Is it possible to run without injuries to the posterior tibialis?  Let's see how

Fisiorunning tips to avoid or recover from a posterior tibial injury in a runner

Dario Domeniconi

In the past few weeks we have considered both the anatomical component of the tibialis posterior and its role in running, recognizing symptoms and signs of injury to help anticipate recovery before it can become an injury. Let’s now analyze the correct actions to recover from injuries to this muscle.

How can physiotherapy rehabilitate the posterior tibialis?

If running the internal malleolus begins to hurt and become inflamed, it is likely that the posterior tibial is going towards a tendinopathy. Then stop your run, lift the limb and place ice in the area (avoid freezing the muscles) for 5 minute on / 5 minute off cycles. It would also be advisable to contact a healthcare professional who deals with running to more specifically assess and rehabilitate the problem. Physiotherapy uses a variety of techniques to resolve posterior tibial tendinopathy. From instrumental therapies to manual and osteopathic techniques to then stabilize the recovery and avoid relapses through targeted exercises, stretching and a good pre-run warm-up. Also through the biomechanical analysis of the race and subsequent postural retraining pathological postures that facilitate injuries are eliminated and biomechanics is improved enhancing its performance.

How to stretch the posterior tibialis correctly?

Several scientific studies have shown that passive stretching should be done away from running. So let’s get into the good habit of doing it in the evening before bed. We can use one instead more active and dynamic stretching in the early stages. Due to its anatomical peculiarity, the posterior tibial is difficult to specifically stretch. There is often the risk of stretching the calves more, limiting their effect. Because of this the best passive stretching exercise for runners recommended by Fisiorunning is the following: we position ourselves with one foot in front of the other, as in the step phase, with the knees slightly bent. In this way we cancel the tension of the two twins that would disturb the elongation of the posterior tibial. Now we are going to bring the rear knee behind the front one by flexing the tibia forward and turning it slightly inward. We are careful not to lift the rear heel. If done well, we will feel a pull on the internal malleolus.

What exercises to do to strengthen the posterior tibialis?

The international scientific community agrees that theeccentric exercise is the most suitable for a correct recovery of tendinopathies. Also for the posterior tibial, this type of reinforcement adapts the load on the tendon better and allows the correct realignment of the collagen fibers on the tissue that has suffered an injury. In Fisiorunning we have created a specific path for the runner’s foot which consists of balance exercises on boards, on different paths and terrains. Foot reactivity and range-of-motion exercises on all levels. We also strengthen the muscles eccentrically and progressively with elastic resistances, jumps, jumps with individualized load. Also checking that there are no upper postural dysfunctions that alter the action of the plantar arch. A excellent exercise of eccentric strengthening of the posterior tibialis developed by Fisiorunning for runners is the following: on tiptoes on the edge of a step we start from a position of slight flexion of the knees and make sure that the latter look outwards keeping the two feet parallel to each other. Now we slowly go down on the heels bringing the knees gradually in internal rotation until they touch each other.

Which pre-run warm-up is suitable for the posterior tibial?

The importance of the warm up pre-run to reduce the risk of injury and prepare the physiological and tissue structures for maximum performance is now well established. For the posterior tibial we will use all the exercises of jumps, bounces and gaits that involve the ankle in general. Wanting to be more specific on the posterior tibial we can perform the following movement: with the toes on the edge of the pavement, we quickly move the knees in front of each other alternately. In this way we will activate the posterior tibialis adapting them to a fast cadence of our running. By making a movement that resembles the motor pattern of running without the impact that would cause overload.

#run #injuries #posterior #tibialis #Lets

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