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Ankle Pain

Tibialis Anterior Tendonitis

Minute Read


Posted 1 year ago


Last updated: 03/12/2022


by James McCormack

Anterior Tibial Tendon Anatomy

The Tibialis anterior muscles’ origin sits on the front of the shin bone, reaching across to the inner side at the lower 1/3 of the shin bone to attach to the medial arch of the foot. The primary function of the Anterior Tibial Muscle is to lift the foot up and inwards but it does work eccentrically to control pronation moments. If this tendon becomes overloaded, it can become painful and inflamed, leading to Anterior Tibial Tendonitis.

In this article, we will explore the causes, symptoms, and treatment for Anterior Tibial Tendonitis.

Picture of someone running outside

Causes of Tibialis Anterior Tendonitis

A sudden change in activity levels, such as increased volume of walking, running, or impact exercises, can cause the Anterior Tibial Tendon.

As a result, it becomes inflamed and painful, leading to tendonitis. Anterior Tibial Tendonitis can also be caused by repetitive overuse of the tendon, biomechanical issues, poor footwear selection, and flat foot deformity.

Tibialis Anterior Tendonitis Symptoms

Anterior Tibial Tendonitis is painful on the front of the shin, usually at the aspect closer to the ankle (lower 1/3). It can be painful to walk, jump or run and should ease when stopping an activity.

It is often painful and stiff when stepping out of bed in the morning and eases within 5-10 minutes of walking. It may be painful at the start of exercises and then ease as it warms up but painful once again in the hour post exercises.

In chronic cases of Anterior Tibial Tendonitis, it can be continuous painful with activity and increase in pain with continued use rather than easing.

There is rarely any bruising or discolouring, while there may be some mild swelling at the lower shin. It can be tender to touch along the Tibialis Anterior muscle, tendon, and shin bone. It is often confused with shin splints, but this condition is isolated to the tendon only.

Shin Splints Diagram

Tibialis Anterior Tendonitis Diagnosis

If you have any symptoms of Tibialis Anterior Tendonitis, it is recommended to have a consultation with a medical professional such as a Physical Therapist. After a clinical interview and a careful clinical assessment of your foot and ankle, they will be able to diagnose Tibialis Anterior Tendonitis. Clinical tests included resistance of ankle dorsiflexion and pain on palpation of the tendon.

Sometimes, a scan may be required to complement a clinical diagnosis. The most accurate types of scans for Anterior Tibial Tendonitis are an Ultrasound Scan or an MRI. An x-ray can rule out other conditions with similar symptoms, such as a Stress Fracture but cannot diagnose Anterior Tibial Tendonitis.


Picture of person with Shin Splints Pain

How to treat Anterior Tibial Tendonitis

Physical Therapy is the best form of treatment for Anterior Tibial Tendonitis. Initial home treatment can involve icing the area for pain relief, stopping impact activity to manageg pain levels and nonsteroidal anti-inflammatories such as Ibuprofen. Foam rolling the Anterior Tibial muscle and stretching the calf muscle is helpful, too.

A physical therapist may carry out manual therapy techniques such as soft tissue massage and assisted stretching of the calf muscle. An ankle brace or taping may be used in irritable cases for the tendon to settle. Common anecdotal treatments such as KT Tape and compression socks are of little clinical benefit for this condition.

Strengthening and stability exercises for the foot and ankle are recommended alongside stretching the Tibialis Anterior muscle and the calf muscles.

Gait analysis is recommended to assess for any biomechanical contributions to the pain. In contrast, steroid injections such as cortisone are not recommended for tendon issues as they can cause long-term deconditioning of the tendon.

Surgery is rare, but a surgical tendon debridement may be required in persistent cases that fail conservative treatment. This is usually followed by 6-12 weeks of Physical Therapy.

Physiotherapy with James McCormack

This is not medical advice. We recommend a consultation with a medical professional such as James McCormack. He offers Online Physiotherapy Appointments for £45.

Related Article: Extensor Tendonitis of the Foot 

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