Written By: Chloe Wilson BSc(Hons) Physiotherapy
Reviewed By: FPE Medical Review Board
Tibialis anterior tendonitis is a common condition that causes pain and discomfort in the front of the ankle and foot.
Also known as anterior tibial tendonitis or anterior tibialis tendonitis, it is caused by inflammation of the tibialis anterior tendon, which runs along the front of the lower leg and attaches to the foot.
Tibialis anterior tendonitis can affect people of all ages, but usually affects people who are active or participate in high-impact activities such as running, jumping, or dancing that place stress on the foot. It typically affects people over the age of 40 due to reduced tendon elasticity and blood flow.
Here, we will explore what tibialis anterior tendonitis is and look at the common causes, symptoms, diagnosis and treatment options as well as prevention techniques and the recovery process.
Tibialis anterior tendonitis is an overuse injury that causes foot pain and inflammation in the tendon at the front of the ankle.
The tendon connects the tibialis anterior muscle, located on the front of the shin, to two of the bones in the top of the foot, the first metatarsal and the medial cuneiform.
The tibialis anterior muscle is responsible for dorsiflexion, or pulling the foot upwards towards the shin, and helps turn the foot inwards.
When the tibialis anterior muscle is overused or misused, it can cause damage to the tendon and result in anterior tibial tendonitis, making it difficult to walk, run, or participate in physical activity.
The most common cause of tibialis anterior tendonitis is overuse, usually from repetitive or prolonged activities that cause strain and stress on the tibialis anterior tendon. This overuse can lead to inflammation, micro-tearing, and degeneration of the tendon.
Common causes of anterior tibial tendonitis include:
Additionally, people who have suffered from previous ankle injuries or who are overweight may be at a higher risk for developing tibialis anterior tendonitis.
Tibialis anterior tendonitis is a relatively common condition, particularly in individuals who participate in activities that require repetitive ankle and foot movements. This includes runners, dancers, and other athletes.
It is estimated that around 10% of runners will experience anterior tibial tendonitis at some point during their running career.
However, it can also affect individuals who are not particularly active especially if they have experienced previous ankle injuries. Tibialis anterior tendonitis is a common cause of top of foot pain, particularly near the ankle.
Common symptoms of tibialis anterior tendonitis include:
Anterior tibialis tendonitis pain may be felt during or after exercise and can range from mild to severe. Symptoms typically worsen with activity and improve with rest.
In some cases, a popping sound may be heard or felt in the ankle at the time of injury. If this is accompanied by immediate swelling then it is likely that the tibialis anterior tendon has completely ruptured.
If you are experiencing symptoms of tibialis anterior tendonitis, it's important to seek an accurate diagnosis from a healthcare professional.
In most cases, a physical therapist or doctor can diagnose tibialis anterior tendonitis by performing a physical exam and reviewing your medical history. Diagnostic tests, such as X-rays or an MRI, may also be used to confirm the diagnosis.
To accurately diagnose tibialis anterior tendonitis your healthcare provider will begin with a physical examination to assess your symptoms and determine the severity of your condition.
During the examination, they may ask you about your medical history, previous injuries, and any other conditions that may be contributing to your symptoms.
They will look for signs of inflammation and tenderness along the front of the ankle. They will then get you to perform certain movements to assess the strength and range of motion in the ankle and foot.
In some cases, they may recommend imaging tests to confirm the diagnosis of tibialis anterior tendonitis and rule out other potential conditions or injuries. Imaging tests may include:
Tibialis anterior tendonitis can sometimes be mistaken for other foot injuries or conditions, however, there are some key differences that can help distinguish them:
Ankle tendonitis is a common problem and can affect any of the foot and ankle tendons. Other common types of foot tendonitis include:
Once you have received a diagnosis of tibialis anterior tendonitis, your healthcare provider will recommend a treatment plan based on the severity of your condition. Treatment options can range from conservative, non-invasive therapies to more aggressive surgical interventions.
Tibialis anterior treatment aims to reduce pain and inflammation, correct any foot deformities and restore normal walking pattern so you can return to your usual activities without any discomfort or stiffness.
In most cases, anterior tibial tendonitis can be treated conservatively, i.e. without the need for surgery, unless there are significant tears in the tendon.
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Conservative treatment for tibialis anterior tendonitis aims to alleviate pain and inflammation while promoting healing and may include:
There are a number of things you can do at home as well to help treat anterior tibialis tendonitis:
Your doctor may recommend surgery for tibialis anterior tendonitis if conservative treatments and immobilization do not provide relief or your condition is severe. Surgical options for tibialis anterior tendonitis may include:
Surgical intervention is usually only necessary if the tendon has completely ruptured. It is typically considered a last resort for treating tibialis anterior tendonitis and is only recommended if all other treatment options have failed.
Tibialis anterior tendonitis can be a painful condition to deal with, but by taking proper preventative measures, you can greatly reduce the risk, such as:
By following these preventative measures, you can significantly reduce your risk of developing tibialis anterior tendonitis.
Recovering from anterior tibial tendonitis takes time and patience and the length of recovery depends on factors such as the severity of your tendonitis, your age, and your overall health. In general, following your doctor's instructions and taking good care of your foot can help speed up the recovery process and prevent future injuries.
Be patient and allow your body the time it needs to heal fully, and you can expect to return to your normal activities soon. If you try and do too much too soon, you will keep aggravating the tendon. It needs time for the inflammation to settle and for the tendon to heal.
While recovery time can vary, most people with tibialis anterior tendonitis can expect to recover fully within 4-12 weeks with proper care. If you require surgery, it can 6 months to a year to make a full recovery.
Tibialis anterior tendonitis is a common foot injury that occurs when the tibialis anterior tendon becomes inflamed.
Common causes of anterior tibialis tendonitis include overuse, improper footwear, sudden increases in activity level, and trauma to the foot or ankle.
Common symptoms of tibialis anterior tendonitis include top of foot pain, swelling, and tenderness along the front of the ankle and foot, particularly during activity.
Treatment for tibialis anterior pain includes conservative measures such as rest, ice, compression, elevation, medications and strengthening and stretching exercises as well as physical therapy, orthotics, and immobilization in severe cases. Surgery is rarely necessary unless the tendon has ruptured.
The best ways to reduce the risk of developing tibialis anterior tendonitis is to wear appropriate footwear, gradually increase activity levels, and avoid sudden increases in intensity or duration of exercise.
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Page Last Updated: 02/28/24
Next Review Due: 02/28/26