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Anterior Tibialis Tendinitis

By Liz Brabston, PTA

What is Anterior Tibialis Tendinitis?

Anterior Tibialis Tendinitis is inflammation of the anterior tibialis tendon. It can also be referred to as 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. This muscle runs down the front of your shin and crosses over your ankle joint line and runs down the inside of your foot where it connects.

Common symptoms felt are a gradual onset of pain and/or stiffness along the front of the ankle when lifting foot or toes up, 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. Overuse is often the most common cause of anterior tibialis tendinitis.

The anterior tibialis can be injured by overuse or using the wrong footwear.

Muscles of the legs and lower body.

How can the Anterior Tibialis Tendon become damaged?

Tension is placed on the anterior tibialis tendon whenever it is stretched. The following factors can also cause the ATT to become damaged:

Any repetitive or high force activity can cause damage to the tendon from it being overstretched, or overused. 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 as well. Improper footwear that is too small or too tight can also cause ATT.

Working out too hard can result in injury.

Overtraining can result in disaster or injury if you are not adequately prepared.

 

How is ATT diagnosed?

An assessment will be performed by your Physical Therapist. 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). Sometimes, an MRI will be performed to rule out a tear or strained tendon.

How is Anterior Tibialis Tendinitis treated?

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, you will be instructed on various exercises to increase:

  • Ankle Mobility

    • Manual therapy performed by PT to maintain mobility and inhibit pain.
  • Strength

    • Theraband exercises.
    • Eccentric exercises to promote the loading of the tendon.
    • Intrinsic muscle strengthening.
  • Balance Training to promote:

    • Stability and improve proprioception of ankle joint on stable and unstable surfaces.
    • Coordination.
    • Neuromuscular response.
  • Correct biomechanical problems:

    • Knee Valgus or Varus, overpronation.

Your physical therapist may also use instrument assisted tools to increase flexibility and decrease pain, as well as educate on proper footwear and may even recommend orthotics, as well as 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 and decrease risks of re-injury.

 

Recovery            

Recovery from anterior tibialis tendinitis can last from a few weeks to several months depending on the severity of the inflammation and damage to the tendon.  If you have been dealing with ATT for some time without rest and rehab, chances are your recovery will be longer than someone who seeks treatment early on.

 

Author: Liz Brabston, PTA

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