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Tibialis posterior in a cadaver dissection

Tibialis Posterior

Integrated functional anatomy of the tibialis posterior. Attachments, nerves, palpation, joint actions, arthrokinematics, fascia, triggerpoints, the muscle's role in shin splints, running/sprinting mechanics, and behavior in postural dysfunction. Examples of common activation exercises, subsystems, and strength exercises of the tibialis posterior.

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Course Description: Tibialis Posterior

This course describes the anatomy and integrated function of the tibialis posterior muscle (a.k.a. post tib, tib post, deep calf muscle, tibial posterior muscle, or posterior tibialis muscle). This muscle is located deep to the calf muscle and posterior compartment, in the deep posterior compartment, and the tibialis posterior tendon courses posterior to the medial malleolus and underneath the foot (near the posterior tibial artery, and tendons of the long toe flexors). The muscle is composed primarily of type II muscle fibers (based on animal studies) and crosses both the ankle joint and foot joints.

The tibialis posterior is the primary invertor of the ankle, will contribute to plantar flexion of the ankle, and is a supinator of the foot (tarsal joints). Further, the tibialis posterior will eccentrically decelerate dorsiflexion, eversion, and pronation (as seen in adult-acquired flatfoot, or flatfoot deformity). This course also describes the role of the tibialis posterior in ankle (talocrural) joint arthrokinematics, fascial integration (Achilles tendon), postural dysfunction, and subsystem integration. Additionally, the location of the tibialis posterior is discussed relative to the anterior tibial artery, posterior tibial artery, fibular artery, sciatic nerve, tibial nerve, common fibular nerve, deep fibular nerve, and the fascial sheaths that comprise the deep posterior compartment, including the interosseus membrane and transverse intermuscular septa.

Sports medicine professionals (personal trainers, fitness instructors, physical therapists, massage therapists, chiropractors, occupational therapists, athletic trainers, etc.) must be aware of the integrated function of the tibialis posterior for the detailed analysis of human movement, and the development of sophisticated exercise programs and therapeutic (rehabilitation) interventions. Further, this course is essential knowledge for future courses discussing injury prevention and physical rehabilitation including pes planus (a.k.a. flat feet, flatfoot deformity, adult acquired flat foot, functional pes planus), tibialis posterior tendinopathy, (a.k.a. posterior tibial tendonitis, posterior tendinopathy, tibialis posterior tendon inflammation, tibial tendon dysfunction, tendon tears, tendon sheath damage), and surgical interventions (tendon tear repair, deep posterior compartment release, tibial tendon dysfunction surgery, tendon transfers). Tibialis posterior exercises and techniques are also introduced in this course (e.g. tibialis posterior activation, integration, and strengthening.)

Pre-approved credits for:

Pre-approved for Continuing Education Credits for:

This Course Includes:

  • AI Tutor
  • Text and Illustrations
  • Audio Voice-over
  • Research Review
  • Technique Videos
  • Practice Exam
  • Pre-approved Final Exam

Brookbush Institute’s most recommended techniques for the Tibialis Posterior (see videos below):

Tibialis posterior in a cadaver dissection
Caption: Tibialis posterior in a cadaver dissection

Introduction to the Tibialis Posterior
3 Sub Sections

Tibialis Posterior Muscle Actions

Arthrokinematics

Fascial Integration

Postural Dysfunction and the Tibialis Posterior

Exercises and Techniques for the Tibialis Posterior
8 Sub Sections

Bibliography

  1. Phillip Page, Clare Frank, Robert Lardner, Assessment and Treatment of Muscle Imbalance: The Janda Approach © 2010 Benchmark Physical Therapy, Inc., Clare C. Frank, and Robert Lardner
  2. Dr. Mike Clark & Scott Lucette, “NASM Essentials of Corrective Exercise Training” © 2011 Lippincott Williams & Wilkins
  3. Donald A. Neumann, “Kinesiology of the Musculoskeletal System: Foundations of Rehabilitation – 2nd Edition” © 2012 Mosby, Inc.
  4. Michael A. Clark, Scott C. Lucett, NASM Essentials of Personal Training: 4th Edition, © 2011 Lippincott Williams and Wilkins
  5. Leon Chaitow, Muscle Energy Techniques: Third Edition, © Elsevier 2007
  6. Tom Myers, Anatomy Trains: Second Edition. © Elsevier Limited 2009
  7. Shirley A Sahrmann, Diagnoses and Treatment of Movement Impairment Syndromes, © 2002 Mosby Inc.
  8. David G. Simons, Janet Travell, Lois S. Simons, Travell & Simmons’ Myofascial Pain and Dysfunction, The Trigger Point Manual, Volume 1. Upper Half of Body: Second Edition,© 1999 Williams and Wilkens
  9. Cynthia C. Norkin, D. Joyce White, Measurement of Joint Motion: A Guide to Goniometry – Third Edition. © 2003 by F.A. Davis Company
  10. Cynthia C. Norkin, Pamela K. Levangie, Joint Structure and Function: A Comprehensive Analysis: Fifth Edition © 2011 F.A. Davis Company
  11. Florence Peterson Kendall, Elizabeth Kendall McCreary, Patricia Geise Provance, Mary McIntyre Rodgers, William Anthony Romani_, Muscles: Testing and Function with Posture and Pain: Fifth Edition © 2005 Lippincott Williams & Wilkins_
  12. Carolyn Richardson, Paul Hodges, Julie Hides. Therapeutic Exercise for Lumbo Pelvic Stabilization – A Motor Control Approach for the Treatment and Prevention of Low Back Pain: 2nd Edition (c) Elsevier Limited, 2004
  13. Andrew Biel, Trail Guide to the Human Body: 4th Edition, © 2010
  14. Murley GS, Landford KB, Menz HB, Bird AR: Effect of foot posture, foor orthoses and footwear on lower limb muscle activity during walking and running: a systematic review, Gait Posture 29:172-187, 2009
  15. Bell, D. R., Oates, D. C., Clark, M. A., & Padua, D. A. (2013). Two-and 3-dimensional knee valgus are reduced after an exercise intervention in young adults with demonstrable valgus during squatting. Journal of athletic training,48(4), 442-449
  16. Yao K, Yang TX, Yew WP. (2015). Posterior tibialis tendon dysfunction: overview of evaluation and management. Orthopedics. 38(6): 385-391.
  17. Frank, RM, Hsu AR, Gross CE, Walton DM, Lee S. (2013). Open and arthroscopic surgical anatomy of the ankle. Anatomy Research International. 1-9.'
  18. Kamiya T, Uchiyama E, Watanabe K, Suzuki D et al. (2012). Dynamic effect of the tibialis posterior muscle on the arch of the foot during cyclic axial loading. Clinical Biomechanics. 27:962-966.
  19. Murley GS, Menz HB, Landorf KB. (2014). Electromyographic patterns of tibialis posterior and related muscles when walking at different speeds. Gait & Posture. 39:1080-1085.
  20. Rabbito M, Pohl MB, Humble N, Ferber R. (2011). Biomechanical and clinical factors related to stage I posterior tibial tendon dysfunction. JOSPT. 41(10): 776-784.
  21. Tasic, D., Dimov, D., Gligorijevic, J., Velickovic, L., Katic, K., Krstic, M., & Dimov, I. (2003). Muscle fibre types and fibre morphometry in the tibialis posterior and anterior of the rat: A comparative study. Medicine and Biology, 10(1): 16-21.

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