3 Exercises for Tibialis Posterior Tendonitis
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- Опубліковано 20 січ 2023
- Today's video covers three exercises that can help reduce pain associated with tibialis posterior tendonitis or tendinopathy. Tibialis posterior is a relatively small muscle that runs along the inside of the lower leg. This muscle acts to invert and plantarflex the ankle and helps support the medial arch of the foot.
Dysfunction of the tibialis posterior tendon can cause pain along the inside of the lower leg and be one cause of posterior shin splints. More severe injuries of tibialis posterior can result in a gradual collapse of the arch of the foot.
If you have pain in this region, the resistance training exercises shown here can work to increase muscle strength and tendon capacity and decrease pain. Give them a try and let me know if you have any questions.
*Make sure to checkout my new pain & injury rehab book. It includes comprehensive programs for the 50 most common orthopedic issues, including five ankle and foot exercise programs. Click the link to learn more. a.co/d/0HzBHAa
Loved your video. No funny stuff. You are serious, professional and easy to follow. Thank you for you help!
No waste of time,straight to the point,short video efficient video,useful exercises,detailed information.Keep up the good work man,i was struggling to find what is this pain called I mean I play cricket professionally and I run everyday and this pain is annoying,it does not allows me to bring out my full potential,but yeah thank you for the video.
Thanks for the comment! I’m glad you found the video to be helpful!
Did the exercises finally helped you to get rid of the pain,
This is so good thank you so much
Concise and helpful! Thank you!
Glad it was helpful! Thank you for the comment.
Thank you for the video 🤗
You’re welcome 😊
Such a random muscle but plays an important role in our whole muscle synergistic system. Great explanations!
Totally agree! So small, but so influential.
‚Random muscle‘ - until it keeps you from playing your favorite sport for more than a year… I am finally eazing back into it. Strengthtraining was key. Unfortunately, physicians did not know about it. Luckily, there are some science papers on it including heel raises etc.
@@catrinrodenberg6236 strengthening is huge and really the most supported intervention in the research. Glad you figured that out!
@@RehabScience it took me a while. My physician had no idea but could not admit it. Luckily, I am a researcher so reading scientific publications also in medicine was possible for me. But so many people out there who could not go down this path… it is a huge field and super interesting. Lots of research to do still!
@@catrinrodenberg6236I cant even do one leg raise, how long it took you ? i walk everyday 10 000 steps but it doesn't help at all..
thanks a lot
Thank you for sharing. For a person like me who can't afford to seek professional help this is really helpful.
Happy to share! I'm glad the video was helpful.
Aaahhh, at last.. i feel sp comfort after doing this exercise. Many thank's kind human 😊
No problem! I hope the exercises help you!
I am 62 y.o teacher...with tendonitis in the tibialis tendon...very painful to walk....I found these excersices but it hurts when I do them...any advised?
Thank you for the great tutorial. I am trying the first two exercises and so far so good. However, the physio I’m seeing has considered FHL tendonopathy to be a diagnostic possibility with my foot and calf pain. It be is a running injury with speed training to be the precipitatant on and off over the last three years.
Are you able to describe any clinical features (in your experience) to differentiate between TP and FHL tendonopathy? I am medical so will understand the lingo.
Good massage
Thank you
Very useful. Thank u! I will try it for pes planus.
Glad the video was useful!
Ive been having this pain for over 8 months now.. i have flat feet
.. it's really getting in a way of my running
Outstanding 🙏🙌
Thank you 🙌
Been running through the pain, now it’s gotten abit worse, thank you for the video!
I hope the exercises help you!
Does the exercises helped you?
Please make a video about end feels 😣😢
Hi 🙋🏻♂️ pain started today. Feels like it is inflamed after walking. Shall I wait until inflammation is gone and do the exercises, or should I start asap eventough pain is still there.
Thanks!
What’s the best shoe for tibialis posterior tendinitis. I am currently wearing an arch support Skechers. I am very active in my yard and most of the time on a 30% incline. Any suggestions on the proper tennis shoe please?
I started jogging a bit more of a month ago. It hurt at the front, like over my tibia. When I jog or touch. People told me it will go away. But no. It's been a month and one week. I'm gonna try this tomorrow morning before jogging now
Great video! 👍 For the first exercise, the doming one, should I curl the toes or try to keep the toes straight and only lift the middle of the foot? I can't tell whether you were only lifting the inside side of the foot (ie., tilting towards the outside) or are you keeping the foot flat on the ground and try to lift the arch only?
