Tibial stress fracture, which occurs in the lower leg bone along the front of the calf muscle, is a bone injury from overuse that is common in runners. The main symptom is shin pain, typically experienced as a crescendo pain, that gets worse with activity. Other symptoms include swelling along the shin and tenderness in the calf muscles. The pain does not usually occur while at rest, however. There are many factors that can lead to a tibial stress fracture, such as overtraining, improper nutrition, and low levels of testosterone or estrogen.
Repetitive overloading and stress of the tibia bone prevent it from being able to naturally heal itself and lead to a stress fracture of the tibia. The bone is unable to absorb shock because of repeated trauma, which weakens the bone. A diagnosis involves a thorough medical history, physical exam, and possibly a bone scan. X-rays generally do not show a bone stress fracture, although successive X-rays can reveal where the bone is trying to heal.
The most common symptom of a tibial stress fracture is localized shin pain along the lower half of the tibia, and it is similar to the pain experienced with shin splints. It will usually start out as a dull ache or slight irritation and build up to a throbbing, sharp pain with continued use of the leg. The pain progressively worsens with activity such as walking, running, or exercise. Generally, the shin pain disappears while at rest, although in severe cases, it can continue even when the leg is not being used. In these cases, the pain can be bad enough to prevent a person from being able to walk.
Another symptom of a stress fracture of the tibia is swelling along the shin due to inflammation of the muscles, tendons, and tissues surrounding the bone. The tibia bone might hurt or there might be muscle tenderness in the area of the fracture when pressed upon. In some instances, calf pain or knee pain can also occur with a tibial stress fracture.
There are several factors that can cause the pain and other symptoms of a tibial stress fracture. Overtraining, like doing a workout that is too intense or too high volume, can result in a tibial bone injury from repetitive stress. Improper nutrition and lack of calcium and magnesium can lead to poor bone health and increases the risk of stress fractures. Low levels of testosterone or estrogen are also risk factors, as well as chronic use of certain medications such as steroids.