The tibialis anterior muscle runs down the front of the shin. The anterior tibial tendon lies on the inner-front of the ankle. The muscle and tendon work together to flex the foot upwards. This condition occurs when the tendon is inflamed from overuse or traumatic ankle injury. If left untreated, the tendon can rupture and is very difficult to treat. In some patients the muscle can become weak leading to a “drop foot.”
Causes and risk factors
- More common in women than in men
- Middle aged and older individuals
- High arched foot types
Symptoms
- Deep achy pain on the inner front of the ankle and on the top of the foot
- Feeling of ankle weakness
- Swelling on the inner front of the ankle
- Symptoms aggravated by walking and activity
Diagnosis and treatment
When diagnosed early, anterior tibialis tendonitis can be treated conservatively. If you have these symptoms, start with the RICE protocol. Bracing, physical therapy, and anti-inflammatory medications (NSAIDS) can also help relieve pain and inflammation. Stretching the calf muscle can also help by putting less strain on the front of the ankle when flexing the foot. Do not use corticosteroid injections for this condition, these can actually accelerate the degenerative process and make the tendon more susceptible to further injury, longer recovery time, and may increase the likelihood of rupture. When conservative methods do not alleviate symptoms, surgery may be an option. Typically surgery includes removing any damaged tendon (debriding) and possibly lengthening the calf muscle. A ruptured tendon always requires surgery and should only be performed by a specially trained foot and ankle orthopedic surgeon.