Back to work, Back to play. Hello, Dr. Noah Volz here, looking at evidence-based exercises to
heal common complaints, and today we're looking at posterior tibial tendon dysfunction. Uh and that's
just a lot of words to say pain at the inside of the ankle, kind of inside of the heel. Oftentimes,
when we're assessing this, we'll find that the the heel is actually deviated slightly to the outside,
we'll often find that people have pain or tenderness or numbness at the inside of the
ankle when they point their toe, or when they kind of come up onto their toes with their heels
up off the floor, so today we're going to look at some exercises that you can use to help to remedy
this situation to help heal the posterior tibial tendon dysfunction quickly. So we'll go into those
exercises now. So the first exercise we're going to do is called the standing inner calf stretch.
This is an exercise that you will hold for about 30 seconds, you want to do this at least a couple
times a day. Uh, the posterior tibial-tibialis muscle goes kind of through the inner calf,
so we're basically stretching out that muscle, stretching out the tendon attached to that muscle,
to help relieve this particular complaint. So first, you'll start in kind of a wide legged
position, your, your feet are about three feet apart, and you're gonna turn that back foot in
about 45 degrees. The other foot can be pointing straight ahead, and then you're just gonna bend
that knee, and then you'll feel kind of a stretch through the inner ankle through the inside of the
foot, that's really, really what you're looking for, is that kind of sensation, and like I said
you'll hold this for 30 seconds, and you'll do that up to three times a day, or excuse me,
two times a day. So that's the first exercise, and we'll start there. So our second exercise is an
eccentric posterior tib exercise, similar to other exercises where we've done, we're gonna stand up
here on a small step, and we're going to lower the heel down at a four second count, and then we'll
use the other foot to bring that heel up, and most of our weight is going to be on the outside of the
foot, so I'm kind of the pinky side of the foot as we do this. And again, you'll want to do about ten
reps of this three times a day. So we'll go ahead and show you how that's done. So you're gonna
come up onto your step, I'm going to do this right foot here, I'm using the left foot to to balance,
and then coming on to the outside of my right foot onto that pinky toe side, lowering the heel
down one, two, three, four, shifting the weight to my left leg in order to bring the heel up,
and then again, one, two, three, four, and then I'll just keep doing that about three times,
really feeling that stretch in the calf and that's the second exercise. The third exercise for
posterior tibial tendon dysfunction is a single leg stance with the knee slightly bent. So you're
gonna want to hold this for about one minute on each leg, and you're basically just balancing
with that knee slightly bent. So I'll go ahead and show you how to do that now. So you're just
standing on one leg, lifting the opposite leg, and then bending the opposite knee, so again, you're
kind of feeling the inside of the heel, the inside of the calf, as you balance here. strengthening
that tendon. You do that for one minute, and then you switch sides and do the other side. So that is
the next exercise. Exercise four for posterior tibial tendon dysfunction is a resisted sole to
sky stretch, um and this again is working on that that posterior tibial tendon and making it strong,
so this one you'll want to do about ten reps, three sets of ten reps. Uh that's the best way to
do that, and so basically you're sitting with your leg cross-legged, you're using a band over that
foot, and then the foot scoops up towards the sky so the solo foot is reaching up towards the sky,
and you do that ten times, I'll go ahead and show you how to do that now. So I'm using the red CLX
band for this, so I'm just gonna go ahead and loop this around my foot, then I'm stepping on
the other side of the band with the other foot to get the desired tension that I want here,
and that's pulling my foot down towards the floor, I'm going to bring that right over the ball of my
foot, and then I'm gonna stretch the sole of the foot up towards the sky, and then I will pull it
down and foot up towards the sky. And I'll do ten reps of these, I'll try and keep my leg out
of it as much as possible and just use my foot and ankle to reach up towards the sky, and then
let that resistance pull the foot back down. So that is the next exercise, and we've got one more.
The fifth and last exercise for posterior tibial tendon dysfunction is the two legged standing calf
stretch. It's just a simple calf stretch that you're gonna want to do and like the last one
you can do three sets of this, I'm gonna do ten reps, and you're basically just standing, you can
stand close to a wall, and your just tilting your entire body forward and stretching the whole back
of the legs. So I'll go ahead and show you how to do that now. So you're just standing here and
then you're leaning yourself forward as far as you can. If you need you can stretch your arm out to
move the weight and then you come back to center, and then you stretch forward as far as you can,
back to center and stretching forward as far as you can. So that is the basic gist,
those are the five exercises that we recommend for a posterior tibial tendon dysfunction, and
then, um, so start there and see how it goes. Ss you're doing these exercises for posterior tibial
tendon dysfunction, you will feel a lot better. After about seven days of doing these exercises
if you're not having significant improvement then you're going to need a more thorough assessment to
figure out what's going on. Sometimes, posterior tibial tendon dysfunction can look like another
condition or it can be happening at the same time as something else, so you'll want to consider
that thorough assessment, if you're already a patient here you can bring up those exercises,
we're happy to go through them with you, uh make any modifications that are specific to
you, either making them easier or more complicated depending on what's needed,
or depending on what's really going on with you, or if you're completely new to the clinic,
you can set up one of our three 20-minute consults and we can go through the exercises with you and
kind of look at how those may help this inner heel inner ankle pain that you may be experiencing,
we'd be happy to help with with that. And um, you know, as always, exercises are really a proactive
way to get better, to keep you out of the doctor's office, including ours, really hope that this
video helped you, give-gave you some tools that you can use today to get yourself better and look
forward to teaching you more in the future. Thanks for watching. Subscribe ProActive Chiropractic.