This is a common injury in many running based sports. It is characterised by diffuse pain in and around the tibia (shin bone) in the lower leg and usually occurs as a result of a sudden
increase in the frequency, duration and/or intensity of activity.

More focal pain should be a red flag for the possibility of a true stress fracture. With the emergence of imaging techniques we are now able to make more accurate anatomical and pathological diagnosis of patients with significant leg pain.

Risk factors include those with abnormal biomechanics, using inappropriate footwear for the activity and often poor flexibility. Other risk factors include female gender, reduced bone density, higher BMI and history of previous fracture.

The basis of treatment is based on symptom relief, identification of risk factors and treatment of the pathology.Initially this starts with rest (immobilisation if necessary), ice and pain relief.

Management will include undertaking adequate and supervised training. Programmes may be required to develop strength, balance, coordination and flexibility. Wearing the appropriate footwear for your foot type and considering a biomechanical foot screening to determine if further orthomechanical control is required is usually necessary.

Like most overuse injuries, shin pain may develop gradually over a period of time but if assessed and treated early, a return to normal activity levels can be easily achieved.