Tag Archives: physical therapy

Is Your Tibialis Posterior Causing Heel Pain?

Heel pain is one of the most common complaints we hear about in the clinic. Whether it is a runner, gymnast or someone who’s always on their feet, heel pain is notorious for interfering with every day activities that once seemed simple. More often than, not people self-diagnose or determine after googling that they have plantar fasciitis. While plantar fascia irritation is definitely a possibility, there are a ton of other structures in the foot that can mimic plantar fascia pain. One of those is the posterior tibialis muscle & tendon. Check out the picture below to get an idea of where this muscle is located…1

The posterior tibialis is a dynamic stabilizer of the arch and has many attachments at the foot which make it susceptible to irritation. The actions of this muscle are to plantarflex (point your toes down) and invert (turn your foot in) your ankle & foot. A dysfunction of this tendon can lead to a collapse of the arch which research has found to be linked to knee dysfunction as well as running injuries.2

Last week, University of St. Augustine DPT students invited a few Orthopedic Manual Fellowship trained PTs to present various manual therapy and exercise techniques and Steve was one of them. Check out his original posterior tibialis exercise that targets both concentric and eccentric strength throughout the full range of motion. Note that before doing this exercise it is best to address foot/ankle mobility & muscle length deficits as these are required for optimal muscle function & strengthening.3

If you are interested in learning more about running related injuries or refining your running mechanics, contact us today at info@vighettipt.com. Be sure to let us know if you try this exercise out!

 

References:

  1. Kendall, F. P., McCreary, E. K., Provance, P. G., Crosby, R. W., Andrews, P. J., & Krause, C. (1993).Muscles, testing and function: With Posture and pain.
  2. Hughes C. The foot and ankle: physical therapy patient management using current evidence. Current Concepts of Orthopaedic Physical Therapy. LaCrosse, Wis: Orthopaedic Section, APTA, 2011. Print.
  3. Patla, C, Chaconas E, et al. Cuboid manipulation and exercise in the management of posterior tibialis tendinopathy: a case report. Int J Sports Phys Ther, 2015; 10(3):363-370

Foam Rolling 101

It seems like every gym & athlete owns a foam roller…. Even the target dollar section sells foam rollers! But what does foam rolling really do and will it really improve your flexibility and decrease soreness after a workout?

Recent research has shown that foam rolling can be helpful in multiple ways if performed appropriately.

Benefits include:1

  • Reduced pain associated with delayed onset muscle soreness (DOMS)
  • Acutely increases range of motion when performed for a longer duration of time (30-60 seconds)
  • Reduces muscle tender spots
  • Improves neuromuscular efficiency after foam rolling which can improve athletic performance
  • Foam rolling after static stretching seems to improve flexibility to a greater degree than stretching alone

To summarize, recent evidence seems to point to the idea that longer durations of foam rolling (30-60 seconds, 2-3x per muscle group) performed after static stretching (2 sets of 30 seconds per day per muscle group) performed 5-6 days a week may be the best way to improve flexibility.2 Let us know if you try this out!

 

References:

  1. Behm, D. ECSS 2017
  2. Thomas et al 2018