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Posterior Tibialis Activation Progression
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Posterior Tibialis Activation Progression is an exercise program designed to strengthen and stabilize the muscles of the lower leg and the ankle. This dynamic program uses a combination of strength, balance, and stability exercises to target the Posterior Tibialis muscle. Through the progression of the series, individuals gain the ability to activate their Posterior Tibialis muscle before and throughout dynamic movement. As a result, the individual is able to move more efficiently and pain free, strengthening the posterior
Transcript
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This is Brent, coming at you with another
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video we're going to actually progress our posterior tib activation. So, if you
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have seen the previous video, where I go through a seated variation, and then
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we progress to a standing bilateral calf raise with inversion, this is going to
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take it up another notch, and we're going to do a leaning, single leg calf raise,
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with inversion. So, I'm going to go ahead and explain the mechanics, as well as
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explain the queuing for this exercise. I'm going to have my friend, Yvette, come out
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and help me demonstrate. So for this exercise I have two huge goals. My goals
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are to create a line of force that resists not only plantar flexion, but
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inversion. And then, the other goal I have, is I need to reciprocally inhibit my
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commonly overactive synergists. So I'm going to have Yvette go ahead and turn
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around. The first thing you guys need to find is some sort of wall that you can
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hang off, or some door jamb. Obviously with the door jamb, be very careful
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not to close people's fingers in it. So she's going to set up one arms-length
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away from where she's hanging from. I actually want just the passive tension
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of her arm to hold her up, not necessarily like her bicep, I don't want
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her curling and holding up her body. So she's one arm length's away. I'm now going to
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bring her foot out, just outside her shoulder, good. We're going to go ahead and
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turn her foot in a little bit here. Once we've got that position down, we're
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going to go ahead and have her lift this leg. Now, if I go ahead and queue all of her
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stabilizers, she's going to draw-in, glutes tight, quads tight. I should have created
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this line with her body, that's just off center. Gravity is still pulling me down, so
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now I do actually have a force that is going to resist not only plantar flexion,
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but inversion. So the lean, right, I said this was a leaning, or hanging, single leg
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calf raise, the hang is all about trying to get us to resistant inversion so that
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we can put a stress on that posterior tib. Now, let's go down to the foot,
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because that's where our reciprocal inhibition of our overactive synergist
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comes in. First things first, I'm going to have her
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pick up her toes. Now what I'm doing there is, one of the overactive synergists
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is a flexor hallucis longus. By asking her to extend her toes, I reciprocally
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inhibit her flexor hallucis longus. It also helps to drive her MTPs into the
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ground, which seems to be a very good queue for getting the posterior tib active.
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The second thing I'm going to have her do, she's going to make sure that her
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foot's turned in a little bit, alright, so fifth metatarsal pointing forward, or
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pinky toe pointed forward. That's going to help stimulate inversion. And, I'm going
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to try to queue her, that this bone right here, the lateral malleolus, I want her to
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think about it going outward just a little bit, as she's going up into
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plantar flexion. Alright, so once we put all of these queues together, and I know that
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was a lot, this takes a little bit of practice, she's going to draw-in, glutes tight,
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she's nice and straight. That wall is keeping her from face-planting into the wall -
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or, I'm sorry, that hand is keeping her from face planting into the wall. She's
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then just going to do a calf raise with this lateral maleoli coming out, and she
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should start to feel it in her inner calf, or I
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should say deep to remedial gastroc, right where that posterior tib is, making
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sure she's keeping those toes off the ground, I've got a nice slow tempo. I try to
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get people doing either a 2, 4, 2 count, as in 2 up, 4 hold at the top,
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and 2 down, or 2 up, 2 hold at the top, and then 4 down, have her do 10 to
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20 reps. I think you are going to find that it is extremely challenging to
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get somebody up to 10 to 20 reps, especially if you try to do a couple of
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sets. It's a tough exercise. So we're going to go ahead and show you another view now. Let
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me go ahead and have you move over to this wall. I still want you to be able to
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see the foot mechanic here. So she's still going to set up, nice long arms,
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she's going to step out a little bit. You can step back from the wall, just a
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little bit. Good. Turn your foot in. Fifth metatarsal pointing forward, should be
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drawn in, glute tight, quad tight. This foot is coming up, single leg calf raise, and have
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her bring her toes up. She's going to press through, especially her first
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metatarsal head, into that calf raise with inversion.
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Perfect, how do you feel? Good. So you see how I set that up, I think you
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will find this as an extremely challenging progression. I think you will
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see huge gains with your clients. Any of your clients who have that feet
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flattened, or feet turned out compensation pattern, this tends to be extremely
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