Just What I Kneeded

What happens after a life-altering knee injury?

No one else like me (or how not to use your tibialis anterior)

7 Comments

Some time back, I mentioned to my PT that the upper lower part of my leg was fairly sore. Like a really sore muscle kind of feeling. It also felt almost like a bruise when I massaged over the area. My PT took a look, palpated a bit and pronounced the anterior tibialis to be the problem. Come again? The what?

Now that I’m in the know, I can tell you that the tibialis anterior (this is the way most tomes reference it) is a muscle that sits on the upper lateral (outside) portion of the leg, just below the knee. In case that description doesn’t do it for you, I’ve carefully drawn a diagram on my whiteboard. See below.

Tibialis Anterior on the whiteboard.

This is the best I could do. I realize now that it’s not even on the right knee. Whatevs.

If that’s not good enough for you, check out this resource that shows the origin, insertion and actions of the tibialis anterior. Normally, this muscle allows you to dorsiflex your foot (pull your toes upward) or invert your foot (point your toes toward your other foot). But, apparently, I’ve managed to unconsciously figure out how to use this muscle to help compensate and alleviate some of the pain in my knee.

PT: “I’ve never seen anyone use their anterior tibialis the way you do. You seem to have figured out how to recruit your anterior tibialis to maintain your external rotation of your tibia.” (I tend to have internal tibial rotation, and we’ve been working on making sure I don’t do that.)

PT a week later: “I’ve learned that my patients often know their bodies better than I do. When you told me a week ago, or when you asked me why that part of your leg would be sore, I didn’t really know. But you’ve somehow figured out how to use your anterior tibialis to manage your tibial rotation.”

I haven’t figured anything out! My body is just doing things without my knowledge or consent. This is the second or third time that my PT has said she’s never seen anyone who does “X.” Since she’s been doing this for 10 years and has seen hundreds of patients, that’s saying something. My right leg is an orthopedic freak show.

At a later appointment, she said she’d been talking to the athletic trainer at Ball State, and he said that a lot of his student athletes are sore in the same spot. There’s apparently an epidemic of inappropriate use of the tibialis anterior. The problem is, though, that I have no cure.

This issue isn’t something that we really tackled with exercises. Instead, I’m working on massaging the muscle to make sure that the knots are worked out. I’m literally taking a rolling pin to it a couple times a week (hey, it’s kind of like foam rolling). The soreness has largely dissipated, but there are still days when I can tell it’s tight and overworked. Then I roll it some more and tell it to stop complaining.

There are just SO MANY things that play into this. It’s a puzzle. And as soon as I get one piece in place, another one goes missing. But, as I mentioned in a recent post, I’m competitive. I like a good challenge. So I’ll keep at it until my knee bends to my will.

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Author: Laura

I have a fern I named Frankenstein. I like leprechauns, practicing kung fu moves on my dining room furniture, and pretending that one day I will move to Fiji. I dislike my neighbors' kids, anything that is chartreuse, and Ben Roethlisberger.

7 thoughts on “No one else like me (or how not to use your tibialis anterior)

  1. It could be that you are over pronating either from a foot issue or compensating for too much valgus collapse (I don’t know obviously I havent ever seen you)…Tibialis anterior soreness is actually pretty common in runners and running sports like basketball

  2. Thanks for your note! Can you explain what you mean by “valgus collapse?” I have slightly knocked knees, and I understand that to be a valgus deformity. Is that the same thing? I don’t tend to over pronate; I under pronate and walk almost exclusively on the outside of my foot unless I’m consciously making an effort to walk in a more correct pattern. My PT has said, in the past, that this combination of knock knees and under pronation is unusual, but I don’t know much more about it.

    What do runners do for this tibialis anterior soreness? Anything other than massaging/rolling? Thanks!

  3. This link explains valgus collapse: http://ascentpt.wordpress.com/2013/09/26/5-things-that-make-your-knee-hurt-other-than-your-kne It can come from your feet or poor hip control or poor ankle mobility, lots of causes. Not sure if you collapse, but with mulitple surgeries and long term issues that is where I might look first.

    Rolling and massage are fine to treat symptoms. You may need to grade activity more gradually. You also need to correct the issue causing the extra stress.

    • Thank you for the link and the description. That makes sense now. We’ve been working a lot to ensure that I don’t have valgus collapse. Lots of work strengthening the hips. I do have a problem with ankle mobility; I don’t have much. I’ve apparently learned how to compensate for the knee in so many ways that it’s been difficult to know what to address when. We’re still working on the cause of the incorrect movement patterns and subsequent extra stress. Right now, the thought is that a tight IT band and knotted up muscles in the lower leg are what need to be worked out.

      Thanks again for your comments! I really appreciate hearing from knowledgeable people with different perspectives.

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