Tibialis Anterior Tendinopathy

The tibialis anterior tendon runs down the front of the shin bone, down the front of the ankle, and attaches to the inner side of the midfoot (into the first metatarsal and medial cuneiform). It works to help point the foot upwards and inwards. Tibialis anterior tendinopathy (or tendonitis) describes damage or irritation to the tibialis anterior tendon that results in painful symptoms at the tendon.  

What causes tibialis anterior tendinopathy?

Tibialis anterior tendinopathy is generally an overuse syndrome. When repetitive strain from strenuous activity is placed on the tendon past the point that it can safely handle, micro-tears and damage occur. This causes the onset of painful symptoms. Overuse may result from:
  • Running sports
  • Kicking sports
  • Training on uneven surfaces
  • Running/walking on hills
Footwear that is too tight and compresses the tendon, causing friction and damage, can also result in tibialis anterior tendinopathy.  

What are the symptoms?

Symptoms can include:
  • Pain and tenderness along the tendon at the shin, foot, and most commonly the ankle
  • Swelling
  • Pain exacerbated or brought on by physical activity
  • Stiffness or weakness at the ankle, that may lead to the dropping of the foot

How is treated?

Because the symptoms of tibialis anterior tendinopathy can gradually worsen if the tendon continued to be overused, it needs to be managed effectively. Initially, treatment focuses on alleviating the pain symptoms following the PRICE principles (protection, rest, ice, compression, elevation). Following this, treatment focuses on facilitating the healing and repair of the tendon, and reducing the likelihood of symptoms returning in the future. This may include:
  • Orthotics to support the tendon and correct any abnormal foot biomechanics that may have been causing overuse of the tendon
  • Footwear assessment to ensure that the shoes are helping and not hindering recovery
  • Stretching tight muscles that may be contributing to abnormal foot function and the overuse of the tibialis anterior tendon, and restoring sufficient motion in the joints
  • Strengthening weakened muscles, including the tibialis anterior once it has healed
  • Activity modification for activities that stress and overload the tendon