Anterior tibial tendonitis
by Nathan Wei, MD, FACP, FACR
Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.
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The anterior tibial tendon is located at the front of the ankle.
Strains of this tendon cause pain with plantar and dorsiflexion of the ankle ( pointing the toe down and up). Activities such as going down stairs, walking, and running hills hurt. Anterior tibialis tendonitis is an overuse condition common in runners and is most symptomatic when running downhill. On exam, there is tenderness over the muscle belly and tendon. There is also pain upon active dorsiflexion (pointing the toe up). Treatment involves rest, stretching, and non-steroidal anti-inflammatory drugs (NSAIDs).
Shin splints also tend to involve the anterior tibial tendon.
The muscle for this tendon is located on the upper outside of the shin. Shin splints are usually confined to the soft tissue of the muscle.
The muscle in the front of the leg which usually becomes painful is the tibialis anterior muscle, which is encased in a thin sheath. This muscle attaches to the foot, and helps with dorsiflexion of the foot.
The main cause of injuries leading to shin splints is abnormal foot pronation.
When over-pronation occurs, the tibialis anterior, soleus, and tibialis posterior muscles overwork in an attempt to maintain the foot in a normal alignment with the leg.
1. Rest with elevation of the leg will reduce the pain and inflammation. Ice will help, as will mild compression of the painful area. Compression can be applied with an Ace wrap applied from the ankle to just below the knee.
2. If the problem persists or reoccurs, custom orthotics may help with over-pronation.
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