Shin Splints or a Stress Fracture? Symptoms, Treatment, and Getting Back to Running

Shin splints cause a dull, aching pain along the inner edge of the shinbone, usually from running, jumping or a sudden jump in training. The pain is spread over several inches, is worst at the start of exercise, and often eases as you warm up. A stress fracture, a tiny crack in the bone, hurts in one specific spot, gets worse the longer you exercise, and may hurt at rest or at night. Shin splints usually heal in a few weeks with rest. A suspected stress fracture needs an exam and possibly an X-ray.

Shin splint symptoms

• Aching or throbbing along the inner edge of the shin, over a span of several inches
• Tenderness when you press along the bone
• Pain at the start of exercise that may ease during it, then return afterward
• Mild swelling in the lower leg

Stress fracture symptoms

• Sharp pain in one small spot on the bone, about the size of a fingertip
• Pain that gets worse the longer you run or walk
• Pain at rest or at night as it progresses
• Swelling or tenderness right over that spot
• Pain when hopping on the leg

Common causes

• Increasing mileage, speed or hills too quickly
• Running on hard or uneven surfaces
• Worn-out or unsupportive shoes
• Flat feet or high arches
• Starting a new sport, a new season, or military or dance training
• Low calcium, vitamin D or energy intake, which raises stress fracture risk

What helps shin splints heal

• Rest from running and jumping for two to four weeks, while staying active with low-impact exercise like swimming or cycling
• Ice for 15 to 20 minutes after activity
• Anti-inflammatory pain relievers, if they're safe for you, for a short time
• Supportive shoes, and replacing running shoes every 300 to 500 miles
• Calf and shin stretches and strengthening for the hips and core

Getting back to running

Return gradually once you can walk briskly and hop on the leg without pain: start with short, easy runs on soft surfaces, and increase mileage by no more than about 10 percent a week. If pain comes back, cut back again.

What urgent care can do

A clinician can examine your leg, check for a stress fracture, and decide whether an X-ray is needed. Early stress fractures don't always show on an X-ray, so you may be told to rest and recheck, or be referred for an MRI. Treatment may include a walking boot, crutches, or a plan for rest and return. Our post on sprains and broken toes, fingers and X-rays cover other common injuries.

At an AfterOurs clinic, a standard self-pay visit is $175, a visit with one moderate service such as an X-ray is $250, and a self-pay in-clinic visit never costs more than $330. We contract with all major commercial and government plans, including Colorado Medicaid and Medicare. See our minor fractures page and the cost and insurance page.

Go to the ER if you have severe lower leg pain with a tight, swollen, hard calf, numbness or tingling in the foot, or pain that's much worse than you'd expect, which can be signs of compartment syndrome; or a swollen, warm, red calf with shortness of breath or chest pain, which can be a blood clot.

Where to find us

Four clinics across metro Denver, all ages welcome, se habla español:

• Hampden (Southeast Denver): 8 AM–11 PM daily
• Littleton: 8 AM–11 PM daily
• Thornton: 8 AM–11 PM daily
• Highlands: Mon–Fri 5–11 PM, Sat–Sun 8 AM–11 PM

Walk in, or book online.