0:05 This is Brent of the Brookbush Institute, and in this video I am going to show you my 0:07 favorite tibialis anterior activation exercise. 0:11 I am going to have my friend Melissa come out, she's going to help me demonstrate this 0:13 exercise. 0:14 You will see how easy the set up is on this one. 0:18 We're going to use one of these monster bands which I think you know as pull-up assist bands. 0:22 I tend to use the serious steel bands, I like them they are good high quality bands. 0:26 We're going to just go ahead and slipknot around the bottom leg of the table here; and 0:42 then I just need to flop this over the top of her foot just like so. 0:45 Now, notice I have this at the base of her foot and not at the top of her foot. 0:50 I understand that the top of her foot would create a larger lever, and make for more resistance 0:54 but you have to think about your tarsal joints which can be a little sensitive, especially 0:59 to this type of pressure. 1:01 We don't want to create dysfunction trying to fix dysfunction. 1:04 Now if you didn't have a treatment table then technique is totally the same. 1:09 What you would do is you would hook a band to a heavy piece of equipment at the floor 1:14 level. 1:15 The only thing you will probably have to do is probably elevate the hele on something 1:18 like a foam roll. 1:20 Because if you don't have just a little bit of a downward angle on this band, it tends 1:24 to flop off the foot every time you go into this plantarflexed relaxed state of this exercise. 1:30 Now lets talk about activation exercise in general, we need figure out what joint actions 1:36 this muscle does. 1:37 And then figure out how to reciprocally inhibit those muscles that become synergistically 1:43 dominant when this muscle becomes inhibited. 1:46 So we have the tibialis anterior does inversion and dorsiflexion, that's pretty easy to do. 1:51 That's going to be foot up and in, and in this case we are going to focus more on dorsiflexion 1:56 than inversion. 1:57 If we focus too much on inversion, we tend to not be able to dorsiflex as well, and since 2:03 we tend to lose dorsiflexion I want to really focus on dorsiflexion and try to get it back. 2:08 Now the overactive synergists for the tibialis anterior are the long toe extensors, especially 2:14 that extensor digitorum longus which also everts and pronates the foot. 2:19 So that muscle tends to want to contribute to our pes-planus or functional flat footedness, 2:24 which you know as feet flat on the overhead squat assessment. 2:27 The way we are going to get our long toe extensors out of the movement is toe flexion. 2:35 SO we are just going to be kind of clever, we're going to use their joint actions at 2:40 the toes to inhibit what we're going to do at the ankle. 2:44 Now the tricky part is getting Melissa to go foot up and in while her toes go down. 2:49 Its kind of the equivalent of this movement with the foot right, so you're going to pull 2:54 up and in and toes down, and she's practiced this a little bit so this isn't too bad for 2:58 her. 2:59 And then she can just relax everything as she goes down, she doesn't have to keep her 3:01 toes curled as she goes down. 3:04 So foot up and in, toes down, and then she can relax it. 3:08 Now, tempo markings for activation exercise are either 4-2-2 concentrating on the eccentric, 3:13 or 2-4-2 concentrating on end range. 3:18 Again since dorsiflexion is something we tend to lose and tibailis anterior activation will 3:22 help me keep it, I tend to use that 2-4-2 count on the second exercise and really make 3:27 people focus at the top. 3:29 I want you to try to get as much dorsiflexion as you possibly can, right, get it, alright. 3:37 Because if I have just done a lot of mobility work with her, right I want good carryover. 3:40 I want her to keep that dorsiflexion for a long time, so hopefully we keep making progress 3:46 over time. 3:47 Good pull up and in. 3:49 Good pull up and in, good. 3:52 Now the other thing I really like about this exercise is there is this really clever progression. 3:58 This clever progression is being able to integrate a lot of commonly active muscles in my lower 4:05 extremity, reinforcing my heel strike mechanic during gait. 4:11 So that moment where my heel strikes the floor and I need my tibialis anterior to eccentrically 4:17 decelerate foot flat. 4:19 I can kind of reinforce that during this which may improve my carry over more, and the way 4:23 I am going to do that is I am actually going to have Melissa go down on her elbows. 4:27 She's in a little too much hip flexion here for me to get the glutes involved. 4:30 I will start with going, okay foot up and in, I want you to lead with this big toe knuckle 4:36 here, right. 