Tibialis Anterior

General information

The tibialis anterior originates in the upper two-thirds of the lateral surface from the tibia. It inserts into the first metatarsal and first cuneiform bones within the foot. The muscle works to invert and dorsiflex the foot. It is located mostly by the shin, lying on the tibia’s lateral side. It is fleshy and thick above and tendinous below. The tibialis anterior lies over the anterior tibial vessels and the deep peroneal nerve in the upper portion of the leg.

Literal meaning

Before shinbone.

Interesting information

The most common injury to this muscle is that of tibialis anterior tendinitis. It happens whenever a large amount of stress is placed on the leg muscle, which leads to the tendon being overloaded. Most of the time, this is caused from strenuous physical activity such as playing sports or running on hard, uneven surfaces and hills. Tightening the shoelaces too much can cause the muscle to become injured from repeated rubbing and the tendon being constricted.

Those who have incurred this type of injury will experience pain that gradually worsens. It often occurs during strenuous activity or in a rest period after this type of activity. Pointing the toes and kneeling down can cause the pain to worsen. To help reduce inflammation and pain, it may be necessary to take an anti-inflammatory medication.

Origin

Lateral condyle, adjacent interosseous membrane and the proximal half of the tibia shaft.

Insertion

Inferior and medial surfaces for the medial cuneiform in addition to the base for the first metatarsal bone.

Function

Dorsal flexion for the ankle joint.

Foot inversion.

Nerve supply

Deep peroneal nerve L4-L5.

Blood supply

Anterior tibial artery.

Anterior tibial recurrent artery.

Anterior medial malleolar artery.

Dorsalis pedis artery.

Medial tarsal arteries.

Posterior tibial artery.

Calcaneal arteries.

Medial malleolar arteries.

Relevant research

Rupturing the tibialis anterior tendon is not common. When it happens, the diagnosis is obvious. Essential clinical symptoms tend to be loss of strength in ankle flexion, pain in the ankle foot, footdrop gait and claw toes. The occurrence of clinical signs and the asymptomatic time between the injury will make diagnosis all that much more complicated. MRIs tend to provide valuable insight into any joint and bone damages from a tendon injury. Surgical exploration is able to confirm the findings from the MRI. It provides the treatment of choice when the tendon has ruptured. The techniques used have an impact on the nature of the rehabilitation programme the patient is advised to follow.

Jellad A, Salah S, Bouaziz MA, Bouzaouache H, Ben Salah Z. Unusual clinical presentation of a partial tibialis anterior rupture. Ann Phys Rehabil Med. 2012;55(1):38-43. doi:10.1016/j.rehab.2011.10.005

Tibialis anterior exercises

Kneeling TA stretch

Kneel on the knees with the legs several inches apart. Toes should be pointed backward, so that the tops of the feet are facing the floor. Flex the knees and lean backwards. Move the buttocks toward the calves until a gentle stretch is felt through the front of the thighs and lower legs. Hold the stretch for 10 to 30 seconds. Place the hands onto the floor by the feet for additional balance. Complete 10 repetitions.