The Tibialis Anterior is a leg muscle that attaches to the inside portion of the middle of the foot or midfoot. During walking this muscle helps to lift the foot off of the ground during the swing, as well as help to slow the foot strike during the stance portion of the walking cycle.

Overuse of this muscle can occur while walking with a long stride length at a quick pace, slowing the foot plant during downhill walking. Tight calf muscles can contribute by increasing the work of the Tibialis Anterior tendon to lift the foot up during the swing portion on walking. Wearing heeled shoes can additionally increase the stress on this muscle increasing the risk for developing tendonitis. The pain associated with Tibialis Anterior tendonitis is generally noted at its attachment to the midfoot. Radiographic studies like X-rays don’t assist in diagnosis and MRI are reserved if symptoms persist despite conservative treatment.
Treatment is aimed at decreasing inflammation to the tissues with ICE and anti-inflammatory medications as well as calf stretching and rest. By restricting ankle motion, the short term use of a removable cast boot can be very helpful. Wearing shoes that have a “rocker sole” tend to decrease the stress on this muscle by allowing a more rolling motion during the walking cycle. The change in mechanical stress through the ankle during walking helps to rest this tendon during the recovery period.