& REHAB
WHY YOU NEED TO ADDRESS
TIBIALIS POSTERIOR WHEN
MANAGING PLANTAR FASCIITIS
With a range of foot-related problems resulting from tibialis posterior
dysfunction, there’s a clear need to assess the function of this muscle.
WORDS: SANDRA STEEL
The 30-second article
• A vital muscle of the lower leg, the
main function of the tibialis posterior is
to push and pull the foot up and down,
as well as to stabilise the ankle and
support the medial arch of the foot
• Problems such as shinsplints, plantar
fasciitis, bunions, hammer toes, and
neuromas are often a result of tibialis
posterior dysfunction
• Plantar fasciitis can be experienced
by a person displaying either
lower- or higher-arched feet
• Assessment of the tibialis posterior
can determine if tibialis posterior
tendinopathy is present, and gauge
whether tibialis posterior is
contributing to the client’s pain and
biomechanical dysfunction.
18 | NETWORK SPRING 2014
full assessment of a client
presenting with plantar fasciitis
(pain in the heel and underside of
the foot) needs to take into account the
client’s hip, knee, ankle and foot function, as
well as all the muscles of importance, such
as the gluteals, peroneals, hamstrings,
quadriceps, tricep surae, tibilias anterior and
tibialis posterior.
The functionality of the joints and relevant
muscles is assessed in order to understand
the contributing biomechanical dysfunction
and allow an appropriate treatment plan to
be established. Here, we examine one of
the muscles which is often seen in clinical
practice to contribute to the pain and
biomechanical dysfunction in clients with
plantar fasciitis, namely the tibialis posterior.
The tibialis posterior is a vital muscle
of the lower leg because of its numerous
insertions, support of the leg, foot and
ankle, and its relationship with normal foot
pronation. Inhibition of the tibialis posterior
often results in knee pain, foot pain, and
ankle pain, as well as overpronation,
A
which can defer excess shock to the rest
of the body during impact. Problems such
as shinsplints, plantar fasciitis, bunions,
hammer toes, and neuromas are often a
result of tibialis posterior dysfunction.
The tibialis posterior’s main action is to
invert and plantar flex the ankle joint (i.e.
push and pull the foot up and down), as well
as stabilise the medial aspect of the ankle.
It is also the major muscle that supports the
medial arch of the foot and, along with many
of the insertions throughout the plantar
aspect of the foot, the tibialis posterior is
responsible for the actual strength and
health of the foot itself.
Origins and insertions
The tibialis posterior originates at the medial
portion of the proximal posterior tibia and the
medial two-thirds of the proximal posterior
fibula. The interosseous membrane binds
the tibia and fibula together, and forms much
of the origin of the tibialis posterior, along
with the deep fascia of the lower leg. The
tibialis posterior inserts into the navicular