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