The tibialis anterior is located just lateral to the anterior crest of the tibia in the anterior compartment of the leg. The tibialis anterior tendon crosses the ankle anteriorly and inserts on the medial cuneiform bone and first metatarsal bone. The tibialis anterior tendon lies just medial to the extensor hallucis longus tendon as it crosses the ankle. The tibialis anterior tendon can be seen more prominently when the patient is asked to dorsiflex their foot.


Peritenditis may develop approximately 4 inches proximal to the ankle. Palpation of this area may cause the patient pain, and the examiner may be able to feel soft tissue crepitus as the patient alternates active plantar and dorsiflexion.

In exercised induced anterior compartment syndrome the muscles of the anterior compartment of the leg are firm and painful to palpation after exercise but are, otherwise, normal to palpation at rest.