit, because you did a great job researching this. Just because you may not know for sure until after the Half, is not an out for you! Shame!
Lol, I know how difficult it is to put down that competitive animal inside. I once limped up to the starting line for a Half I had trained well for and was dying to run. My heroes were there, and the weather was perfect. I limped back to my car instead, watching the winners (my heroes) come in was worth swallowing my pride. Since I paid my way in like everybody else, I enjoyed some of the post-race chow - with a little guilt, I might add, and some deference to their earned hunger - looking exceptionally fresh to the marvel of other runners (sure, I fessed up after playing with it a bit). I hope you will not have as close a call as I did to making the mistake of running on an unknown injury. The event, even if you already paid, will still be fun. You'll be back.. If you can make both the race festivities and your appointment, I say do them both (without running). Maybe you can delay the appointment to make this possible. Regardless, enjoy your recovery and heal well!
Hi MissMoRunner,
I am experiencing very similar shin pain that you are describing...and I have also done lots of research online over the last few days about the difference between stress fracture and shin splints. It does seem that I may have a stress fracture as well. I am very close to making a doctor appointment, as my pain has been about a month now, but so worried about what the doctor will say..."no running for 6-8 weeks..." A runner's worst nightmare! I would be very interested to hear how your doctor appointment went and if you did indeed have a stress fracture.
Thank you and hope to hear from you!
Hey there!
I went to a sports doctor last Saturday (October 15th), and, rather surprisingly, he did NOT think it was a stress fracture. (Just a really bad case of shin splints.) He didn't take a bone scan to confirm his speculations, but he did prescribe 4-6 weeks of physical therapy...which I started today. I go back to the sports doctor at the end of November, so I've pretty much resigned myself to life without running until then. I'm able to the elliptical without any pain, so I've been substituting that to a (much preferred) runner's high. I'm also working hard to strengthen my hips, quads, and hamstrings--all of which the physical therapist told me were weak.
An intereting piece of the puzzle that I forgot to mention is that, back in July and as a result of finishing 'Born to Run,' I started playing with my stride a bit. I realized that I was definitely a heel-to-toe runner and started making more of an effort to strike on my mid-foot/the balls of my feet. Rather stupidly, I picked a 10-mile Sunday run to start experimenting with my stride and can remember my calves SCREAMING after the first couple miles of toe-strike running. My calves definitely felt the burn for several days after that run. I continued to run through the soreness, and, after a week or two, the soreness subsided to what I thought were much stronger calves and overall better running form. Looking back now, my sports doctor, physical therapist, and myself all think that this was the precursor to my shin injury.
I'm mentioning it just incase it resonates with you...or in case you are a toe striker. I know I've read a lot about the benefits of toe (vs. heel) striking, but my doctors seem to think that it (or an abrupt transition to toe striking) may put undue stress on the tibia, along with tightening the calves, which, in turn, causes the muscle/tendons to tug on your bone.
I hate to say it, but I'd go see your doctor. After all, 6-8 weeks without running is far superior to 6-8 months without running...which is what you might face if you continue to run and the injury gets worse. (This is what I kept telling myself to prevent myself from running the Hartford Half on the day of my sports doctor appointment.) If you DO have a stress fracture, imagine the following image (I read this online and it's been burned into my memory ever since):
Imagine your bone like a pane of glass, and your running like a hammer tapping ever so gently on this glass. After a while, this tapping will cause (or, as the case may be, has already caused) miniscule cracks in your bone. Over time, continued tapping (running) will exacerbate the cracks into what could eventually become a full-on break in your bone. In order to avoid such breaking (gulp!), you (we) must stop the tapping (running).
Believe me, I know it's hard to stop running and take yourself to a doctor. (I had many teary-eyed pout fests/pity parties about it. I know, I know...I'm kind of a sally.) Think of the rehab as a time learn to enjoy cross-training and strength train to address any weak muscle groups. It sucks at first, but a little time and a lot of positive thinking will make it better--I promise!
Keep me posted about your shin! Wishing you the best!
I have to wonder about your changes to your footplant. It may just be a matter of terminology, calling it "toe strike running". A good forefoot strike does not land on the toes. Initial contact is on the ball of the foot, with the midfoot and heel following quickly before pronation and toe-off. So your toes are not really involved until the end. If you have been landing on and staying on your toes, that may very well have contributed to your shin splints. Check the pictures of forefoot strike at this web site (right column of pictures).
http://www.barefootrunning.fas.harvard.edu/4BiomechanicsofFootStrike.html
Len
Len
Thank you, Len! The videos/images you included were VERY helpful, and suspect you're correct about my toe rather than forefoot striking. The forefoot striker in the videos looks so graceful--definitely form to strive for!
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