This is Brent of the Brookbush Institute, and in this video I am going to show you my
favorite tibialis anterior activation exercise.
I am going to have my friend Melissa come out, she's going to help me demonstrate this
exercise.
You will see how easy the set up is on this one.
We're going to use one of these monster bands which I think you know as pull-up assist bands.
I tend to use the serious steel bands, I like them they are good high quality bands.
We're going to just go ahead and slipknot around the bottom leg of the table here; and
then I just need to flop this over the top of her foot just like so.
Now, notice I have this at the base of her foot and not at the top of her foot.
I understand that the top of her foot would create a larger lever, and make for more resistance
but you have to think about your tarsal joints which can be a little sensitive, especially
to this type of pressure.
We don't want to create dysfunction trying to fix dysfunction.
Now if you didn't have a treatment table then technique is totally the same.
What you would do is you would hook a band to a heavy piece of equipment at the floor
level.
The only thing you will probably have to do is probably elevate the hele on something
like a foam roll.
Because if you don't have just a little bit of a downward angle on this band, it tends
to flop off the foot every time you go into this plantarflexed relaxed state of this exercise.
Now lets talk about activation exercise in general, we need figure out what joint actions
this muscle does.
And then figure out how to reciprocally inhibit those muscles that become synergistically
dominant when this muscle becomes inhibited.
So we have the tibialis anterior does inversion and dorsiflexion, that's pretty easy to do.
That's going to be foot up and in, and in this case we are going to focus more on dorsiflexion
than inversion.
If we focus too much on inversion, we tend to not be able to dorsiflex as well, and since
we tend to lose dorsiflexion I want to really focus on dorsiflexion and try to get it back.
Now the overactive synergists for the tibialis anterior are the long toe extensors, especially
that extensor digitorum longus which also everts and pronates the foot.
So that muscle tends to want to contribute to our pes-planus or functional flat footedness,
which you know as feet flat on the overhead squat assessment.
The way we are going to get our long toe extensors out of the movement is toe flexion.
SO we are just going to be kind of clever, we're going to use their joint actions at
the toes to inhibit what we're going to do at the ankle.
Now the tricky part is getting Melissa to go foot up and in while her toes go down.
Its kind of the equivalent of this movement with the foot right, so you're going to pull
up and in and toes down, and she's practiced this a little bit so this isn't too bad for
her.
And then she can just relax everything as she goes down, she doesn't have to keep her
toes curled as she goes down.
So foot up and in, toes down, and then she can relax it.
Now, tempo markings for activation exercise are either 4-2-2 concentrating on the eccentric,
or 2-4-2 concentrating on end range.
Again since dorsiflexion is something we tend to lose and tibailis anterior activation will
help me keep it, I tend to use that 2-4-2 count on the second exercise and really make
people focus at the top.
I want you to try to get as much dorsiflexion as you possibly can, right, get it, alright.
Because if I have just done a lot of mobility work with her, right I want good carryover.
I want her to keep that dorsiflexion for a long time, so hopefully we keep making progress
over time.
Good pull up and in.
Good pull up and in, good.
Now the other thing I really like about this exercise is there is this really clever progression.
This clever progression is being able to integrate a lot of commonly active muscles in my lower
extremity, reinforcing my heel strike mechanic during gait.
So that moment where my heel strikes the floor and I need my tibialis anterior to eccentrically
decelerate foot flat.
I can kind of reinforce that during this which may improve my carry over more, and the way
I am going to do that is I am actually going to have Melissa go down on her elbows.
She's in a little too much hip flexion here for me to get the glutes involved.
I will start with going, okay foot up and in, I want you to lead with this big toe knuckle
here, right.
And you are curling your toes so this really becomes prominent, lets get up as high as
we can, and now I want you to try to squeeze your quad.
And you will find a lot of people with have a hard time with this because before when
they were dorsiflexing, they were trying to do this, right they were trying to pull their
whole leg up.
And what we want is lock your knee, pull up like this, good.
You will also find that this makes it a little easier to con them into holding that isometric
at the top, but we are not done yet.
We are going to give her a couple of reps of foot up and in, toes curled, squeeze your
quad, make sure we reinforce that a couple of times.
Alright foot up and in, toes curled, squeeze your quad.
Good hopefully you are starting to get that chain together in your head, foot up and In
toes curled, flex my quad.
Now what are we going to do?
Squeeze the glute.
So foot up and in, toes curled, squeeze your quad, squeeze your and squeeze your glute
like you are trying to smash my palm right; and what you can do is throw a rolled up towel
underneath your heel, give them something tactile to squish.
Be careful, if you know somebody that has some hypermobility in their knee, they tend
to do that rock at the bottom where they get that hyperextension, you can throw a towel
under the knee so that they can squeeze their knee against that towel and not get into hyperextension.
But back to our tactile cueing for this, foot up and in, toes down, squeeze, squeeze, hold.
Good, you think you got 15 more?
Trying to get somebody to do 20 of these, especially if they are one of these individuals
who really compensates, you know knees bow in, feet turn out, feet flatten and excessive
forward lean and they are so use to that compensatory pattern, this is something they have to work
at.
Which is good, because if they keep working at this, I have to tell you guys, this exercise
have given me better carryover than any other tibialis anterior activation exercise I have
ever done before, which is why it I my favorite.
Because I know it makes big changes in my goniometry and I know when they come in for
their next session my carryover is generally better.
For the most part I don't find too much difficult for people doing this as their home exercise,
but we did make another video just incase you don't have somewhere to tie one of these
super heavy bands to.
A tibialis anterior activation that uses no equipment, so make sure you look up that video
as well.
You might wonder how I progress this exercise.
Well we can't really get more complicated or less stable in this position to continue
progressing in that way, however we can progress in resistance and I do recommend it.
Serious steel makes these larger blue and green bands, and I think everybody should
get to green, I do.
At the very least blue.
The only reason I would let somebody get away with blue is if they were a smaller human
being.
Melissa I would expect to get to green.
There are heavier bands than this, but that might be going too far.
But think about what your tibialis anterior has to do.
Every time you heel strike, especially when speeds get higher, when you are running, when
you are jumping, your heel hits and your tibailis anterior is essentially the only muscle to
slow your foot from just slapping into the ground.
It is your primary decelerator of plantarflexion.
We have a lot of people who come in and complain about shin splints, we have a lot of people
who complain about these lower extremity injuries.
A lot of them have this combination of they don't have enough dorsiflexion, and part of
the reason they don't have enough dorsiflexion is because every time they try to get dorsiflexion
with a calf stretch, or an ankle mobilisation, or calf release, or all three if we're lucky,
is because they don't do the other side of it which I strengthen their dorsiflexor so
that they maintain that dorsiflexion.
They use that dorsiflexion during their daily activities.
Give this exercise a try, set up a few stations in your gym.
I can tell you that when I am treating I just leave a few of these bands tied around the
legs of my table so that I can just flop them up.
I can get in and out of this really quick, and I can even add like internal rotator activation
if I want, and maybe go right into my glute activation, its all right there set up.
You can just have some bands hooked around your power racks or your cable columns so
that people can be getting this in, in their warm-ups.
If you have any questions or comments please leave them in the box below.
I hope you have enjoyed this video.