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stress fracture vs. mtss and how do you know the difference?

Question: stress fracture vs. mtss and how do you know the difference?

So I haven't been running for very long time, but lately I've been running frequently. I've been very careful to take it slow and give myself rest in between runs. However, the last time I ran a few times a week (only for about 2 miles or so each time) I experienced shin pain after. It was so bad that I decided not to run until it was no longer painful. This lasted for over a week. It was not my whole shin that was painful, only a very small area was extremely tender. It hurt to touch that spot, and for a few days I felt pain even when standing for long periods of time. After I felt it was okay to run again I did so, only to experience the same thing again (maybe even worse this time). How do I know if it's MTSS or if there's something more going on? Also, my other shin is painful as well, but not nearly as bad and that too is only a small area. Thanks!


One good but not foolproof way to tell the difference is the pattern in which the pain occurs. If the shin is sore before running, subsides after you've warmed up, and is sore afterwards, it is probably MTSS. If the pain gets worse as you run and leaves you almost unable to walk immediately after, it could be a stress fracture. Also, if the pain is in a widespread area on the inside of your lower leg, it's probably MTSS, whereas if it is concentrated in, say, a quarter sized spot and you can feel a bump there, it is likely a stress fracture.

I've had stress fractures and the bump indicates a calcium deposit where the bone is trying to rapidly heal itself. I would get a bone scan or MRI to be absolutely sure.