Posterior Tibialis- step 2

As you may recall from our intro post on kinesiology taping, we’re going to focus on each muscle group/joint and show you how to use kinesiology tape in three distinct ways:

  1. Immediately after injury  (for swelling and pain
  2. During the healing process (correction techniques to restore normal position and allow for healing)
  3. Techniques to help improve strength + function

In our last post on the calf, we reviewed taping applications for pain and swelling (you can review that here). In this post, we’ re going to be talking about taping techniques that are trying to decrease the activity of the posterior tibialis muscle. This is perfect for recovering muscles where you want to provide support and allow for rest so that the injured muscle/tendon can heal.

This type of application is called an inhibition technique. The key for using it is to use the anatomy! Remember, the tape is specifically made to pull on itself. That is what the weird spirals and shapes are when you look a the back of the tape. When trying to inhibit the muscle, you want the tape to move from the muscle insertion to origin so that when the tape pull on itself, it results in an eccentric pull (eccentric = lengthening of the muscle). This is ideal for trying to diminish the contraction which will allow for rest and more importantly recovery.

Muscle origin & insertion

This muscle is located deep to both the soleus and gastroc. It runs down the middle of the back of your lower leg before moving towards the inside of the leg and down the tibia. It’s tendon can be felt as it wraps around the inside ankle bone (medial malleolus) and inserts into the arch of your foot. The reason that I want to involve this muscle is that it is frequently involved in plantar fasciitis/heel injuries and is a sight of tendonitis behind the ankle. The post tib helps support the arch and maintain heel position as you step onto your foot. From a muscle action perspective, the post tib plantar flexes the ankle (points the toes down) and inverts the calcaneous (points the toes in towards the midline of the body). As the larger calf muscles fatigue/stiffen, it is very common for the posterior tib to help compensate by helping with push off and toe clearance. The result is frequently the foot swinging through with the arch positioned up towards the sky instead of down towards the ground. The post tib can also be a source of “shin splints” because of this.

In the second picture it is the red muscle. While it’s deep to the larger gastroc/soleus muscles, it can be easily found on the inside part of your leg where it comes out near the bone, becomes a tendon and then runs down the leg, behind your ankle bone and wraps into the arch of your foot. Start by sitting cross legged (on the floor or in a chair) with the inner ankle bone up towards the sky. With your thumbs on the tibia bone in the middle of the calf between knee and ankle, slide backwards an inch or so into the muscle. Using just your ankle, try to supinate your foot (lift your arch up towards the ceiling). You will feel the muscle move under your thumbs.

Origin: Back of the lower leg between the tibia and fibular just below the knee.

Insertion: The posterior tib travels from the outside of the lower leg in a diagonal direction behind the inner ankle bone (medial malleolus) and into the arch.

What you will need:

1) Roll of kinesiology tape

2) Sharpest scissors in the house.

Prep work:

1) Clean skin. This means no oils or lotions of any kind. You want your skin to be clean and more importantly dry. Moisture of any kind = tape will fall off or fail to stick altogether.

2) Hair care. Ideally, the less hair the better. Guys, this means that for best results you will need to trim any long leg hair or shave the calf area.

3) If clean, dry, and hairless skin still = no sticking of tape. Time to get some adhesive spray like Tuf Skin.

4) The tape should last 3-5 days. You can get it wet and shower with it on. Just towel dry it after. No hair dryer! The tape is heat activated. ;)

Taping Techniques

1) Posterior Tibialis

Key Points:

  • The tape must run from the muscle insertion to origin. In the case of the posterior tibialis muscle, this means from under the arch, behind the inner ankle bone, and the back of the leg.
  • Prep the skin first and then place the muscle on stretch. For the posterior tib this means having the ankle dorsiflexed (toes + ankle pulled up towards the knee) and the foot rotated out (eversion).
  • Apply primary strip WITHOUT tension. The tape works by pulling on itself. Lay the anchor down first (last 1-2″ of the tape), apply the tape and then rub the tape to warm up and activate the adhesive.
  • A secondary correction strip can be applied behind the medial malleolus to help correct heel position. Cut the tape so that it is long enough to cover the behind the malleolus with 1″ of tape on either side. Round the edges, apply 50-75% stretch and place the tape. Then remove the paper backing and lay down the ends. Don’t sweat the 50-75%. Think medium stretch versus maximum “how far can I pull this tape” kind of stretch.
  • In some cases, posterior tibialis symptoms can move into the arch itself. For this, you may want to try applying a plantar fascia strip first. In this case, apply the fascia strip, the primary inhibition strip, and then the correction strip.
  • See the video above for full details.

References

1) Capobianco, Dr. Steven and van den Dries, Greg. (2009). Power Taping, 2nd Edition, Rock Tape Inc, Los Gatos, CA.

2) Hammer, Warren. (2007). Functional Soft-Tissue Examination and Treatment by Manual Methods, 3rd edition. Jones and Bartlett Publishers, Inc, Sudbury, MA.

3) Kase, Kenzo, Wallis, Jim, and Kase, Tsuyoshi. (2003). Clinical Therapeutic Applications of the Kinesio Taping Method.

4) Muscolino, Joseph. (2009). The Muscle and Bone Palpation Manual. Mosby, Inc, St. Louis, MO.