Shin Pain When Running: Is It Shin Splints or a Stress Fracture?

If you’re a runner, athlete, or someone who spends long hours on your feet, chances are you’ve experienced lower leg pain at some point. Two of the most common causes are shin splints and stress fractures. While they can feel similar, these conditions are very different—and knowing which one you have is essential for proper treatment and recovery.

At Restore Foot & Ankle Specialists, we frequently see patients who confuse shin splints with stress fractures. Here’s how to spot the difference and when to seek professional care.

What Are Shin Splints?

“Shin splints” is the common term for medial tibial stress syndrome (MTSS). It occurs when repetitive stress causes inflammation of the muscles, tendons, and bone tissue around the tibia (shin bone).

Common Symptoms of Shin Splints:

• Achy, diffuse pain along the inside of the shin

• Pain that improves with rest but returns during activity

• Tenderness along a broad area of the shinbone

• Sometimes mild swelling

Shin splints are especially common in runners, dancers, and athletes who suddenly increase training intensity or frequency.

What Are Stress Fractures?

A stress fracture is a small crack in the bone caused by repetitive force or overuse. In the shin, stress fractures often occur in the tibia from high-impact activities.

Common Symptoms of Stress Fractures:

• Sharp, localized pain at a specific spot on the shin

• Pain that worsens with activity and may persist at rest

• Tenderness when pressing directly on the fracture site

• Possible swelling

Stress fractures are more serious than shin splints because they involve actual bone injury, and they require strict rest to heal.

Key Differences Between Shin Splints and Stress Fractures

Although both conditions cause shin pain, the main difference lies in how the pain feels and where it is located. Shin splints usually cause a dull, aching pain that spreads along the inner edge of the shinbone, while stress fractures produce sharp, pinpoint pain in one specific area.

Another important distinction is how the pain behaves. With shin splints, pain often eases with rest and may improve once you warm up during exercise. Stress fracture pain, on the other hand, tends to linger—even at rest—and worsens with continued activity.

Finally, shin splints result from inflammation of the muscles and tendons around the shin, while stress fractures involve actual cracks in the bone.

Causes and Risk Factors

Both conditions are linked to overuse and repetitive stress, but risk factors include:

• Sudden increases in activity or training intensity

• Running on hard surfaces

• Poor footwear or worn-out shoes

• Flat feet or high arches (biomechanical issues)

• Weak calf or shin muscles

• Low bone density (increases stress fracture risk)

Diagnosis: How Podiatrists Tell the Difference

Since symptoms can overlap, it’s important to get an accurate diagnosis. At your visit, a podiatrist may:

• Perform a physical exam to identify pain location and severity

• Order X-rays (though stress fractures may not appear early)

• Recommend an MRI or bone scan if a stress fracture is suspected

Treatment Options

Shin Splints

• Rest and activity modification

• Ice and anti-inflammatory medications

• Supportive footwear or custom orthotics

• Stretching and strengthening exercises

• Gradual return to activity

Stress Fractures

• Complete rest from high-impact activities

• Possible use of a walking boot or crutches

• Nutritional support (calcium, vitamin D, proper diet)

• Gradual reintroduction to activity after healing

• In rare cases, surgery may be needed for severe fractures

Prevention Tips

• Increase training intensity gradually

• Wear supportive, well-fitting shoes designed for your activity

• Cross-train to reduce repetitive stress on the legs

• Strengthen calves, shins, and core muscles

• Consider custom orthotics if you have flat feet, high arches, or other biomechanical issues

The Bottom Line

While shin splints and stress fractures can feel similar, stress fractures are more serious and require immediate medical care. If you’re experiencing persistent shin pain, don’t try to push through it—get evaluated by a podiatrist to avoid long-term complications.

✅ At Restore Foot & Ankle Specialists, we specialize in diagnosing and treating shin pain, whether it’s shin splints or a stress fracture. Our goal is to get you back on your feet safely and prevent future injuries. Contact our office today with Dr. Gireesh Reddy or Dr. Sirisha Pokala by calling (469) 573-3427 or by booking an appointment online.