Anterior Tibialis Tendinitis

By Liz Brabston, PTA

What is Anterior Tibialis Tendinitis?

The quick answer, 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 ankle’s front 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. 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. 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 injury

How is ATT diagnosed?

Your Physical Therapist will perform an assessment. 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.


  • 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 re-injury risks.


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 ATT for some time without rest and rehab, chances are your recovery will be longer than someone who seeks treatment early on.

JOI Fracture and Injury Care

JOI Physicians are currently offering ASAP fracture and injury care. This is a new option for patients who would like to avoid the emergency room if they have suffered a fracture or soft tissue injury. To learn more about this service, read this article about fracture and injury care. Make an appointment by calling (904)JOI-2000.

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Author: Liz Brabston, PTA

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