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.
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.