Bike fit and anterior tibial tendonitis

Apologies if this type of post is not allowed. I’m NOT looking for medical advice.

I’m new to structured training and generally to cycling. I started trainer road at the end of October.

Over the last few weeks I’ve developed pain and weakness in dorsiflexion of my right foot, associated with a freaking sensation of the ankle. I’ve seen a doctor (specialising in sports med) and it has been confirmed as being anterior tibial tendonitis.

My question is whether this could be related to my bike fit (I’ve had trouble trying to get saddle height right given a previous knee injury (same leg))

Yes, based on that info, it is possibly bike fit related. That said, it may not be the issue at all. This is limited info and not enough to make any real judgement other than a “maybe”.

Thanks Chad. Might try and lower the saddle height a bit and see how I get on (along with RICE protocol). I use flat pedals so it’s not be pulling up against the pedal and the most recent changes to bike were raising the saddle height. I’ll also look into bike fitting services locally to see if that helps.

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I had the same issue of tendonitis, however on my right side. Was very hard to find information of this injury pertaining to cyclists. For me, even with a proper bike setup it simply boiled down as an overuse injury. Time off the bike (and the RICE protocol, as you mention) worked best. You can also find a number of youtube vids on how to remediate this tendon specifically, but honestly for me 2 weeks off the bike reduced the inflammation and i was able to ride again. Not sure how much this helps, considering the circumstances of your previous injuries may by the mitigating factor.

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This is a dubious diagnosis for a cyclist. The ant tib dorsiflexes the ankle so the toes clear the ground when walking or running. To produce significant force over time that would create an anterior tendonitis doesn’t seem quite right when the ankle is mostly a platform for pushing.

More concerning and way more common is the presence of neural impingement at the lumbar spine. This should be checked and ruled out before a diagnosis of tendonitis is ruled in. Neural impingement can happen with or without lower back pain. Have this checked by a PT or physician before going any further.

Thanks for the reply, I did have it checked out by a physician specialising in sports medicine. It is an unusal diagnosis but it seems to be the case for me. I’ve taken time off the bike and things have improved significantly, which admittedly, would be the case if this were a lower back injruy also

I think overuse is often the culprit and can be frustrating - For example, I tend to train 95% of the time in a fixed gear on my road bike. I’d been riding fixed at a 53/15 for a few months (it’s flat in South Florida) - using my 53/14 when the wind was at my back but staying in 53/14 for a headwind and the bridge hill (5.5% gradient for .25 miles) LOL. Over the past week my anterior tibial tendon was acting a bit of a bi***. I was slow to ice it, opting instead to “see how it went.” It wasn’t until the other day I realized I’d been riding only in my 53/14 (stupid I know) and shifting to 53/13 for tail wind. So, here we are, “overuse” born riding in too high of a gear. I’m all for the effort it takes to advance gears to a more painful notch - but usually I do so for half days (a stepwise approach).