Asked for Male | 23 Years
Shin Pain Evaluation: Marathon Training Concerns
Patient's Query
Hi there, Hope you’re doing well. I’m reaching out to ask about medial tibial stress syndrome/tibial stress fractures. I’ve been training for my 2nd marathon for the past few months and have experienced some shin pain along the inside of my left leg (dominate leg). It’s a low pain level that never exceeds 1-3 out of 10 on a pain level scale. My main issue is that it’s challenging to self diagnose this. Part of me sees a couple fracture symptoms - the pain is localized (not big like a typical shin splint), there is slight pain when I run up or down stairs, some discomfort when I jump multiple times on the one leg, and the pain fluctuates from day to day. And although the pain point is localized, it’s not quite as tender or painful as some examples I’ve read online (so maybe not a fracture?). My reasons why I think this could just be a shin splint are because the pain has not gotten worse over the past 3 weeks (while running), and the pain fades away most of the time when I’m running (sometimes I feel discomfort during the first mile or 2 but then it’s gone). I even ran a half marathon race with a personal best time just 5 days ago, and was not bothered by it during or after the race. I started noticing this issue about 3 weeks ago. I took a couple days off from running 2.5 weeks ago to address it. I didn’t think it was anything alarming, so I continued my training for 2 weeks - I run about 50 to 60 miles a week. I haven’t ran for 5 days this week because I began to get paranoid about this injury still lingering (last thing I want is to turn a shin splint into a fracture). It’s strange the injury hasn’t gotten worse, and like I said, the pain fluctuates from day to day, but never exceeds a 3 out of 10 on the pain level scale. I’m wondering if you have any recommendations and if it’s worth visiting a doctor in person soon. My ultimate goal is to still run my marathon the final weekend of April, but I’ll need at least 5 to 6 more weeks of training - therefore if my rest time exceeds 3 weeks, I probably can’t do the race. Obviously it’s not the end of the world if I have to sit out. Thank you for your time and I hope to hear from you soon! Take care, Dominic
Answered by Dr. Pramod Bhor
You might have medial tibial stress syndrome or tibial stress fractures, which occur when your shin bones experience repeated stress from activities like running. You may feel localized pain, discomfort when jumping, and varying levels of pain. Rest, apply ice to the area, and consider seeing an orthopedist for evaluation and advice.

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