I have intense shin splints or a stress fracture, but how can i know which?

X-ray or MRI: You need to have diagnostic testing to see what your problem is.

MRI: Mri or bone scan may be able to differentiate. An additional consideration is exertional compartment syndrome, which can be diagnosed by a sports medicine physician in clinic. Ct or x rays may show a "dreaded black line" in the case of a stress fracture. In the shin bone, these fractures are notorious for their slow rate of healing. Some elect to have surgery to stimulate healing.