What to Know About Tibialis Anterior Tendonitis

Medically Reviewed by Jabeen Begum, MD on November 04, 2022
Written by Victoria Hamilton
4 min read

Tibialis anterior tendonitis affects your shin and ankle joint, all the way down to the inside of your foot. It can take some time to recover, but there are treatments and exercises you can do to help yourself. Read on to learn more about this condition.

Your anterior tibial tendon is the part of your foot that controls movement as it touches the ground, pulls up from the ground, or turns the foot inward. Tendons are the soft tissue that connects the muscles in that part of your body to the bones. You use it especially when you walk down stairs or on hills.

As with any set of muscles, if you use them too much or incorrectly, you’re likely to injure yourself. This initial injury will result in pain and swelling that likely won’t last. If you start to strain the muscles too soon, though, you’ll overtire your muscles quickly. This could result in more swelling or even minor tearing in your tendon. If you don’t let yourself heal, the damage will add up and turn into tendonitis.

Tibialis anterior tendonitis is a common injury for runners and is similar to other tendon injuries in that it starts out as an aching, dull pain that fades in and out.

Tibialis anterior tendonitis symptoms include the following:

  • Tenderness, pain, stiffness, and swelling in the front of your ankle where it meets your foot
  • Redness on the front of your ankle
  • Pain as you move your ankle around, especially as you turn your foot in or pull it up
  • Pain that gets worse as you’re more active, especially if you frequently run or walk up hills or stairs
  • A cracking sound when you move or touch the tendon
  • Weakness as you lift your foot upward

Tibialis anterior tendonitis causes can be boiled down to one thing: overusing your anterior tibial tendon. There are risk factors that increase your chances of getting it, like:

  • Running or walking up and down hills
  • Playing sports where you make quick, repeated starts, kick a lot, or run frequently
  • Being physically active while you’re in poor physical shape or have low flexibility
  • Having flat feet
  • Sustaining a previous injury to your leg, ankle, or foot

Tendinopathy is a more specific way to diagnose tendonitis. If you've had chronic tendonitis for a long time, you probably have tendinopathy. This means that your tendon is degenerating due to continual, repeated stress. Tendonitis refers to acute, quick-setting inflammation.

An anterior tibial stress fracture doesn’t take place on the inside of the tibia but the surface or the “leading edge” of your shin. This injury is particularly concerning because it happens on the side of the bone that has the most tension. 

As you put weight on your foot, the crack in your bone will worsen and struggle to heal completely. You’ll have a sharp, acute pain on the front of your shin bone, especially if you push on that area. You might also experience tightness in surrounding muscles. If you have this bone pain, you likely have a stress fracture and should see a health care provider to confirm.

Exertional anterior compartment syndrome happens when the sheath that covers your tibialis anterior muscle isn’t big enough. So, when you exercise and blood flow to your muscles increases, the muscle swells up and presses against this sheath. This pain is persistent and is often accompanied by feeling like your muscle is full, cold, tingly, or numb. A health care provider can quickly diagnose compartment syndrome by checking the pressure on the muscle while you exercise.

There are a number of assessment tests that can help diagnose tibialis anterior tendonitis, including:

  • Resisted dorsiflexion. A health care provider adds resistance as you try to lift your foot up.
  • Resisted eccentric inversion. A health care provider moves your foot around as your try to resist.
  • Ultrasounds or MRI scans. These will help a health care provider rule out a less serious strain or more serious tendonitis.

There are a number of tibialis anterior tendonitis treatments you can try. Consult with a health care provider to know what to try:

  • Medication, including anti-inflammatory medicine and pain relievers
  • Applying cold after doing something that makes your symptoms worse
  • Applying heat after strength activities and stretching
  • Resting from activities that make your symptoms worse
  • Using orthopedic aids like a cast, walking boot, heel lift, or arch support
  • Attending rehab with an athletic trainer or physical therapist
  • Using kinesiology tape to strengthen your tibialis anterior
  • Running on a softer surfaces
  • Wearing shoes that have low heels
  • Strengthening and stretching the tibialis anterior with heel walks and toe raises

Depending on the severity of your injury, tibialis anterior tendonitis recovery time will vary. If you try treatment on your own and your symptoms don’t get better after a couple of weeks, you should get in touch with your health care provider quickly.

As you learn to treat your tibialis anterior tendonitis, you should take preventative measures to protect yourself from future injuries. You can try:

  • Taking the time to warm up and stretch before engaging in physical activity
  • Focusing on flexibility, endurance, and strength in your ankle and leg
  • Using proper techniques when engaging in physical activity
  • Giving yourself plenty of time to rest and recover between exercising
  • Wearing arch supports if you have flat feet
  • Using correct equipment, like cleats that are the correct length
  • Completing rehab after a previous injury, if applicable

Listen to your body! If you need to take time off, do it. If you think your injury may be more serious than tendonitis, consult with a healthcare provider.