Tibialis-Anterior-Tendonitis

The tibialis anterior, which is the large muscle that runs down the outside of the shin, helps lift the foot up during walking. Tibialis anterior tendonitis refers to irritation and swelling of the tendon that lies in front of the ankle into the midfoot.

Symptoms

Pain when bending the foot and toes up

Tenderness, redness and swelling over front of ankle into midfoot area

Weakness when lifting foot upwards

Tightness in calf muscles

Causes

Overuse of muscle — walking with long stride length at quick pace, walking downhill, running on hard surfaces, playing sports with frequent changes in direction

Tight calf muscles

High-heeled shoes

Treatment

Treatment focus is on resting irritated tendon and decreasing inflammation. Surgery may be an option if conservative treatment is ineffective.

Activity limitation / rest

Over the counter pain medication, such as ibuprofen (Advil, Motrin) or naproxen (Aleve), as needed

Ice to affected area

Calf stretches

Walker boot or cast if symptoms are severe

Ankle brace

Shoes with a “rocker sole”

Padding in shoe to relieve pressure on area

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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.

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