Tibialis Posterior Muscle

Authors
Affiliations

Nathaniel Yomogida, B.S., SPT

Doctor of Physical Therapy

B.S. in Kinesiology

Chloë Kerstein, B.S., SPT

Doctor of Physical Therapy

B.A. in Neuroscience

Schematic of Deep Flexors of the Posterior Compartment of the Leg 1: Tibialis Posterior 2: FDL 3: FHL 4: Popliteus1

Schematic of Deep Flexors of the Posterior Compartment of the Leg
1: Tibialis Posterior
2: FDL
3: FHL
4: Popliteus1

Deep Flexors of the Posterior Compartment of the Leg1

Deep Flexors of the Posterior Compartment of the Leg1

Tibialis Posterior1

Tibialis Posterior1

Tibialis Posterior insertion1

Tibialis Posterior insertion1

Origin

  • IO membrane1
  • Tibia (adjacent border)1
  • Fibula (adjacent border)1

Insertion

  • Navicular tuberosity1
  • Cuneiforms (medial, intermediate, and lateral)1
  • Bases of metatarsals 2-41

Nerve

Tibial N. (L4, L5)1

Action

  • TCJ: Plantarflexion1
  • STJ: Inversion (supination)1
  • Longitudinal Arch: Support1
  • Transverse Arch: Support1

Tendon

“This tendon is palpable at the level of the medial malleolus, especially with the foot held in plantar flexion and supination. Distal and medial to this tendon, the crossing of the FDL and flexor hallucis tendons can be felt.”2

Examination

Strength Testing

“The tibialis posterior muscle produces the motion of inversion in a plantar flexed position. The leg is stabilized in the anatomic position, with the ankle in slight plantar flexion. The plantar flexion is important to minimize the influence of the tibialis anterior muscle.77 Resistance is applied to the medial border of the forefoot into eversion and dorsiflexion (Fig. 21-24) VIDEO. The standing heel raise test can also be used to detect tibialis posterior weakness. It is thought that during a standing heel rise that the tibialis posterior and fibularis muscles co-contract to control hindfoot position. Thus, when the hindfoot everts during the heel-rise task, this is seen as a clinical sign of tibialis posterior weakness.”2

Dysfunction

Tibialis Posterior tendonitis

Myofascial release

Pails & Rails

P.A.I.L.’s

  • Plantarflexion
  • Inversion

R.A.I.L.’s

  • Extension
  • Eversion

Stretch

References

1.
Gilroy AM, MacPherson BR, Wikenheiser JC, Voll MM, Wesker K, Schünke M, eds. Atlas of Anatomy. 4th ed. Thieme; 2020.
2.
Dutton M. Dutton’s Orthopaedic Examination, Evaluation, and Intervention. 5th ed. McGraw Hill Education; 2020.

Citation

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