Which statement best differentiates shin splints from stress fractures?

• A. Shin splints show focal pain; stress fracture diffuse pain
• B. Shin splints show diffuse tibial pain worsened with exercise; stress fracture shows focal localized pain and point tenderness
• C. Shin splints are not painful; stress fractures are not painful
• D. Shin splints occur with swelling; stress fracture with numbness

Answer: (B)

Differentiating shin splints from a stress fracture hinges on how the pain presents and where it’s felt. Shin splints (medial tibial stress syndrome) usually cause diffuse, aching pain along a length of the tibia that worsens with continued activity and improves with rest. The tenderness is spread over a broad area rather than confined to one spot. A stress fracture, on the other hand, tends to produce focal, localized pain with point tenderness over a small area of the bone, often painful with weight bearing and possibly persisting even after stopping activity.

The statement that shin splints involve diffuse tibial pain worsened with exercise and that a stress fracture involves focal localized pain with point tenderness best reflects these patterns. The other options don’t fit because shin splints are not nonpainful or purely focal, and stress fractures aren’t typically associated with numbness.