Anterior Tibialis Tendinitis: Causes, Symptoms, and Treatment
By Tim Wall, MS, ATC
Getting to Know Anterior Tibialis Tendinitis
Anterior Tibialis Tendinitis is a condition that affects a tendon in the lower leg, which is crucial for controlling the front muscle’s movement. It can cause pain and discomfort, particularly during physical activities. In this article, we will explore the reasons, risk factors, symptoms, diagnostic methods, and treatment options for this condition. Our goal is to provide you with the information you need about this subject from a trusted source in the orthopedics.
What is Anterior Tibialis Tendinitis?
The quick answer, Anterior Tibialis Tendinitis is inflammation of the anterior tibialis tendon. It can also be the degeneration of the tendon sheath. The anterior tibialis muscle can be found easily by lifting the foot up toward the head and seeing the muscle belly contract on the front of your shin.
What Causes It and Who’s at Risk?
Several factors can lead to anterior tibialis tendinitis, including overuse, repetitive strain injuries, wearing improper footwear, poor training techniques, and muscle imbalances or weakness in the lower leg.
The main cause of anterior tibialis tendinitis is overuse or repetitive strain injuries. This happens when the tendon that connects the front muscle to the shinbone becomes inflamed due to too much stress or repetitive movement. Activities like running, jumping, or dancing can increase the risk of developing this condition.
Using improper footwear or poor training techniques can also contribute to anterior tibialis tendinitis. Wearing shoes that don’t fit properly or don’t provide the right support can put excessive strain on the tendon. Likewise, doing physical activities with incorrect form can put unnecessary stress on the anterior tibialis tendon, resulting in inflammation and pain.
Muscle imbalances or weakness in the lower leg can also increase the risk of developing anterior tibialis tendinitis. When certain muscles, like the calf muscles, become tight or overactive, it can cause an imbalance that puts excessive strain on the tendon and leads to tendinitis.
Symptoms of Anterior Tibialis Tendinitis
Common symptoms felt are a gradual onset of pain or stiffness along the front of the ankle. Pain when lifting foot or toes, swelling, feeling of ankle weakness, or tenderness when palpating the tendon. The pain can increase with activity, most commonly with walking or running uphill or downhill.
Recognizing the Symptoms
If you’re feeling pain and tenderness at the front of your lower leg, it could be a sign of anterior tibialis tendinitis. This condition is often identified by discomfort where the anterior tibialis tendon runs along the shinbone. The pain can be a dull ache or a sharp sting and may get worse with activity.
Along with pain, you may also notice swelling or inflammation in the affected area. This can make your leg feel warm and look red or swollen. Swelling can make it challenging to wear certain types of shoes or participate in activities that require you to flex your foot.
Individuals with anterior tibialis tendinitis may find it hard to walk or run. The pain and inflammation can make it tough to put weight on the affected leg, leading to a limp or altered walk. This can significantly affect daily activities and performance in sports.
Diagram of the Human Leg Anatomy showing the Anterior Tibialis
What does the Anterior Tibialis Tendon do?
This muscle runs down the front of your shin and crosses over your ankle joint. It then runs down the inside of your foot where it connects. It enables you to lift the foot upwards towards the head.
How can the Anterior Tibialis Tendon become damaged?
When stretching, there is tension on the anterior tibialis tendon. The following factors are also indications for injury:
- Poor foot biomechanics.
- Inappropriate Footwear.
- Tight Muscles of the lower leg.
- Excessive training or overtraining.
- Overweight.
Any repetitive or high force activity can cause damage to the tendon. Running uphill or on uneven surfaces or kicking with toes pointed are perfect examples. If you overpronate (your foot rolls inward when walking or running), this can also overstretch the tendon resulting in damage. Finally, improper footwear that is too small or too tight can also cause ATT.
Anterior Tibialis Tendonitis
How It’s Diagnosed and Treated?
To diagnose anterior tibialis tendinitis, healthcare professionals usually begin with a physical exam and a review of your medical history. These steps help identify the cause and rule out other potential injuries or conditions.
During the physical exam, the healthcare provider will check the affected area for signs of inflammation, tenderness, or swelling. They may also test the range of motion and strength of your foot and ankle. It will cover your ankle strength, range of motion and applying resistance to your foot while you attempt to lift your foot toward your head (this motion is referred to as dorsiflexion).
In some instances, they may recommend imaging tests like X-rays or MRI scans to further evaluate the condition. X-rays can help detect any structural issues or fractures, while MRI scans provide detailed images of soft tissues, such as tendons and ligaments.
The treatment for anterior tibialis tendinitis usually involves rest, ice, compression, and elevation (RICE) to ease pain and inflammation. Physical therapy may also be suggested to strengthen the affected muscles and improve flexibility. Anti-inflammatory medication, like nonsteroidal anti-inflammatory drugs (NSAIDs), can help lessen pain and reduce inflammation.
Remember, while these treatments are commonly used, the specific approach will vary depending on the individual and the severity of the condition. It’s always best to consult with a healthcare professional for a precise diagnosis and personalized treatment plan.
How do you fix Anterior Tibialis Tendinitis?
Physical Therapists treat Anterior Tibialis Tendinitis using various methods. Decreasing inflammation with rest and ice is a good place to start at home. Once you meet with a Physical Therapist, they will instruct you on various exercises for a home program. Their exercises will consist of ankle mobility, ankle strengthening, and balance exercises to improve your symptoms.
Ankle Mobility
Manual therapy performed by a PT to maintain mobility and inhibit pain. This is just another way in physical therapy to get back to a full recovery. Stretching of all of the structures of the ankle and calf are also very important.
Proper way to stretch the calf.
Strengthening of the Ankle and Lower Leg
Strengthening the muscles and tendons of the lower leg and ankle are so important for the treatment of this condition.
- Theraband exercises for all motions of the ankle.
- Eccentric exercises to promote the loading of the tendon.
- Intrinsic muscle strengthening using marbles or towels.
Balance or Proprioception Training
- Stability and improve proprioception of ankle joint on stable and unstable surfaces.
- Improve Coordination and decrease the risk for re-injury.
- Neuromuscular response.
Correct Biomechanical Problems
Excessive Knee Valgus or Varus and overpronation are factors related to this injury.
Your physical therapist may also use Graston tools to increase flexibility and decrease pain. As well as education on the proper footwear. They may also recommend orthotics or taping for improved stability.
What are the benefits of strengthening the Tibialis Anterior Muscle?
Strengthening the tibialis muscle will allow for improved stability, coordination, balance, and agility. It will also help decrease the risk for re-injury. In other words, physical therapy can really help the healing process with this injury.
Ankle Exercises Picture
How long does it take for anterior tibialis muscle to heal?
Recovery from anterior tibialis tendinitis can last from a few weeks to several months. Depending on the inflammation’s severity and damage to the tendon. If you have been dealing with this for some time, chances are your recovery will be longer than someone who seeks treatment early on. In order to return to your previous activities, you must be pain free and have good strength of the ankle and lower leg.
Related Video:
Basic Ankle Ankle Exercises Video
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Author: Tim Wall, MS, ATC