What is a Stress Fracture of the Tibia? A stress fracture of the tibia is an overuse injury to the bone caused by excessive, repetitive stresses. This is caused by an abrupt increase in the duration, intensity, or frequency of physical activity without adequate rest. The most commonly seen location in the body for a stress fracture is in the tibia. Stress fractures of the tibia typically start as “shin splints” (medial tibial stress syndrome), then progress to a stress reaction and finally a stress fracture. A stress fracture can progress into a complete fracture in severe cases which is why early diagnosis is crucial. Who is at Risk? Athletes engaging in high-impact, repetitive activities (runners) Military personnel/recruits Females have been shown to be more at risk than males Signs and Symptoms Pain directly over the tibia (shin) that is usually worse with activity and better with rest Pain without any distinct injury that gradually gets worse over time Pain that started mild and over time becomes sharp Treatment Treatment for stress fractures requires rest from all physical activity. Crutches and even a walking boot may be used to reduce the stress in the tibia, especially for daily activities such as walking. Further imaging may be used to evaluate the extent of the stress fracture such as X-rays, MRI, or bone scan. Depending on the severity of the stress fracture, prolonged recover can occur, but a full recovery and return to sport is achievable with proper management. A slow gradual return to sport and activity is recommended once completely symptom free. If rest and conservative treatment does not seem to be improving symptoms, aggressive measures such as surgical intervention may be deemed necessary.