Since last April I´ve been having a lot of problems with tibialis anterior pain in both two legs while riding.
It is strange because I only feel pain while riding (especially when I ride hard), when I stop, after more or less 30 minutes I´m ok and I don´t feel any pain, just sometimes I feel weakness around the area but not very often.
I did a couple of bikefits and tried to put my cleats all the way back but that didn´t solve my problem.
If anyone has gone through something similar or know something I can do to get a bit better please let me know, because it´s starting to get really frustrating…
(btw sorry if there are a lot of gramatic mistakes, i´m not an english native speaker).
Get evaluated for anterior compartment syndrome, usually by a vascular
Yes, I get the same pain on my tibialis anterior, right leg only and just the top bit. I recently looked up the Internet to find the name for the precise muscle or tendon that aches for me, and pinpointed it to the tibialis anterior muscle. I believe the pain is also known as ‘shin splints’.
I had been using TR for over three years and the pain (or muscle/tendon strain) recently manifested itself. It usually pops up during an over/under interval where I think the transitions between really hard and backing slightly down to pretty hard provoke the problem. I’ve dropped the FTP level by a few points and swopped the over-under (threshold) rides for other types, mainly sweet spot. This helps a little but am not yet out of the woods. Complete breaks of two weeks or so do not make it go away, so I’m trying the pathway of gentler exercise levels to hopefully restore the muscle to full working order.
I’ve also started doing some tibialis anterior stretching exercises (Google it) and don’t yet know if they will help. Just sharing my current experience.
As suggested elsewhere, this could be chronic exertional compartment syndrome of the anterior compartment of your lower leg (though this is more common in runners). There are other things it could be too though. Given that CECS can be complicated by nerve damage, you should be assessed by a physician for this, ideally someone with experience in sports medicine.
Thanks everyone for your replies, I think I’m gonna talk with a physiotherapist I trust a lot to see if my problem can be exertional compartment syndrome or something else. As suggested above I’m gonna start focusing more on stretching and doing some strength work to see if it improves. Hopefully all your tips help me to recover!
In my case I can handle the pain until I do vo2max efforts when it becomes awful but after 15-30 minutes of not riding it disappears. I’ll start stretching more and maybe doing some strength work to see if it improves. Thanks for your message!
Before you see a physio, have a look to see if your feet roll inwards when you stand. Ideally stand barefoot in front of a full-length mirror or get someone to take a photo of your feet - stand straight upright and look as far forward as you can (don’t look at your feet!). If your ankles or the tops of your feet push inwards (or if your arches are noticeably lower than when your foot is relaxed in mid-air), you might need an arch support. Try standing on one leg and see how much your ankle wobbles; then do a one-leg squat (or a pistol squat if you can) and see if it wobbles more. Tib ant is the primary dorsiflexor and inverter (pulls your foot upwards and inwards), so if your pedalling action forces your forefoot to move downwards and outwards, you may be overworking it. Conversely, if your pedalling action pulls your foot upwards and inwards, it may be getting tight and stiff through underuse.
Also check out some youtube vids from Cam Nicholls or RCA (same guy, different channels) - he works with a great bike fitter called Neil Stanbury, who has taught me more about some elements of anatomy and human movement than a 4-year orthotics degree. I couldn’t find a specific tib ant video but their “bike fit dos-and-don’ts” and “numb foot” videos are a great place to start.
This sounds similar to a running injury had in late 2020 after “tweaking” things while dodging a dog that was off it’s leash. The left tibialis felt tender along the back/inside where the calf would connect. It became inflamed when running hard, but wasn’t overly bothered by cycling unless doing a longer ride. Shortly after hopping off the bike or heating/stretching for a bit, the pain went away. Two issues were identified. The first was a strained anterior tibialis tendon. The second was moderately high and inflexible arches.
Resolving the first issue was PT work and time. This involved single-leg deadlifts, single leg squats (as best you can do), ankle/toe exercises with bands, etc. I keep this up and don’t have any issues. Basically, stabilizer muscles needed work.
Resolving the second issue was a cost issue. I needed insoles with higher arch support on the bike so the foot muscles weren’t stabilizing the entire time. You can get new shoes with higher arch insoles, new insoles that you cut to fit, or explore taping if the issue is moderate.
The combination of the two was better stabilizer muscles that don’t have to work as hard to support the foot/ankle which reduces the strain on everything else. More than likely, it’s a combination of kinetic chain and fit issues. A popular insole if you have a moderate-to-high arch is sole active.
Just a quick update on my injury. After consulting with a physiotherapist and a sports doctor, it turns out that I have chronic exertional compartment syndrome in both legs. We´ve been trying to solve it with insoles, ice after workouts and massages but none of those have helped me very much so i´m going again on Thursday to the sports doctor to see if i have to get the pressure of those compartiments measured.
I´ll keep you updated in case this eventually helps someone with the same injury in the future.
I’m sorry to hear about the compartment syndrome diagnosis. That sucks. Hopefully, you’ll be able to work through that soon. Good luck with everything and let us know how treatment goes.
Any luck here? I have inflammation and pain in mine for the past few days. The pain actually started 3 days after a monster ride i did, and scuppered my m312 attempt.
Has RICE, stretching, strengthening worked for you?
Not sure how it works for anterior issues but I’m currently working through a posterior tibial injury since October last year. It was after a 7 hour cycling day (I don’t run)…morning session plus night session. 21 hour week. Had to drop to 4 - 6 hrs for a time, with 3 and 4 day off periods initially. Used a brace for close to 5 months. Was back to 10 - 14 hrs but six weeks ago I could still feel a twinge, even though it happened 2 - 3 days after a day where I did 450 calf raises. So I’m not sure if that facilitated a little flare up. Usually tendons need 48 hrs to absorb tough work.
I currently ICE after every ride…and roll my calf muscles.
If it’s inflamed I would definitely ICE and shut it down for 3 to 4 days (7 would be better if possible). Get the inflammation out before you try and start strengthening. Stretching and ice is probably best in the interim. Once the pain and swelling subsides then start with exercises, careful not to do too much too soon. Don’t be afraid to load the tendons…up to a point. That point is pain.
I would not try to “ride through” this. You will lose more than you would’ve lost trying to hang on to fitness…like I did. You will have to find your threshold for what you can safely do on rides…but I would not attempt to do anything more than the top of Z2 for the first two weeks. The icing, stretching and exercises will be more important. Whatever your hours are…cut it by at least 50% for the first two - four weeks. Otherwise it will be harder to put this behind you.
That said…seek out more advice and guidance as this is never a one-size fits all approach. Every person is different, and since this is an anterior, not posterior issue, others with this exact issue can probably offer better advice.
thanks for the detailed response.
7 days would be great, but i feel like it could be more than that before i get back on the bike. i srsly think 2-3 weeks for me. I will stretch, ice and seek some professional advice!