For the doming exercise, you want to try to keep the toes straight and not to tilt towards the outside. You really want to try and keep the entire foot on the ground and just lift the arch. Does that make sense?
@@RehabScience yes, thank you so much!👍
Hi 👋
Can this condition cause swelling in the calf/shin as well? Doctors aren’t very knowledgeable in this area and I can’t seem to find one that wants to explore further. I have Achilles tendinitis, plantar fasciitis and arthritis in my foot. How can I get checked for this and who should I see please?
I am in treatment, and I got green light to run but this thing still hurts
Same brother
What should you do when not in rehab when you have pain. Should i use insoles? And is painfully walking with flat feet undoing my rehab sessions?
Can a person with metallic rod fixed nearly 5 years back due to fracture and do this exercise or is it safe for such person to lift weight of 15 kg approximately on regular basis ?
Wow these are good I have horrible pttd. My tendons are swollen to 2.6 and 2.8 centimeters. My PT person just had me start coming and I hff ave doneca variation if the band. I gave tried ball on my own but wasn't sure I was doing it right, Yourvexamoke were good and I understand better. Hopefully I can heal. I am not a runner by the way don't know I developed it other than bad shoes I am guessing
Sorry to hear you have developed this issue. I hope the exercises help!
Would you recommend these exercises before or after a workout?
Also, do you recommend stretching the post tib after these exercises?
I'm an avid runner(60-80+ miles/week) this post tib started flaring up after 8 weeks with no pain. Now it has sidelined me. Realizingi need these excercises daily to get this thing tampered down. Thanks for your help!
No problem! When you say ‘workout’, do you mean a run or a different type of workout? If you’re referring to a run, then I would really recommend doing these on non-running days. If you’re referring to other workouts, then you really could do them at the beginning or the end of the workout as there wouldn’t be a huge difference.
@@RehabScience "workout" = Run 🏃♂️
I run everyday, so, I'm wondering how to pepper these excercises before or after a run.
Also, do you recommend stretching the post tib after these excercises?
@@TheEnergyAlchemist6 You would probably benefit from not running every single day. Kind of like a Goku vs. Vegeta type of thing.
What if you really can't make a dome? How many should you try to do sets/reps?
Ive had this problem for almost 3 years now.. seems like it gets better and then it comes back again and cant play soccer properly.. its such a frustrating injury.. when it first happened in couldn't walk properly for a week on crotches.. thought i did serious damage. Mri and xray nothing with bones or tendons. Just found excessive fluid in my inner ankle bone... i will try these exercises as i miss playing so much..
Sorry to hear you have been struggling with this issue for so long. I hope these exercises help you. You could also try experimenting with an orthotic that supports the medial arch. In some cases, this can help reduce workload on tibialis posterior and reduce pain.
Try 200 mg ibpprufen while playing soccer
Please speak about how to strengthen muscles/ligaments on sides of knees- to avoid discomfort& swelling/ not able to end knee to pray age 66 & 253 female yikes!
Hey thank you for the exercises! I’m a runner (training for a half) and only just started getting this pain but it is not accompanied with swelling. I do have a podiatrist but wondering if you think it’s ok for me to keep running while I strengthen. The pain is not bad at all but definitely obvious and don’t want to cause more damage.
Hey! I'm having the same issue. Did you run your half? How did you get on? Or how are you doing with the training?
hey@@@rebekahlouise2765 ! I did run the half. I just made sure I did the theraband exercises a lot, heel raises and using my orthotics. The pain was definitely there but didn't cause myself too much of an issue which is encouraging!
@@KiraleeRuth That's great, good for you. I hope you enjoyed it. Leading up to your HM did you run far? I've been advised to cross train on the bike, strengthen, and then only run short distances until my HM.
Hello, Have you healed since your comment? I recently have been having this pain but also want to continue running long distance as well 😔
This pain started in the ankle 2'years ago! Now my shins are on fire! Constant aches all through my shins burning sensations. I've developed a small hammer toe. I have calluses. I'm seeing an orthopedic soon because this has gotten progressively worse. Im now feeling it on right leg now. This all started walking to a friends house when i got this jolt of sharp pain through my foot, any step i took off the sidewalk or off a step sent electric shock pain through my foot. Putting any pressure hurts. I feel like my gait has changed.
Did you get any improvement? I've had these same symptoms for a year now.
I really appreciate this! I’m a runner and just got an mri saying small longitudinal tear in the post tib. Super mad but ready to heal. Don’t have much pain but stiffness and def slightly collapsed arch. I’ve been cycling and told elliptical and stair stepper might be ok. Do you
Think I shouldn’t be walking? I got custom inserts to take some load off (don’t want these long term but shorterm I think they’re ok).
