The tibialis anterior is the muscle located on the front of your lower leg or shin. Injuries or conditions such as shin splints, tendinosis, an ankle sprain and drop foot could damage and weaken the tibialis anterior muscle. The goals of physical therapy are to reduce inflammation and pain, increase flexibility, strength and stability -- and prepare you to return to normal activities. Physical therapy varies based on your injury, so consult your physical therapist for detailed instructions.
Causes and Injuries
Poor walking or running mechanics, overtraining and improper or worn shoes can lead to injuries such as shin splints, ankle sprains, muscle strains and tendinitis or tendinosis. A fall or hit to your shin can cause anterior compartment syndrome, a tibial fracture and contusion or bruise. Anterior compartment syndrome is swelling around your tibialis anterior muscle, creating pressure and damage to your muscle and nerves. Another injury is called "drop foot," when you cannot contract your tibialis anterior muscle to flex your ankle, consequently causing your foot to "drop" during walking. Neuropathy is the leading cause of drop foot.
R.I.C.E.
The acronym R.I.C.E. is used to reduce and manage inflammation and pain. It stands for rest, ice, compression and elevation. A cast or walking boot and crutches may be necessary for injuries such as tibial fractures and severe ankle sprains. Wear an elastic warp around your foot, ankle and lower leg to apply compression and decrease swelling. Elevation means keeping your foot and ankle above your heart.
Stretches and Massage
Stretches to regain tibialis anterior ankle flexibility include ankle circles and pointing your toes down and in. Another way to stretch your tibialis anterior is to take your hand and gently pull your ankle down and in. Massage including friction massage may improve flexibility, as well as promote healing, according to a 2006 article in the journal "Dynamic Chiropractor." Calf and Achilles tendon stretches may further improve ankle flexion.
Strength and Stability Exercises
Start with non weight-bearing strength exercises such as resisted ankle flexion and inversion using an elastic band. Sitting with your legs straight, tie an elastic band around your foot and anchor the other end on a piece of furniture. Slowly pull your toes toward you for flexion, or draw your foot in for inversion. Advanced weight-bearing exercises include heel walks and single-leg balance on uneven surfaces such as a BAPS board. A 1991 University of Iowa study found that the tibialis anterior muscle contracted the most when the board was "anteriorly inclined" during single-leg balance. The tibialis anterior contracts to flex the ankle, shifting the weight to the heel and causing the board to tilt back. Therefore, exercises on the BAPS board increase tibialis anterior strength and ankle stability. Return to normal activities when you are pain-free and regain normal flexibility and strength.
References
- University of Washington Department of Radiology: Tibialis Anterior
- "Dynamic Chiropractor"; Rehab Recommendations for Tibialis Anterior Tendinosis; Kim Christensen, DC; July 2006
- "Advances in Clinical Neuroscience and Rehabilitation"; Foot Drop; Brian McNamara, P.h.D; 2003
- "Physical Therapy"; Electromyographic Activity of Selected Leg Musculature in Subjects with Normal and Chronically Sprained Ankles Performing on a BAPS Board; Gary L. Soderberg, et al.; July 1991
- Haymarket Physical Therapy and Chiropractic: Shin Pain
- American Academy of Orthopaedic Surgeons; Compartment Syndrome; October 2009
