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Tibialis Posterior Activation
Tibialis Posterior Activation is a form of physical therapy designed to strengthen the muscles that support the arch of the foot and the ankle, improve the range of motion, and reduce the risk of injury. This specific form of therapy utilizes specific exercises and stretches to target the tibialis posterior muscle, which is located at the back of the lower leg. This specialized treatment can help provide relief for conditions such as plantar fasciitis, Achilles tendinitis, and
Transcript
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This is Brent of the Brookbush Institute
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...blank
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bringing you tibialis posterior
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activation. Its' a muscle that has a
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propensity to get long and under active
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in those individuals who have feet
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flattened or feet turned out on that
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overhead squat assessment, or those who
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can't maintain their medial longitudinal
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arch in standing single leg balance or
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potentially during gait. I'm going to
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have my friend, Melissa, come out. She's
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going to help me demonstrate. Now I think
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the hardest part of- the part of this
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exercise where people get a little
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confused is which direction should my
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resistance actually pull. Alright, so we
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need to remember that the tibialis
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posterior does both plantar flexion and
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inversion. So, we need something that
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resists this way for plantar flexion. And
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then inversion is kind of this inward
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motion so that she shows the sole of her
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foot inwards, so I need something that
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pulls out that way a little bit. So, my
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force should probably go out a little bit
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of an angle over yonder, which is
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actually pretty easy to create. If I
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bring her foot in this way, I hook a band
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around that back leg of the
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plinth, I can then just take this band and
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loop it through the handle, and then throw it
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up over her foot. And now I have that nice
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angle, out away from plantar flexion and
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inversion. To prevent her from using her
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adductors to maintain her leg in this
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position, because the band kind of wants
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to just take her and pull her out that
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way, to keep her in this position, I'm
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going to have her take this leg and cross it
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over. Alright, so she's using this leg to
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brace this leg, she doesn't have to come
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up quite as high. If she didn't have quite as
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much flexibility, we could try something
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like that. Now we're all set up for
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just band resisted tibialis posterior
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activation. The next thing we have to
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figure out is who are are overactive
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synergists for the tibialis posterior, so
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any muscle that has a propensity to become
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long and under active, any prime mover.
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And with the tibialis posterior being a very
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important inverter, who's taking over for
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this inhibition? Well, chances are it's
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going to be the flexor hallucis longus,
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the flexor digitorum longus, and our
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fibularis or peroneal
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muscles. The way we get our peroneal
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muscles out is simply through inversion.
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Our peroneals are everters, so we
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don't have to do anything special there,
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other than create this line of pull,
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which we've already set up. The flexor
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hallucis longus and the flexor digitorum
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longus, well if they flex the toes, I can
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reciprocally inhibit them using
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extension of the toes. So, now what I'm
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going to have her do is she's going to
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point her foot going down and in a
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little bit, right, while bringing her toes
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up. Let's try that again. So you're
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going to go down and in while bringing
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your toes up. Good, and you can even give
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a little cue, a cue that works really well.
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If you put a little pressure on the ball
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behind her big toe and go, "Here, press
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right through here," she'll do a lot of
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those things, the toes up, the
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inversion, and plantar flexion naturally.
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So, I'm just going to give her that
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little tactile cue. There we go. And now
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I want you to go back nice and slow for me.
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Can you do that four second eccentric?
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I'm going to have her out for two, hold
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for two, and then back two, three, four.
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Nice job. Now, I have to admit, guys, this
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is a fairly low-level, fairly low
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intensity posterior tib. activation
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exercise. Generally, I don't need to use
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this exercise. I can progress somebody to
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our standing progressions for posterior
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tibialis activation. But, this is an
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important one to have in your arsenal,
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because I guarantee, the longer you
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practice, the longer you train, eventually
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you're going to find somebody who can't
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maintain the medial longitudinal arch of
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their foot in standing even if you put
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them there first. Or, maybe they've had
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really painful plantar fasciitis, and
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this is the only posterior tib.
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activation exercise that doesn't cause
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them further pain. It's also one of the
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few exercises that's really easy to set
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up at home. All they need is one of
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these resistant bands, which is fairly
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cheap. And this doesn't have to be done
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on a plinth. Obviously, they could tie
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this to
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their bed or a heavy dining room table
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or something to create this level of
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resistance. So once again, guys, here's a quick
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reviews on set up. Remember, we need to
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create a resistance that pulls back and
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that way a little bit, so I put
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it on the back leg of the plinth. I then
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took the band and just looped a little
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section of the band through the handle.
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That's important, guys, you want to create
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a slipknot. Don't do this thing, where you
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just slip the handle over the foot,
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unless you want this to fly off and hit
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somebody. Alright, so make sure you
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create that little slip knot. Now,
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to prevent her from using her adductors,
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which are muscles that also have a
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propensity to become a little overactive, and
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we don't want to exacerbate dysfunction,
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I'm going to have her use this leg and
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create a brace. Are you nice and
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comfortable? And then remember you can have
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her push through the ball of her big toe
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to stimulate flexion and inversion, and
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we're going to make sure to reciprocally
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inhibit her flexor hallucis longus and
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her flexor digitorum longus by doing
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big toe extension. Our common tempo
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markings for activation exercise is a 4-2-
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2 count. Since we're starting with the
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concentric, we're going to go down for
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two, hold for two, and then back for four.
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Thank you, Melissa. I hope you guys enjoyed
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the video. I look forward to seeing or
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hearing about the results, the
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outcomes, and all of the changes you guys
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get in human movement.
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