|
|
Re: Tibialis Posterior heel walking
|
Logged in as: Guest
|
|
Users viewing this topic:
none
|
|
Login  | |
|
Re: Tibialis Posterior heel walking - April 23, 2007 12:00:00 PM
|
|
|
Tom Reeves DPT ATC
Posts: 447
Joined: March 14, 2006
Status: offline
|
fI understand that but Steven seems to not grasp what I am telling him. Or maybe he grasps it but can't let go of the dead guy in the anatomy lab.
|
|
|
|
|
Re: Tibialis Posterior heel walking - April 23, 2007 12:57:00 PM
|
|
|
Steven 59
Posts: 13
Joined: April 19, 2007
Status: offline
|
Tom,
The tibialis posterior appears to work during heel strike (heel strike is 0-10) from the 5-10. Thank you for clearing up that it is active during heel strike. It also appears it works more during heel strike than toe off (50-60) if I understand the graph correctly. I haven't read the article yet.
I am not sure what is to grasp that you are telling me. I did not ask for the best exercises etc.. I also know the anatomy and action of tib posterior (in general).
|
|
|
|
|
Re: Tibialis Posterior heel walking - April 25, 2007 12:54:00 PM
|
|
|
VagusX
Posts: 215
Joined: March 26, 2003
From: Savannah, GA, USA
Status: offline
|
I find this a strange topic to be having conflicting opinions about at work, but I hope you can win the argument after getting all this interesting info.
Rearfoot motion is controlled by the tib posterior mainly from midstance to push-off by bringing the rearfoot into varus. I would consider that a concentric contraction. Open Chain motion the TP Plantarflexes and inverts.
[QUOTE]What do you think happens with the tibialis posterior when you are heel walking and lift the heel off the ground? [/QUOTE]not much. Possibly some isometic contraction, just the TP trying to resist gravity. IMO it really should be a moot point being that the TP is hardly active (If at all) OKC/CKC movements above neutral. The tib anterior overwhelms anything that the TP tries to do during the aforementioned foot postion.
|
|
|
|
|
Re: Tibialis Posterior heel walking - April 25, 2007 4:50:00 PM
|
|
|
Steven 59
Posts: 13
Joined: April 19, 2007
Status: offline
|
Vagus,
I found this article a while back
http://www.sportsinjurybulletin.com/archive/tibialis-tendinitis.html
The authors used heel walking to fatigue the tibialis anterior then when the muscle was fatigued the tibialis posterior could be worked.
The authors describe the rationale under "A Pain Duet" and the heel walking activity is described shortly after.
I often thought about this activity and brought it up to a co-worker and several of us discussed.
I simply wondered what kind of contraction it would be concentric, eccentric, isometric. I thought if it was eccentric I could positively effect the tibialis posterior as well as help to strengthen and maybe help "re-train" the muscle (more-so to strengthen and get a possible eccentric benefit). I researched and could not find much information. I am still not 100% satisfied I have an answer yet (does the posterior tib contract eccentric, concentric or isometric while heel walking?). I think it is eccentric during heel strike and probably mostly eccentric during heel walking as of now.
I usually can find information very easily but there was not much on the topic.
Vagus thank you for the response.
Another question to be answered is if heel walking is functional or not. Does the brain tell the tibialis posterior to contract "non-functionally" while heel walking as Tom Reeves implied? To help me with this question; Tom what exactly do you think functional exercise is?
|
|
|
|
|
Re: Tibialis Posterior heel walking - April 25, 2007 6:26:00 PM
|
|
|
Tom Reeves DPT ATC
Posts: 447
Joined: March 14, 2006
Status: offline
|
IMO Functional exercise is any activity that simulates what happens in normal life. por ejemplo, controlling the deceleration of pronation and the reversal or supination like Vagus said. If you are trying to contract or train the TP by heel walking, you are consciously telling it to contract which is IMO non-functional. To truly train the muscle, you must encourage it to contract appropriately WITHOUT conscious thought. The muscle that allows you to heel walk ( or functionally decelerates the movement from heel strike to foot flat) is the TA, not the TP. Therefore, if you are trying to train the TP, you should work on midstance deceleration of pronation to a supinated position including propulsion or the initiation of propulsion, not wasting your time working on CKC dorsiflexion.
you mentioned "re-training" TP, but you are really not training it to do anything it really does in function. To me that means you are actually de-training it.
|
|
|
|
|
Re: Tibialis Posterior heel walking - April 25, 2007 6:46:00 PM
|
|
|
VagusX
Posts: 215
Joined: March 26, 2003
From: Savannah, GA, USA
Status: offline
|
Very interesting Stephen about fatiguing the Tib Ant. I will look over that article.
If I can but in with my thoughts on functional activities, I would give two answers depending on the situation. In the situation of the tib posterior being deficint but yet to be lacking the deformation of Stage II Dysfunction I would use a Eccentric heel raise progression exactly like that used during Achilles tendon rehab. Kulig et al showed ~21% activation during the heel raise. 21% activation combined with functionality and ease of the heel raise progression wins my vote over the 60% activation of the resisted CKC plantarflexion with inversion.
HOwever if deformation has occurred as in the case of the stage II PTTD I would err on the side of safety and avoid the heel raise progression. With the axis of rotation shifted laterally and the Peroneus Brevis, ground reaction forces, and the pull of the achilles, acting against a very weak Post tib, the progression may be accelerated and further deformity may occur. I would would revert back to using CKC resisted plantarflexion with inversion in sit then progressing them to the same exercise while leaning against a wall (to provide the needed plantarflexion to activate the Tib Posterior.
Here is a link to Kulig's latest RCT on Tib Post [URL=http://www.madonna.org/institute/centers/msc/research/pdf/2006%20CSM%20-%20Long-term%20Effectiveness%20of%20PRE%20on%20PTTD.pdf]link[/URL]
|
|
|
|
|
Re: Tibialis Posterior heel walking - April 26, 2007 1:30:00 AM
|
|
|
Steven 59
Posts: 13
Joined: April 19, 2007
Status: offline
|
Good stuff Vagus, thanks.
|
|
|
|
|
Re: Tibialis Posterior heel walking - April 26, 2007 1:40:00 AM
|
|
|
Steven 59
Posts: 13
Joined: April 19, 2007
Status: offline
|
Tom,
Heel walking is functional. One goes through heel strike every step they take (you can not get more functional). The tib post contracts without conscious thought during heel strike. Again I am not arguing the better exercises. "Re-training" is, I believe what the article was trying to imply, I am wary of the "re-training" myself .
|
|
|
|
 New Messages |
 No New Messages |
 Hot Topic w/ New Messages |
 Hot Topic w/o New Messages |
 Locked w/ New Messages |
 Locked w/o New Messages |
|
 Post New Thread
Reply to Message
Post New Poll
Submit Vote
Delete My Own Post
Delete My Own Thread
Rate Posts |
|
0.094
|
Printable Version
