Tibialis Posterior Strengthening | Flat Feet Exercise

In this video I’m going to show you the
best exercise for the tibialis posterior in flat feet Hi and welcome back to
Physiotutors! The tibialis posterior is an essential stabilizer of the foot
during standing and walking. The tibialis posterior tendon provides dynamic
support along the plantar aspect of the foot and arch and when the muscle or
tendon are deficient decreases in longitudinal arch height often occur and
can lead to flat feet For this reason tibialis posterior
strengthening is recommended next to foot orthosis in the rehabilitation of
painful pes planus to prevent tibialis posterior tendon dysfunction and foot
arch collapse. But how can we strengthen this muscle ideally? Kulig et al. did an
MRI study to determine which exercise most selectively and effectively activates the tibialis posterior They found the greatest
isolated activation with the following exercise: Have your patients sit on the
bench with his knees about a full arm length apart and flexed about 80°. Then the patient is asked to stabilize his leg by placing the
contralateral forearm between the knees and reinforcing it with the ipsilateral
hand. Then an elastic band is looped around the medial and distal part of the
foot that is to be trained and stretch to full tension, while maintaining an
inclination angle of 45 degrees While the examiner ensures tension throughout the whole movement, the patient is asked to slide his forefoot into adduction
from full abduction with the foot remaining in contact with the floor. The
total range of motion can be marked with a tape to ensure full range of motion
with every repetition In 2005 Kulig et al. compared the
activation of the tibialis posterior in patients with flat feet and found a
higher selective activation in those patients when wearing foot orthosis and
shoes. As this is the patient group you would want to give this exercise to
wearing insoles and footwear is recommended. Progression can be adjusted based on the tension of the theraband by the examiner or by choosing a
theraband with a higher resistance Like with any other rehabilitation program
the total volume of the exercise should be slowly increased over time. Kulig et al.
were able to decrease pain and increase function in their third study
in 2009 after a 10 week program with 3 sets of 15 repetitions twice per day.
Alright, this was our video on the resisted foot adduction exercise to
strengthen the tibialis posterior. If you want to learn how to assess for forefoot
over pronation check out our video on the navicular drop test right next to me.
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Assessment E-book. Thanks a lot for watching! I’ll see in the next video – bye

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