I’ve experience this on and off for a few years now. I’ve shortened and softened my stride, which seemed to help. I run on trails as much as possible. I started using compression sleeves, which really seemed to help. Finally after this most recent bout, I moved to the Brooks Beast to control the pronation that I though was the problem. It seemed to help initially, but now it’s back again.
The tightness/pain is startsjust below the knee and extends about halfway down.
I forgot to mention that when this occurs my foot slaps. It is only my left leg. No issues with my right. I really notice the slapping on the treadmill. I was able to mostly remedy this using aan incline.
Painful if you press hard on the tendon? If so, I have similar on & off and goes in tandem with a slight niggle I get at big-toe metatarsal - kinda makes sense considering the ant’ tib attachment point.
I found that compression socks don’t help & some times make it worse which perhaps suggests its a foot issue - I do have a tight left PF & tend to land mid to fore-foot.
I’ll watch this thread with interest - cheers for posting!
Edit: doing a lot of bike training? I’ve got to the point now that I’m thinking it could be bike related rather than run - also, any sort of dorsi-flexion aggravates the condition, like kicking off the pool wall…
Good ol’ running could be the red-herring here, just an idea.
Just thought I’d add that I have noticed that a lot of my “running” issues are exacerbated by swimming. I was a swimmer in HS and have a strong flip turn/push off, and that really irritates my feet if they are already tired/sore from running.
You mentioned “foot slap” - do you have any low back issues or sciatica at all? A weak anterior tibial will cause a foot slap (or even foot drop post stroke, UMN injury, post knee surg, etc.). Yes, overstriding will exacerbate it. The anterior tibial is mostly a dorsiflexor of the ankle and doesn’t really help in resisting pronation at all, so the Brooks Beast is not likely to help and may even be worse because of the very large, flared heel in that shoe.
Two years ago I had a bad flare up of the tibialis anterior tendon. It got so bad I had to get PT since nothing else seemed to help. I was training for a trail ultra at the time, so I couldn’t completely stop running. I noticed that it didn’t hurt at all when on the trails; only roads (run in Brooks Cascadias on trails and Brooks Ghost on roads). The PT made it tolerable, but it didn’t completely go away until I began strength training with one-leg exercises. I think my problems were caused by an asymmetry in my bio mechanics. Since I began my strength training I’ve been injury free. Maybe it’s something you want to consider? Couldn’t hurt, anyways.
My wife works IT at a rehab facility and she spoke with a few of her friends there who are PT’s. They seem to think it is compartment syndrome.
Anyway it looks like I will be missing the Fly by Night Duathlon tonight. I was really looking forward to riding on the track.
Scheduling an appointment next week to get it evaluated.
Chronic compartment syndrome? Maybe and easy enough to rule out with a wick catheter compartment test (after some treadmill running of course). But in your original post you mentioned you used a compression sleeve that seemed to HELP. This should have made it worse if compartment syndrome. Best of luck!
I had something similar a while ago. The doc said it was over rotation of my ankle when running which was working the tibialis too much. I ended up getting orthotics to give more arch support (stop over rotation) and it went away. About a year after getting the orthotics I stopped using them and have not had problems since - most likely the muscles in the ankle became stronger.
I think were on to something. After roof’s message I thought a little more about things and I think what’s happening is that a weakness somewhere is causing the dorsiflexors to fatigue, which leads to the foot slap, which then causes some trauma.
Thanks everyone for taking some time to help out. Hopefully, we’ll get this figured out and get back to racing this year.
I had a similar issue last year and my anterior tibialis still gets really tight, generally when my calf gets tight as well (that whole damn balance thing). Friend of mine who is an AWESOME ART therapist/PT worked on releasing it and the difference was amazing in terms of stability in my foot plant. She did a general active release treatment on it, likely a bit deeper than normal but I went from getting almost no function from it to near full function back. I’ve seen been fairly good at keeping it loose by rolling on my TP Therapy roller (quadballer/big roller, kneeling position rolling over the tibialis and it works but got it hurts!). Generally if I do the entire lower leg at least once a week or so it stays pretty loose but if I don’t it tightens up fast and as a result so does my whole lower leg often resulting in a bit of PF.
anyways, personally the ART worked wonders on me
Otherwise, I’d reccomend trying out a roller, I love the TP therapy stuff for areas like that which are denser and harder to hit effectively with a regular foam roller or the stick.
Not sure on the shoes. I’m guessing that while that could definitely be an issue that your choice there would be more related to your overall biomechanics and build. The Beast is a pretty stiff shoe with a lot of correction but at the same time I remember the lateral edge in the forfoot being pretty supportive (versus others that have a ton of correction but super soft lateral side) so the chances of it over correcting and causing excessive supination which could put more pressure on the lateral anterior are likely lower. Might be something to look into. If you don’t probate a lot you might try something like a Dyad with is a bit more neutral yet still stable.
Going for a compartment test on Wednesday. The possibility of surgery is scary but I am told that this issue may be more of a concern long term because of my type 1.
I’ve had similar issues with my right ta for quite some time. In my case what Tai said worked for me as well. I see an ART chiropractor who just works wonders. That and using the stick on the right calf keeps things at bay usually. It tuned out to be a major balance issue with the at. Good luck
My doctors thought that the issue was chronic exertional compartment syndrome.
I had the compartment test yesterday and my numbers were 17 pre and 33-34 post for both the anterior and lateral compartments. They recommended therapy at this point.
Thanks for the follow-up and good luck with therapy (not often effective, but won’t hurt anything). Might want to search the several compartment syndrome threads here recently (well, last 18 months or so) for some input from fellow suffers/triathletes.