Pain with initial weight bearing at the attachment site for the tibialis anterior tendon on the cuneiform bone often times related to excessive downhill walking. This tendon acts to slow down the foot plant and is working at heel contact just prior to putting pressure on the ball of the foot.

Symptoms

• Pain with subtle swelling at the attachment site for the tibialis anterior tendon

• Pain with initial weight-bearing activity

• Pain worse with long strides during walking or going up or down stairs

Radiology

• Regular x-rays not needed because this is a soft tissue injury

• MRI can be used to show evidence of inflammation and possible tearing of the tendon at its attachment site.

Treatment

• Short term CAM boot immobilization for three to four weeks

• Ice therapy twice daily

• Non steroidal antinflammatory therapies like ibuprofen or naproxen

• Physical therapy modalities