Tibialis Anterior: Pain & Trigger Points

The tibialis anterior is an important muscle at the anterior compartment of the lower leg.

Active trigger points in this muscle can cause pain in the big toe and in the ankle joint. Particularly affected are runners and indoor athletes.

However, you can treat these points and pain with a self-massage.

On this page you will learn how to do this, and much more.

1. Pain Patterns & Symptoms

1.1 Pain patterns

Tensions in the tibialis anterior can lead to pain, sensitivity to pressure and a feeling of tension in the tibia (shin bone).

Trigger points, on the other hand, refer the pain into the big toe and into the anterior middle area of the ankle.

Shin pain may also occur, but it’s not the primary pain caused by this muscle.

1.2 Symptoms and further ailments

Besides pain, people with trigger points in this muscle complain about …

  • Weakness when “contracting the toes” (dorsiflexion) => Pulling the toes up.
  • Frequent dragging of the toes when walking.
  • Frequent tripping.

All these problems can have the same myofascial origin, namely trigger points. Trigger points in a muscle often impair the control over a muscle and its function, respectively.

This means it cannot be “properly” controlled by the nervous system.

The function of the tibialis anterior is, among others, to pull the back of the foot upwards.

If this function is impaired, the symptoms described above, such as tripping, are likely to occur.

2. Tibialis Anterior: Attachment Points

The muscle extends from the anterior lower leg down to the medial side of the foot.


  • Lateral condyle of the tibia
  • Membrana interossea
  • Fascia cruris


  • Os cuneiforme
  • Os metatarsale I


  • The muscle is innervated by the nervus peronaeus profundus.

Trigger points occur mainly in the upper third of the muscle.

3. Tibialis Anterior: Functions

In the following, I name the functions of the muscle and illustrate them with pictures.

Then I’ll give you everyday examples for these functions.

Short overview of the functions

Note: In order to perform its function, the muscle has to contract.

  • Dorsiflexion with a free foot
  • Moving the tibia forward with a grounded foot (= also dorsiflexion)
  • Supination of the foot

Dorsiflexion with free foot


Supination of the foot

3.1 Everyday examples for dorsiflexion

Dorsiflexion means that the back of the foot is pulled towards the shin, but also the other way is possible, with the shin moving towards the foot.

This movement can occur with a free foot, for example if you are sitting on a chair, or with a grounded foot if you are standing on the ground and move your shin forward over your toes.

In everyday life this movement/function is needed for:

  • Balance and control
  • Rolling the foot during the gait cycle

3.1.1 Balance control

If you shift too far back when standing, your shin will also move back.

The tibialis anterior can prevent this and pull you forward again by approaching the shin to the back of the foot, respectively.


Neutral position.


Here the tibialis prevents an even stronger backward shift by contracting and pulling the shinbone "forward".

3.1.2 Rolling the foot during gait cycle

As soon as your heel touches the ground, the tibialis contracts in order to prevent the sole of your foot from “clapping” abruptly on the ground.

This means holds the back of the foot pulled upwards. During the “rolling movement” of the foot, it contracts while it gets longer (eccentric contraction), thus controlling the movement.

3.2 Everyday examples of supination

The supination is important to stabilize the ankle joint when the foot is grounded.

When standing, walking and running, forces always act on the ankle which “want” to push it inwards or outwards.

The supination counteracts the forces that would push the ankle joint into an X-position (valgus stress).


Neutral ankle joint.


X position / valgus stress on the ankle joint.

4. Tibialis Anterior: Trigger Point Activation

The tibialis anterior is made for continuous work (it contains 2/3 slow-twitch fibers type I) and is therefore less frequently overstrained in everyday life.

Still, intense sports and trauma can overload the muscle and activate trigger points.

4.1 Sports

These occur mainly in indoor sports. A sticky floor and sticky shoes ensure fast start-stop movements and quick changes of direction. The ankle joint needs to be stabilized and the tibialis has to perform at its best. This can activate trigger points!

4.1.1 Fast & abrupt movements

These occur mainly in indoor sports. A sticky floor and sticky shoes ensure extremely fast start-stop movements and quick changes of direction.

The ankle joint has to be stabilized and the tibialis has to perform at its best. This can overload it!

4.1.2 Monotonous motion sequences

You will find these especially in endurance sports.

For the tibialis, for example, running is very demanding. With each step it must contract eccentrically (contraction during elongation/stretch) to stabilize the ankle and to ensure a smooth rolling motion.

These movements are very monotonous when running in the plane. With trail running, on the other hand, they are more diverse.

Still, trail running involves running downhill, which is very demanding for the anterior tibialis, too.

4.2 Trauma

Mainly fractures of the lower leg need to be mentioned.

A fracture can press the tibia against the tibialis anterior and activate trigger points due to the mechanical stress.

5. Palpation

Feeling the muscle is easy. Proceed as follows:

  • Sit down and place two or three fingers on your shinbone.
  • Lift the sole of your foot off the ground a few times. Your heel remains grounded.
  • Try to feel a muscle contracting under your fingers. This is your tibialis anterior.
  • Try to feel its course downwards before it merges into its tendon after approximately 2/3 of the length of the shin bone.

6. Tibialis Anterior: Self-massage

You can massage the tibialis anterior in several ways, using different devices and techniques.

On this page, I will show you how to massage it with a small foam roller using precise rolling movements.

This massage is well suited for beginners.

6.1 Self-massage with a small foam roller

I recommend using a small roller for the massage, for example the BlackRoll Mini or the AchillX.

The massage is possible with a common foam roller, too, but not very comfortable, because they are larger in diameter – which puts your leg in a very high position.

  • Take the quadruped stand.
  • Place the foam roller under your shinbone.
  • Now shift some weight to the side to be massaged in order to push the roll into the muscle.
  • If you don‘t shift your weight, you will as a result only press on your shinbone.
  • Execute short and slow rolling movements over the entire length of the tibialis and look for painful tensions.
  • Once you find one, roll a few times from just before to just behind the painful spot.
  • This is another massage position


  • Calais-German, Blandine. Anatomy of Movement. Seattle: Eastland Press, 1993. Print
  • Davies, Clair, and Davies, Amber. The Trigger Point Workbook: Your Self-Treatment Guide For Pain Relief. Oakland: New Harbinger Publications, Inc., Print
  • Simons, David G., Lois S. Simons, and Janet G. Travell. Travell & Simons’ Myofascial Pain and Dysfunction: The Trigger Point Manual. Baltimore, MD: Williams & Wilkins, 1999. Print.
  • Schünke, Michael., Schulte, Erik, and Schumacher, Udo. Prometheus: Lernatlas der Anatomie. Stuttgart/New York: Georg Thieme Verlag, 2007. Print