Ankle Tendonitis in Runners – How To Stop Anterior Tibial Tendonitis While Running

runner suffering from shin splints

If you’re dealing with tibialis anterior pain (or have a history) and are looking for the best ways to treat and prevent it, look no further.

In today’s post, I’m sharing with you the full guide to tibialis anterior tendonitis so you can get back to running as quickly as possible.

Sounds great?

Let’s get started.

What is Tibialis Anterior Tendinopathy

Tibialis anterior pain refers to swelling within the anterior tibialis tendon.

The injury is caused either by overuse or traumatic ankle injury.

But what’s the anterior tibialis tendon in the first place?

Time for anatomy 101.

The lower leg is made of four compartments that separate and contain the muscles located within the knee to the ankle.

The four compartments include:

  • The Anterior (A),
  • Lateral (L),
  • Deep Posterior (DP), and
  • Superficial Posterior (SP)

The tibia and fibula (bones of the lower legs), the anterior intermuscular septum, and the interosseous membrane are the borders of the compartments.

See Image.

What is The Anterior Tibialis?

The anterior tibialis consists of a muscle-tendon unit that runs along the outside of the tibia (the shin bone), crosses the ankle, then ends along the inside of the foot, connecting to the bone just behind the big toe.

This tendon has two primary roles during gait.

The first one is to concentrically dorsiflex your ankle during the swing phase for foot placement.

The second is to eccentrically contract once your foot makes initial contact with the ground to regulate the transition from heel strike to mid-stance.

Check out the Tutorial.

The Dire Consequences

Ignored, the anterior tibialis injury can force the tendon to rupture, and it becomes a real pain to treat and recover from.

In some extreme cases, the muscle can become so weak that it can result in a “drop foot.”

Causes of Tibialis Anterior Pain

Tibialis anterior tendinopathy is the classic overuse syndrome.

When respective stress from consistent training is placed on the tendon beyond what it can comfortably endure, damage in the form of micro-tears occurs.

That’s when your body reacts by initiating an inflammatory response to heal these tiny tears.

Tendinopathy is the swelling within the tendon.

The condition can also be caused by tight footwear or tight shoelaces that compresses the over the anterior tibialis tendon.

The following culprits can also increase your risk of injury:

  • Running on hard or uneven surfaces
  • Bad running form
  • Falling or direct trauma to the tendon.
  • Poor foot or ankle biomechanics

The Symptoms

Runners suffering from tibialis anterior muscle strain are likely to experience discomfort or pain anywhere from the knee down to the big toe.

The condition triggers a gradual onset of pain within the tendon itself as it crosses the front of the ankle joint.

The pain may come and go and or be chronic, and the symptoms may worsen depending on your exercise intensity.

Stiffness may also be experienced at the front of the ankle joint.

As the condition worsens, any extra miles will cause more pain, and you even experience pain when doing non-running activities.

This is especially the case when dorsiflexing your foot, climbing stairs, or running.

You may also feel the pain while operating the gas and brake pedals while driving.

Some of the telling signs include:

  • Swelling at the affected area
  • Pain, usually cramping, aching, or burning
  • Weakness
  • Pressure or tension

How To Treat

So, what should you do if you have tibialis anterior tendinopathy?

Here’s the truth.

This injury won’t get better on its own—especially if you kept on running as usual.

Here’s what you should do:

First, consult a doctor or therapist.

This helps confirm your diagnosis as well as a rule out any other culprit.

Your doctor may offer you a personalized treatment plan that can include:

  • Add strength to weakened or dysfunctional muscles, especially the tibialis anterior.
  • To loosen up tight muscles that may cause abnormal movement within the limb. It also helps to restore the full range of motion in the joint.
  • Cold therapy. This helps soothe inflammation and pain, which may speed up recovery.
  • Orthotics. To bring more support to the tendon and amend any abnormal foot biomechanics that may have contributed to the overuse of the tendon.
  • Gait analysis. For uncovering any muscular imbalance or biomechanical abnormality that could cause an overuse of the tendon.

Prefer to Treat it On Your Own?

Here’s how to do it

Begin by applying the RICE method.

The goal behind this method is to bring swelling and pain under control as fast as possible.

You should start applying it as soon as pain and swelling occurs and keep doing it until symptoms start to fade and healing is almost complete.

R – Rest the affected limb for as long as you have pain during weight-bearing.

Devoid of rest, movement, and weight-bearing can make your injury worse, causing increased inflammation and swelling.

And you don’t want that.

I – Ice the affected area with a bag of frozen peas or crushed ice wrapped in a damp cloth for 10 to 15 minutes, three times a day.

Whatever you do, do not apply ice directly to the skin—that’s why you should always make sure you’re using some layer of materials between the ice and your skin.

C – Compress the injured foot to protect it from further irritation.

You can use an elastic bandage, such as ACE wraps, to provide the compression and support needed. Remember to keep the wrap snug but allow for proper circulation.

It’s not a tourniquet.

E – Keep the injured foot elevated above heart level when laying down or sleeping so that gravity can move fluids away from the affected limb, which may reduce pain and swelling.

At best, try elevating the entire foot eight to ten inches above the heart, so there’s a complete downhill path.

Additional Resource – How To Prevent Ankle Pain For Runners


There you have it

The above tips are all you need to know about treating (and why not prevent) this injury for good.

Please feel free to leave your comments and questions in the section below.

In the meantime, thank you for dropping by.

Keep training strong.

David D.