Shin soreness, commonly known as 'shin splints' refers to pain or discomfort over the front of the lower leg. The pain may also be felt along or between the two bones (and may involve bone, muscle, tendon or a combination of these).

It is an overuse injury in which the body does not adapt to the repeated stress causing minute injuries to the soft tissues or to the bone, as in a stress fracture. This leads to inflammation, which is the body's response to injury. The inflammation causes pain, swelling and warmth at the injury site. If activity is continued, the inflammation is worsened.

The lower leg is composed of 2 bones, the tibia and the smaller fibula. Muscles attaching to the tibia on the inside run down behind the ankle and across the bottom (arch) of the foot. These include the posterior tibialis and the flexor digitorum longus (which, when contracted, curls the toes).

To the tibia on the outside is attached the muscles which uncurl and extend the toes and at the front, the tibialis anterior, which dorsiflexes (or picks up) the foot.

To the fibula are attached the peroneal muscles which turn the foot.

The most common site of shin soreness is on the inside of the tibia, where the tibialis posterior attaches. This muscle crosses the longitudinal arch of the foot, so excessive stress can be caused by anything which causes the foot to flatten more, e.g. flat feet, poor shoes, hard surfaces, excessive weight.

Common site is along the front of the leg, which is the anterior tibialis muscle. This muscle attaches to the top of the foot and is primarily responsible for dorsiflexion. The problem here can be tendinitis, myositis, stress fracture, anterior compartment syndrome.

Shin soreness may have many causes.
These include:
1. Tendinitis (inflammation of one or more of the many tendons).
2. Myositis (inflammation of the muscle).
3. Periostitis (inflammation of the outer covering of the bone).
4. Stress fractures of the tibia and fibula.
5. Anterior compartment syndrome.
6. Referred pain from lower back.

1. Footwear - may be inappropriate for activity or individual foot.
2. Sudden changes in training habits (distance, speed, surface).
3. Maialignment of foot andlor lower leg.
4 .Lack of conditioning.
5. Weak or flat longitudinal arch of foot.
6. Running on slopes.
7. 'Tight'Achilles tendon.
8. A blow to the shin may set off inflammatory reaction.

The goal of immediate care is to reduce the inflammation:
1. Ice massage the complete area for 15-20 minutes or wrap on an ice pack using an elastic non-adhesive bandage.
2. Anti-inflammatory medication may be prescribed by your doctor.

The goals of treatment are to reduce inflammation, remove the cause and allow a return to full activity safely, without a recurrence of the injury.

Treatment may include:
1. Physiotherapy, which may include ice, ultrasound, electrical stimulation and exercise. 2. Anti-inflammatory medication.
3. Modification of activity.
4. Orthotics or change of shoes.

5. Stretch and strengthen routines.

Shin soreness can be prevented. However, if you have had shin soreness and then fully rehabilitated, it is possible to prevent them recurring.
1. A warm-up (including stretching) and warm-down (including stretching) for all activity. 2. Strength program.
3. Stretching program.
4. Good training program to include gradual changes in distance, speed or surfaces, not sudden. Ten percent increase or change per week is a good guide to follow.
5. Proper footwear.
6. Taping.

Various taping techniques have been effective in controlling shin soreness as well as in assisting recovery.
The two simplest and most often effective are:
1. Longitudinal arch.
2. Spirals.

Taping (from left to right) for lateral and anterior pain or media pain, and taping the longitudinal arch.