A female National Collegiate Athletic Association Division I track athlete experienced nonlocalized shin pain midway through her first season, which was diagnosed as medial tibial stress syndrome. Treatments included strengthening and range of motion exercises, reduced training volume, and pain control modalities, but symptoms worsened. It was revealed she had been suffering from severe sleep deprivation (<3 hours/night) contributing to bilateral tibial and fibular stress reactions. Months of trial and error eventually resulted in the implementation of sleep interventions which improved her total body bone mineral density and bilateral stress reactions. Two years after successful sleep interventions, this athlete has remained injury-free and continues to set personal bests in her events. Our standard injury screening protocols did not include questioning sleep quality and quantity early in the process, and in this case, we highlight the need for these measures to be considered initially and throughout the treatment and recovery phases of sports-related injuries.