Tibialis Posterior Tendinopathy Strengthening Exercises

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Strengthening exercises for Tibialis Posterior Tendinopathy focus on developing strength and eccentric strength in particular, in the tib posterior muscle which plantarflexes and inverts the ankle.

The rehabilitation guidelines below are for information purposes only. We recommend seeking professional advice before attempting any rehabilitation.

Inversion Exercises

These exercises will specifically strengthen the tibialis posterior muscle. It is important that the athlete has given the tendon enough time to heal before attempting strengthening exercises.

Isometric (static)

  • A therapist provides resistance as the athlete tries to push the foot outwards against their resistance.
  • There shouldn't be any movement (see the first exercise shown in the video above)
  • This is the first exercise which can be performed after injury as it places the least stress on the tendon.

Active

  • Stand (in bare feet) long ways on a step with the inside of the foot half way over the step.
  • Gently roll the foot inwards (evert or pronate) so the inside of the foot rolls in and downwards.
  • Return to the starting position by inverting it so it is flat on the step again.
  • Aim for 3 sets of 10 repetitions and gradually build up to 3 sets of 30 repetitions.

Resistance band inversion

  • In a seated position, wrap a resistance band around the foot and either attach it to something to the outside of the foot, or get someone to hold it.
  • Invert the foot against the resistance of the band.
  • Ensure you are only using the ankle/foot to perform this movement and not the lower leg/knee.
  • Slowly return to a neutral position and repeat.
  • Start with 10 repetitions and gradually increase to 20 reps.

Calf raise

This exercise will also strengthen the calf muscles (Gastrocnemius and Soleus).

  • Stand with your feet on the floor, shoulder width apart, close to something to hold on to.
  • Rise up on to your tip toes as high as possible.
  • Lower the heels back down to the floor.
  • You should be able to progress quite quickly with this one but aim for 3 sets of 10 and build up steadily, a few each day.
  • You can then progress to performing on single legs.
  • You can also perform these on a step so that the heels drop down below the level of the step.
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