by There is more than one posterior tibialis tendonitis exercise used for rehabilitation. However, the most effective and the one I often recommended to patients in the clinic, is the posterior tibialis eccentric strengthening exercise. It usually gets the job done, and due to its ease of execution, patients tend to prefer it. In this article, we will discuss how to carry out the exercise, who it’s for and the precautions one needs to be aware of. Read on to find out more!
How to do the exercise
The best way I have found for anyone to do the exercise, especially those in whom the tibialis posterior is painful, is to do the exercise seated with a resistance band. The knee should be bent, the lower limb perpendicular, and the feet parallel to the floor. It may help to explain the movement first without the resistance band to make it easier to do the actual exercise.
- First: Sit comfortably with your upper torso upright and your feet and legs in the position already described.
- Second: Raise the forefoot of the pathological foot while keeping the heel on the floor.
- Third: Invert the foot (turn in) and slowly return to the starting position.
Source: Wellness in Motion Boston - Fourth: Do it a couple of times until you get used to it.
Many patients find where and how to attach the resistance band challenging. However, this does not have to be the case. The band should be placed around the inside of the forefoot and attached away from the body. Ideally, around a table foot or get your partner or somebody else to stand on it, as shown in the image.
Level of resistance
Resistance bands come in different grades of resistance. With that in mind, start at an appropriate resistance level. Do just two sets of 15 repetitions initially and gradually increase to 3 sets over time. Doing this amount of repetition means that the resistance is at the appropriate level. When the posterior tibialis exercise gets easy, you can increase the repetitions. Higher reps are known to increase strength. The exercise is simple. Hence, patients are okay doing it, and it’s very effective.
Focus on the eccentric phase
Injuries often occur to muscles and tendons in the eccentric phase of the movement. When doing the tibialis posterior tendonitis eccentric exercise, do the inversion phase normally, but the eversion phase (outward) should be done slowly. Doing the exercise this way ensures the collagen fibres within the tendon are strengthened eccentrically. Do the exercise daily until you become familiar, then twice daily if time allows.
Who is the posterior tibialis exercise for
The exercise is mainly for anyone doing rehabilitation for a posterior tibialis injury, such as tendonitis. Posterior tibialis tendonitis is an inflammation and irritation of the posterior tibialis tendon. It can cause pain, swelling and tenderness on the inside of the ankle. The most common causes for posterior tibialis tendonitis are overuse or a sudden increase in physical activity and improper shoes.
The exercise can be incorporated into any exercise program to help prevent injury. In cases where there is an injury to the tendon, it is appropriate to be assessed by a healthcare practitioner and get them to show you how to do the exercise initially. They should also evaluate your progress at various intervals to ensure you are on the right track. Your trainer should guide you in doing the exercise if you are an athlete or just working out.
Precautions
When incorporating exercise into your treatment plan for posterior tibial tendonitis, taking a few precautions is essential to ensure you’re performing the exercise safely and effectively. Here are a few tips to keep in mind:
- Start slowly: It’s important to gradually increase intensity as you become more comfortable and confident with the exercise. If you push yourself too hard too soon, you risk further irritation or injury to the tendon.
- Pay attention to form: Proper form is crucial in preventing unnecessary strain on the tendon. Be sure to follow the specific instructions for the exercise and focus on maintaining good alignment and technique. If you need help with the proper form, consider seeking guidance from a healthcare professional or physiotherapist.
- Allow for rest: It’s essential to allow plenty of rest between workouts to give your tendon time to heal. Don’t try to do too much too soon. It’s better to start with shorter, more frequent workouts and gradually increase the duration as your strength and endurance improve.
- Listen to your body: If you experience any pain or discomfort while doing the exercise, stop immediately and consider seeking guidance from a healthcare professional. It’s crucial to allow the tendon time to recover and heal. Pushing through pain can make the condition worse in the long run.
- Wear proper footwear: Proper footwear can help support your foot and ankle and reduce the risk of injury. Look for shoes with good arch support and a sturdy, supportive sole. If you need help with the best shoes, consider consulting with a podiatrist or other foot and ankle specialist. Please note that you do not necessarily need a shoe to perform the exercise.
By following these precautions, you can help ensure that you’re performing the exercise safely and effectively and minimizing the risk of further irritation or injury to the tendon. Remember to listen to your body and seek guidance from a healthcare professional if you have any concerns or questions.
Questions to ask your therapist about posterior tibialis tendonitis exercise
Here are some more questions a patient can ask their therapist regarding posterior tibialis exercise:
- How long should I perform each exercise?
- Are there any signs or symptoms that indicate I should stop performing the exercise?
- What can I do to reduce pain and inflammation in the area?
- Can I use heat or cold therapy before/after completing the exercise?
- Are there any activities or movements I should avoid while doing the exercise?
- How often should I be performing the exercise?
- What is the progression of difficulty I should follow for each exercise?
Final thoughts
Exercise is a vital component of the treatment of posterior tibial tendonitis. By incorporating strengthening exercises, you can help improve the strength of your tendon and reduce the risk of future injuries. It would help if you also included proprioceptive exercises in your program to help reduce the risk of injury. As always, speaking with a healthcare professional before beginning any new exercise program is vital to ensure it’s safe and appropriate for your individual needs. Your health is your wealth! Seek help for your ankle pain!
