Tibialis Posterior

Origin
Medial surface of the fibula, the interosseous membrane, the lateral portion of the posterior surface of the body of the tibia, the deep transverse fascia and the intermuscular septa

Insertion
Mainly to the plantar surface of the navicular but also to the plantar surfaces of the calcaneus, cuboid, all cuneiforms and to the base of the second to fourth metatarsals

Action
Inversion and plantar flexion of the foot. Basically, it supports the arch elevating the navicular and in doing so, prevents excessive pronation.
It aids in the even distribution of the weight the metatarsals.

Test position of body part
The subject is asked to fully plantar flex the foot and then fully invert the foot. Care is takenthe foot in full plantarflexion

Stabilization
Pressure is applied proximal to malleolli grasping the lower leg and one finger or thumb is placed over the tendon of the tibialis anterior to feel for elevation of the tendon indicating recruitment.

Testing hand position
Grasp the foot using the full hand. Avoid excessive force over the first metarsal joint or over the great toe. Pressure is applied to keep the foot in full plantarflexion

Vector of force
Pressure is applied through the broad contact in the direction of eversion. This force is from inferior to superior and medial to lateral in an arc.

Common Errors Excessive pressure is applied over the first metatarsal creating oain. Bony parts of the testers hand are used. Patient recruits using the tibialis anterior muscle as evidenced by elevation of the tendon.

If you are interested in learning more, please attend the ICAK-U.S.A.

Muscle Testing Course. CLICK HERE to learn more about this course.