Shin stress fractures are more accurately known as Tibial stress fractures. The Tibia is the larger, weight bearing bone of the lower leg. As the Fibula doesn’t bear any weight, stress fractures here are pretty rare.
Pain from shin stress fractures develop gradually over a period of a few weeks usually. The pain is felt on the bone and can usually be pin-pointed to a small area of the shin, usually in the lower half of the bone. It may be sore to press on this area and warmth and redness may be detected. Pain gets worse as a run continues and then eases after a day or two’s rest. In more severe cases, pain may also be whilst whilst walking and doing other, non-running activities.
What is it?
Stress fractures are exactly as they sound – a fracture of a bone due to repeated stresses, rather than one sudden force. The fracture itself is like a crack in the bone, sometimes also known as a hairline fracture.
Whilst x-rays usually pick up a fracture, in the early stages of stress fracture, they may not. This is because they are not full thickness breaks and so the x-rays do not pass through the gap in the bone, like they do with full fractures. Stress fractures only tend to be visible on x-rays after a few weeks, when new bone is being laid down.
Treatment of Shin Stress Fractures
As with all fractures, the key ingredient to successful treatment is rest. With a full fracture you would usually be placed in a plaster cast to protect the bone, but in the case of shin stress fractures, this isn’t really necessary. You may be offered crutches or a walking boot to help take the weight off it for a week or two. But generally, they will heal fine with a combination of no running and no unneccessary walking for a couple of weeks. You can then start to increase walking, provided it is pain free to do so. Generally the healing time for a stress fracture is 4-6 weeks.
Correcting the cause
As with most running injuries, there is at least one, sometimes more, factor which has caused the injury to develop. In the case of shin stress fractures it can be anything which increases the stress on the Tibia. The most common examples are running with worn out running shoes; running with a heavy heel strike; running on concrete pavements continuously; running in unsuitable running shoes for your foot type; running too much too soon or transitioning to minimalist or barefoot running too quickly.
If any of these apply to you, then make sure you sort it our before even considering returning to running. Get a gait analysis, get new running shoes and consider your training program and running form.
Returning to running
Returning to running following shin stress fractures must be a very gradual process to avoid re-injuring the bone. Start with short runs on a soft surface such as grass or sand. Even a treadmill is better than road runners. These all absorb more of the shock which otherwise passes right through your Tibia.
Start with 5 minutes. Then have 3 days rest – ensure there is not pain at the time or inbetween and then try another 5 minutes. Have another 3 days rest and if all is well, try 10 minutes. Follow this with another three days rest before another 10 minute run. Rest again and try 15. Gradually build in this manner. If there is any pain at all, then stop and return to resting.