Walking isn’t necessarily bad. It does apply some stress to tibialis posterior, so you just need to experiment with how much volume the tissue can tolerate. Too much walking often triggers symptoms, so you just have to find the appropriate level for your stage of healing.
@@RehabScience much appreciated, thanks 🙏🏼
link doesn't work "page not found:" thank you for the exercises they are helpful
Sorry about that. Thanks for letting me know. Here is a link to my book, if that is what you were looking for. a.co/d/1q3BjgP
Do you think surgery is helpful?
If someone has chronic PTTD, is it wise to just go into strengthening? My feet have flattened due to PTTD and all they can advice is braces or orthotics. I do not want orthotics as I have had them and made the problem worse in my opinion and my feet and calves become atrophied from all the years I wore them.
The muscle behind the shin is swollen and very sore, should this be released before strengthening? Have been going to PT for months and they feel that myofascial therapy is necessary in resolving this issue. I feel as I am wasting my time going to PT as they don't even address this issue.
I would love to resolve this pain in both feet, as it has been so problematic in my life. I do like your strengthening exercises. I have learned so much more on my own but I have no professional experience in dealing with this.
Thank you for your video.
Sorry to hear this problem is bothering you so much. While manual therapy can help reduce pain, it won't help strengthen the muscle or help with lifting your arch. If you can do these exercises with mild or less pain, then I would recommend starting to practice them.
0:06 reading your comment resonated with me. I injured my ankle some years back and damaged the posterior tibial tendon. Unfortunately, it was not diagnosed at the time and I have gone on to develop PTTD or Adult Acquired Flat Foot. Tomorrow I am having an operation to realign my heel bone and tibia. In addition, the surgeon will graft a new tendon to replace the now dead tissue. Having done quite a bit of research, it would appear that damaged or ruptured tendons are very difficult to heal and can lead to deformity as described above. My advice would be to anyone who injures their ankle joint, and if the soft tissue does not recover, ensure that it is reviewed by a specialist in orthopedics and hopefully avoid, as in my case, having to have aggressive surgery at a later date.
Found this YT link showing the surgical procedure to correct PTTD.
ua-cam.com/video/Zm8q4-uF3cw/v-deo.htmlsi=mDZcWJzAvf4b_mTT
How many reps for the banded excercise?
How many recommended Reps for the Arch Dome excercises? The First one mentioned in the Video? Thanks
15reps 3 sets
I've been taking ballet classes for years but my ankle hurts whenever I tried to get on demi-pointe etc. My doctor told me I have posterior tendonitis and need to stop dancing for several months to let my ankle heal. But isn't the heel lift exercise the same as ballet dancer trying to get on demi pointe? So do I really need to stop dancing? I stopped for a while, but when I started dancing again, it hurts again. I don't want to stop dancing forever, so is dancing similar to the exercises and can help heal the tendonitis? Thank you so much!
Yes, you are correct in that the calf raises are very similar to the movements you are doing in ballet. What you described is what we often see with tendinitis. It gets better when the person rests, but then comes back again when they resume their activities. You definitely don’t need to stop dance forever. The key is to let the tendon calm down and then strengthen it gradually over over time. Once it has desensitized and gained enough strength, you will be able to go back to activities that initially caused pain. Hope this helps!
@@RehabScience Thank you very much! This is really helpful! Please keep making these great videos! I really appreciate your help!❤️❤️❤️
I've been having this issue for 5 months now. The Pain is inside the foot. How long would you say does it take to see serious improvements?
Usually, you should see improvements within that window of time. If you are modifying aggravating activities and performing exercises like shown in this video, and still not seeing improvement, that I would probably recommend seeing an orthopedic physical therapist for more specific guidance.
I can’t speak for your timeline but for me it comes and goes. I’ve had mine for a year. Working with a professional running coach helped me understand that this also come at least in my case from weak hips. One thing that really helps mine is adding weight to those calf raises, icing after runs, and a massage gun.
If this is a running injury, pay attention to where you’re striking. For me, I found I was over striding and not keeping my feet under me. Hope this helps. Also arch support and Altra shoes
Acupuncture is very effective is speeding healing and shortening this timeline. Tendons have a poor blood supply and take a long time to heal. Acupuncture reduces pain, inflammation and increases blood flow.
My 4th toe clawed up and it feels like my inside arch has changed. I need help. Doctors suck
❤❤❤
Can you tell me why we use a ball for calf raises?
