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Tibialis Posterior

 

The Tibialis Posterior is a deep posterior muscle of the leg.

Anatomical Attachments:

  • Origin: Attaches to the lateral part of the posterior surface of the tibia fibula and the interosseus membrane.
  • Insertion: Attaches to the navicular bone, the cuneiform bones, the cuboid bone and the plantar surface of the base of the 2nd, 3rd and 4th metatarsal bones.

Action: Plantar flexes and inverts the foot.

Synergist: Gastrocnemius, Flexor digitorum longus, Flexor hallucis longus, Peroneus longus and brevis, Soleus, Plantaris.

Antagonist: Extensor hallucis longus, Extensor digitorum longus, Tibialis anterior, Peroneus tertius.

 

Click for Muscle Test 

 

Nerve Supply: Tibial Nerve (L5, S1).

Vascular supply: Peroneal artery.

Travell and Simons Trigger Point Pain Referral:  

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Trigger Point Signs and Symptoms: Pain in the foot when jogging or walking, it is worse when walking or running on uneven surfaces.

Trigger Point Activating and Perpetuating Factors: Persistent pronation or hyperpronation of the foot, over exercising, walking or running on uneven surfaces.

Differential Diagnosis: (Segmental, Subluxation, Somatic dysfunction) L4 L5 S1 or S2 radiculopathy, Diabetic neuropathy, Posteriomedial Shin splints, Deep posterior compartment syndrome, Tibialis posterior tendon dysfunction, Tarsal tunnel syndrome, Hammer or claw toes, Plantar fasciitis, Plantar wart, Pes cavus, Pes Planus, Osteoarthritis, Rheumatoid arthritis, gout, Bursitis, Frostbite, Neurogenic arthropathy (Charcotís Joint), Metatarsal stress fracture, Bone cancer, Sprain/strain of the ankle, Peripheral vascular disease (PVD)-Intermittent claudication, Deep Vascular Thrombosis (DVT), Ruptured Achilles tendon, Achilles tendinitis, Severís Disease, Calcaneal spur syndrome, Overuse syndrome, Systemic infections or inflammation, Nutritional inadequacy, Metabolic imbalance, Toxicity, Side effects of medication.

 

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