Tibialis Anterior

Pointer Plus The Pointer Plus is an easy to use trigger point (TP) locator which incorporates a push button stimulation feature to immediately treat Trigger point pain.

The Tibialis Anterior is an anterior muscle of the leg.

Anatomical Attachments:

• Origin: Attaches to the lateral condyle of the upper 2/3 of the lateral shaft of the tibia, adjoining the interosseus membrane, and the lateral intermuscular septum.
• Insertion: Attaches to the plantar surface of the first cuneiform bone and the base of the 1st metatarsal bone.

Action: Dorsiflexes and inverts the foot.

Synergist: Extensor hallucis longus, Extensor digitorum longus, and Peroneus tertius.

Antagonist: Gastrocnemius, Flexor digitorum longus, Flexor hallucis longus, Peroneus longus, Peroneus brevis, Tibialis posterior, Soleus, Plantaris

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Nerve Supply: Deep Peroneal Nerve (L4, L5, S1).

Vascular supply: Anterior tibial artery.

• Primary: The pain refers to the great toe, the dorsum of the foot and ankle, with a spill over to the shin.
• Satellite or associated triggers: Peroneus longus, Extensor Hallucis longus, Extensor Digitorum longus, Peroneus Longus.

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Trigger Point Signs and Symptoms: Pain on the anteromedial aspect of the ankle and in the great toe, foot drop, weakness of the ankles and weakness during dorsiflexion. TrP formation frequently accompanies the swelling of the Tibialis anterior in an anterior compartment syndrome.

Trigger Point Activating and Perpetuating Factors: Running or walking on uneven ground, toe tripping which abnormally lengthens the tibialis anterior and results in strain or micro-tearing of the muscle.

Differential Diagnosis: (Segmental, Subluxation, Somatic dysfunction) L4 or L5 radiculopathy or S1 neuropathy, Diabetic neuropathy, Charcot’s arthropathy, Muscular Dystrophy, Tendinitis, Rupture of tendon, Hammer toes or claw toes, Bone cancer, Gout, Osteoarthritis, Rheumatoid arthritis, Anterior compartment syndrome, Tearing of the Tibialis anterior muscle, Paronychia (ingrown toenail), Systemic infections or inflammation, Nutritional inadequacy, Metabolic imbalance, Toxicity, Side effects of medication.

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