It helps target the ankle inverters, including tibialis posterior.
Honest question- is medial shin splints a type of post tib tendinitis? It seems based on other videos that the tendinitis pain presents in the foot and not the shin. But your video says otherwise
Tibialis posterior tendinopathy can present in the foot where the tendons insert or in the distal (bottom) end of the shin where the tendons run.
@@RehabScience thanks. So how do you know if you have shin splints or tendinopathy?
When I do the second exercise, I can feel the peroneal tendon on the outside of the foot overstretching. Is this normal or do I have bad form? If so how do I correct my form?
That’s because your peroneals are tight and inhibiting tibialis posterior from doing it’s job. Foam roll the peroneals then foam roll tibialis posterior then do the exercises
If I do these exercises daily for a year can I cure my flat feet? Thank you!
Unfortunately, exercise will not change postural alignment. However, these exercises will strengthen the muscles that lift your arch.
If even the first exercise hurts to do - just need to rest and do nothing for a while?
It’s okay to have mild pain when performing these exercises as long as your pain is not worse the next day after the exercise session.
Why squeze the ball in calf raises activate tibialis posterior ? Struggling to understand this…
Yes, the ball squeeze helps to encourage activity in the ankle invertors, including tibialis posterior.
Ive been getting posterior shin pain/soreness for almost 3 yrs now and im losing hope ive been to rehab twice and it is still there after a run 😭. At this point idk if it is still shin splints.
Have you seen an orthopedic doctor to rule out a stress fracture. Being that you have had this issue for so long, it would be good to rule out other causes, like a stress fracture. If the bone is fine, then you might want to consider finding a facility with an unloading treadmill (Alter G) so that you can run with less of your body weight and slowly rebuild strength and capacity in the area. Also, running in a pool can be useful.
@@RehabScience yes results came back negative and I have also tried alter G with zero pain but once i tried regular run/jog the shin soreness came back.
@@syrphilipgulmatico5352 Glad to hear a stress fracture was ruled out. Have you tried running on softer surfaces, such as track or modifying your shoes? Also, increasing cadence with some of the apps that are out there can help reduce tissue stress. Other than those things, resistance training is the major element. Strengthening the entire leg (glutes, quads, hamstrings and calf) can really help with an issue like shin splints.
@@RehabScience i just finished therapy although it did help reduce the sore ess it is still there continuing to strengthen more at home im also buying an iso tibia bar
@@RehabScience i have also been massaging the top part of my shin on the posterior side it feels so tight like a brick 3 inches below my knee between muscle and bone
Hey Tom, are there factors excluding neuromuscular control that dictate the ability for a muscle to experience DOMS? I find that the propensity for my patients and I to experience soreness in muscles like the tib posterior or forearm muscles to be less than others like the glutes or pecs, thanks!
That’s a great question and I’m sure there are other factors. I would imagine some of this is associated with how many muscles are located in a given compartment and which muscles accept most of the load. With tibialis posterior (posterior compartment), the calf muscles are going to accept most of the load, so it would be difficult to isolate tib. posterior and create DOMS in that muscle. With the forearm muscles, I don’t think most people load them heavy enough or long enough to achieve DOMS. However, an exercise like multiple sets of dead hands to fatigue can definitely create soreness in the wrist and finger flexors (anterior forearm). I think so much of whether or not DOMS occurs is due to how much a particular muscle is load and can be isolated.
How many days i will rest sir
Usually you will want to rest and perform gentle movements until you can perform these exercises with no more than mild pain.
Of coarse noticed you are barefoot for these exercises. Better that way?… given i am using an air cast arch support for recovery.
I've been battling this for years nothing helps
Sorry to hear that. You might explore shockwave therapy as another option as it has received more research support recently for stubborn musculoskeletal conditions.
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Vorrei poter gioire anche io , ma nn c'è traduzione in italiano 😢
pubalgia exercise please
I will try to do a video on that soon.
@@RehabScience thanks a lot, because last time so much patients with this problem and recovery takes a long time. Subtle problem 👋🏻
im really tired with thisnpain. already more than 15 years .... always going doctors and they send to physiotherapist and after 6 months again! i want do something can really fix this . i can't anymore 😢
I have super flat feet and they recommend exercises because the posterior tibial tendon is really weak. Have a surgery consult soon to discuss arch reconstruction 🥹
I'm the same I've tried everything multiple injections cortisone prp shockwave therapy weeks of physio. Insoles still no relief. Hope you get sorted