200: TIBIALIS ANTERIOR TENDINITIS

CONDITION/DISORDER SYNONYMS

• Anterior lateral tibial periostitis

• Anterior lateral tibial stress syndrome

• Anterior lateral stress fracture

• Anterior shin splints

• Anterior tibialis tendonitis

ICD-9-CM CODE¹

• 844.9 Sprains and strains of unspecified site of knee and leg

ICD-10-CM CODE²

• S86.919A Strain of unspecified muscle(s) and tendon(s) at lower leg level, unspecified leg, initial encounter

PREFERRED PRACTICE PATTERN³

• 4E: Impaired Joint Mobility, Motor Function, Muscle Performance, and Range of Motion Associated with Localized Inflammation

KEY FEATURES

Description

• Lower anterior lateral leg pain provoked by activity

• Pain is localized in the anterior lateral aspects of the tibia

• Produced by stress or traction that causes microtrauma to the soleus muscle at the origin point of the shinbone

• Stress-reaction inflammation of the periosteal and musculotendinous fascial junctions

• Results from repeated activity without proper conditioning or allowing enough recovery time between activities

• Attributed to muscles of the lower extremities being overloaded or by biomechanical irregularities

• Recurring dull ache along the anterior lateral aspect of the upper tibia

Essentials of Diagnosis

• Diagnosis usually made by clinical examination

• Pain increases with active dorsiflexion and when the anterior tibialis muscle stretched into plantarflexion

• Muscle length and strength imbalances, especially a tight gastrocnemius-soleus muscle group

• Common to see compartment syndrome associated with shin splints

General Considerations

• Pain with repetitive activity, when the involved musculotendinous unit is stretched

Demographics

• Athletes who increase activity intensity and/or duration along with a lack of appropriate recovery between workouts

• Beginning runners with poor lower-extremity muscle control

CLINICAL FINDINGS