Sports Medicine: Anterior Tibialis Tendonitis

Helping Hand Logo

Anterior tibialis tendonitis is an injury of the anterior tibialis tendon in the front of the ankle where it meets the foot. The tendon is important in pulling the foot up (dorsiflexion), lifting the foot off the ground while running, and in turning the foot inward (inversion).

Signs and Symptoms

  • pain, tenderness, and sometimes swelling over the front of the ankle where it meets the foot
  • pain with ankle motion, especially when pulling the foot up or when turning the foot in
  • pain that worsens with increased activity, mostly with running or walking up hills
  • a cracking sound when the tendon is moved or touched

Increased Risk

  • sports that require sudden, repetitive jumping and quick starts, or kicking and running sports, especially running hills and long distances
  • poor physical conditioning (strength and flexibility)
  • flat feet
  • previous injury to the foot, ankle or leg


  • Medicine
    • Anti-inflammatory medicines, such as ibuprofen (Motrin® or Advil®) or naproxen (Aleve®) may be recommended. Take these as directed by your health care provider.
    • Other minor pain relivers, such as acetaminophen (Tylenol®), may be used.
  • Use of cold and heat
    • Cold should be applied for 10 to 15 minutes every 2 to 3 hours and after any activity that makes symptoms worse. Use ice packs or an ice massage.
    • Heat should not be used on a new injury but may be used before performing stretching and strengthening activities prescribed by your health care provider or athletic trainer. Use a heat pack or a warm soak.
  • Rest
    • Rest or decreased activity should help decrease pain and swelling.
  • Orthopedic aids
    • A cast or walking boot may be advised in severe cases to limit activity and improve pain.
    • A heel lift or arch support (orthotic) may be used in some cases.
  • Rehab
    • Rehab with a physical therapist or athletic trainer can increase flexibility and strength, decrease pain and help the athlete return to activity.

How to Prevent

  • Do correct warm-up and stretching before practice or competition.
  • Maintain ankle and leg flexibility, muscle strength and endurance.
  • Use proper technique.
  • Allow time for ample rest and recovery between practice and competition.
  • Wear arch supports for flat feet.
  • Use proper equipment (for example, correct length of cleats).
  • Complete rehab from a previous injury.

When to Call the Health Care Provider

Call your health care provider or the Sports Medicine team at (614) 355-6000 if:

  • symptoms get worse or do not improve after 2 to 4 weeks of treatment
  • new, unexplained systems develop 

Sports Medicine: Anterior Tibialis Tendonitis (PDF)

HH-I-504 ©2021, Nationwide Children’s Hospital