Tibialis posterior tendinopathy

Question 1

What are the actions of tibialis posterior

Answer 1

-Plantarflexion
-Inverter
-Abductor

Question 2

What does it do in gait

Answer 2

-Midstance, eccentric contract control pronation
-Propulsion, concentric contract rigid lever

Question 3

What are some clinical tests to perform

Answer 3

-Single leg heel raise
-palpation of pain medial ankle

Question 4

Why would you perform a single leg squat for post tib injury

Answer 4

-To assess if there is compensation occurring proximally which is resulting in foot eversion which resulting in tib post compression and tensile force increase

Question 5

What are treatments

Answer 5

Load management
footwear and orthotics
exercises

Question 6

For a runner what changes would you make to load

Answer 6

-Duration, how far they are running
-Frequency, how much times a week
-Intensity, speed of run
*manipulate these factors to find their capacity

Question 7

What are some known deficits with post tib tendinopathy patients

Answer 7

-Decreased single limb heel raise strength, endurance and height
-Plantar flexion, inversion and forefoot adduction weakness
-Hip extensor strength and endurance deficits
-Hip abductor endurance deficits
-Decreased weight bearing ankle dorsiflexion ROM
-Single leg balance deficits

Question 8

What is Strength and conditioning protocol you would implement

Answer 8

-Foot adduction
-Heel raise
-Single leg balance
-Squat
-Single leg deadlift

Question 9

How to load manage a posterior tibial tendinopathy

Answer 9

-Reduce or modify load current load on the tendon
-Tracking steps via a step counter app

Question 10

What are some walking and running cues in the short term that may help a patient with post tib problems?

Answer 10

-Walking with wider base of gait has been proven to offload the tendon

Question 11

What are footwear and orthotics aimed to do

Answer 11

-Reduce the demand/load on the tibialis posterior