4:37 And you are curling your toes so this really becomes prominent, lets get up as high as 4:40 we can, and now I want you to try to squeeze your quad. 4:43 And you will find a lot of people with have a hard time with this because before when 4:47 they were dorsiflexing, they were trying to do this, right they were trying to pull their 4:50 whole leg up. 4:51 And what we want is lock your knee, pull up like this, good. 4:57 You will also find that this makes it a little easier to con them into holding that isometric 5:02 at the top, but we are not done yet. 5:04 We are going to give her a couple of reps of foot up and in, toes curled, squeeze your 5:08 quad, make sure we reinforce that a couple of times. 5:11 Alright foot up and in, toes curled, squeeze your quad. 5:15 Good hopefully you are starting to get that chain together in your head, foot up and In 5:19 toes curled, flex my quad. 5:22 Now what are we going to do? 5:24 Squeeze the glute. 5:25 So foot up and in, toes curled, squeeze your quad, squeeze your and squeeze your glute 5:29 like you are trying to smash my palm right; and what you can do is throw a rolled up towel 5:36 underneath your heel, give them something tactile to squish. 5:41 Be careful, if you know somebody that has some hypermobility in their knee, they tend 5:45 to do that rock at the bottom where they get that hyperextension, you can throw a towel 5:48 under the knee so that they can squeeze their knee against that towel and not get into hyperextension. 5:55 But back to our tactile cueing for this, foot up and in, toes down, squeeze, squeeze, hold. 6:03 Good, you think you got 15 more? 6:06 Trying to get somebody to do 20 of these, especially if they are one of these individuals 6:11 who really compensates, you know knees bow in, feet turn out, feet flatten and excessive 6:16 forward lean and they are so use to that compensatory pattern, this is something they have to work 6:22 at. 6:23 Which is good, because if they keep working at this, I have to tell you guys, this exercise 6:29 have given me better carryover than any other tibialis anterior activation exercise I have 6:34 ever done before, which is why it I my favorite. 6:38 Because I know it makes big changes in my goniometry and I know when they come in for 6:42 their next session my carryover is generally better. 6:47 For the most part I don't find too much difficult for people doing this as their home exercise, 6:52 but we did make another video just incase you don't have somewhere to tie one of these 6:58 super heavy bands to. 6:59 A tibialis anterior activation that uses no equipment, so make sure you look up that video 7:05 as well. 7:07 You might wonder how I progress this exercise. 7:09 Well we can't really get more complicated or less stable in this position to continue 7:17 progressing in that way, however we can progress in resistance and I do recommend it. 7:24 Serious steel makes these larger blue and green bands, and I think everybody should 7:31 get to green, I do. 7:34 At the very least blue. 7:36 The only reason I would let somebody get away with blue is if they were a smaller human 7:40 being. 7:41 Melissa I would expect to get to green. 7:43 There are heavier bands than this, but that might be going too far. 7:47 But think about what your tibialis anterior has to do. 7:51 Every time you heel strike, especially when speeds get higher, when you are running, when 7:56 you are jumping, your heel hits and your tibailis anterior is essentially the only muscle to 8:04 slow your foot from just slapping into the ground. 8:07 It is your primary decelerator of plantarflexion. 8:13 We have a lot of people who come in and complain about shin splints, we have a lot of people 8:17 who complain about these lower extremity injuries. 8:19 A lot of them have this combination of they don't have enough dorsiflexion, and part of 8:26 the reason they don't have enough dorsiflexion is because every time they try to get dorsiflexion 8:29 with a calf stretch, or an ankle mobilisation, or calf release, or all three if we're lucky, 8:34 is because they don't do the other side of it which I strengthen their dorsiflexor so 8:39 that they maintain that dorsiflexion. 8:42 They use that dorsiflexion during their daily activities. 8:46 Give this exercise a try, set up a few stations in your gym. 8:50 I can tell you that when I am treating I just leave a few of these bands tied around the 8:54 legs of my table so that I can just flop them up. 8:57 I can get in and out of this really quick, and I can even add like internal rotator activation 9:01 if I want, and maybe go right into my glute activation, its all right there set up. 9:07 You can just have some bands hooked around your power racks or your cable columns so 9:13 that people can be getting this in, in their warm-ups. 9:16 If you have any questions or comments please leave them in the box below. 9:21 I hope you have enjoyed this video.
