Anterior Tibial Tendonitis

Anterior Tibial Tendonitis is inflammation within the tendon. It is typically from overuse. This muscle runs down the front of your shin and crosses the ankle, then ends along the inside of the foot.

What Causes it?

  • Overuse of the tendon
  • Excessive Training
  • Sports:
    •  Running on uneven surfaces
    •  Kicking with toes pointed
    • Repetitive movements
  • Tight foot or ankle wear
  • High Heels
  • Poor foot/ankle biomechanics – pronated feet

Anterior Tibial Tendonitis




Symptoms are typically gradual at onset with pain or stiffness along the front of the ankle and worsened when trying to lift the foot or toes up. There is pain when pressing the tendon with your finger, and the pain worsens when doing activities like walking or running up or down a slope. Swelling, stiffness and weakness may occur and can progress to development of foot drop.

Patients experiencing nighttime pain can also have this condition. When patients sleep on their stomach, they bend the toes down at the ankle and stretch the tendon. In addition, if patients sleep on their back and use a heavy blanket to sleep with, the weight of the blanket can cause pain along the tendon. Symptoms are reproduced when walking on heels.


Assessment by a foot and ankle specialist. An MRI or Ultrasound may be performed to rule out a tear or strained tendon.


Once the diagnosis has been made, conservative therapy begins:

  • Rest/Ice Massage
  • Avoid barefoot walking
  • Take a short course of non-steroidal anti-inflammatory drugs (NSAIDs)
  • Immobilization
  • Ankle Brace
  • Custom Orthoses/Bracing: Prevent excessive eversion, help support the tendon
  • and correct underlying foot abnormalities.
  • Physical Therapy: stretching & strengthening the tendon

How to SPEED UP the healing time?

  • Extracorporeal Pulse Activation Technology (EPAT) “Shockwave Therapy”
    • Non-invasive way to speed up the healing process with great results for both chronic and acute conditions.
  • MLS Laser Therapy
  • Platelet Rich Plasma (PRP) Injections

When conservative therapy fails, and patients continue to experience pain, surgical management becomes a viable option but is rarely needed:

  • Tendon Repair – remove damaged tendon and repair the remaining good tendon. Sometimes a tendon transfer or tendon graft is needed depending on the severity of the condition.

Anterior Tibial Tendonitis is a common condition seen with overuse of the tendon. It may take a few weeks to months to improve, depending on the severity. Many treatment modalities can speed up the recovery process and help you return to activity sooner. A foot and ankle specialist can guide you in your diagnosis and recovery process.


  1. About The Author Mike Walden Mike is creator & CEO of A qualified Sports Injury Therapist with a degree in Physical Education. (2020, June 03). Tibialis Anterior Tendonitis (Tendinopathy) – Symptoms, Causes, Treatment. Retrieved June 29, 2020, from


About the Author:

Dr. Brittany Brower, a board certified foot and ankle specialist, provides care in Holly Springs, NC and Raleigh, NC for your convenience.

Dr. Brittany Brower grew up in Greensboro, North Carolina. She graduated summa cum laude from North Carolina State University with a B.S. in Human Biology and a Minor in Health. She earned her medical degree from Dr. William M. Scholl College of Podiatric Medicine in Illinois where she graduated as valedictorian. Dr. Brower completed a three-year foot and ankle surgical residency at John Peter Smith Hospital, a level 1 trauma center in Fort Worth, Texas.







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