Tibialis Posterior: The Leg Muscle You Might Not Be Training Enough

The tibialis posterior is a deep muscle located in the calf, originating on the back of the tibia (shin bone) and attaching to the bones of the midfoot. Its primary functions include:

  • Supporting the arch of the foot, helping to maintain proper alignment and weight distribution.

  • Controlling pronation or the inward rolling of the foot as you walk or run.

  • Stabilizing the ankle during weight-bearing activities, such as walking, running, or jumping.

When the tibialis posterior is functioning well, it helps you maintain good posture, balance, and mobility. However, when it becomes weak or overworked, it can lead to pain and dysfunction, especially in the arch, ankle, and even up into the knee.

Common Problems Associated with a Weak Tibialis Posterior

A weak or injured tibialis posterior can contribute to a range of issues, such as:

1. Flat feet or fallen arches: Without proper support from the tibialis posterior, the arch can collapse, leading to flat feet. This causes discomfort and improper mechanics during walking or running.

2. Posterior tibial tendonitis: When the tibialis posterior muscle becomes overworked or strained, inflammation can occur in the tendon, leading to pain along the inside of the ankle and foot.

3. Shin splints: Weakness in the tibialis posterior can contribute to excessive strain on the shin muscles, leading to shin splints, especially in runners and athletes.

4. Overpronation: Overpronation, or excessive inward rolling of the foot, is a common problem when the tibialis posterior is weak. This can lead to misalignment, pain, and injury in the ankle, knee, and hip.

Strengthening the tibialis posterior helps improve the muscle's ability to support your arch, control pronation, and stabilize your ankle. By doing so, you can reduce pain and prevent further injury. Whether you suffer from flat feet, ankle pain, or recurrent injuries, focusing on this often-overlooked muscle can make a significant difference in your foot and leg health.

Key Exercises to Strengthen the Tibialis Posterior

Note: these are suggested exercises and parameters. Please consult a professional if you are unsure if these are right for you.

Incorporating targeted exercises for the tibialis posterior into your routine is essential for improving its strength and function. Below are some of the most effective exercises you can try:

1. Calf Raises with Inward Focus

Calf raises are a classic exercise for strengthening the lower leg muscles, but to really target the tibialis posterior, try adding an inward rotation.

How to do it:

- Stand with your feet hip-width apart, holding onto a wall or chair for balance.

- Slowly raise your heels off the floor, coming up onto your toes.

- As you lift, focus on slightly rolling your ankles inward to emphasize the inner part of your calf.

- Hold for a second at the top, then slowly lower your heels back to the floor.

- Perform 3 sets of 12-15 reps.

2. Resisted Foot Inversion

This exercise directly targets the tibialis posterior by working against resistance.

How to do it:

- Sit on the floor with your legs extended straight in front of you.

- Attach a resistance band to a sturdy object and loop the other end around the inside of your foot.

- Slowly pull your foot inward against the resistance, focusing on engaging the muscles along the inside of your lower leg.

- Hold for a few seconds, then slowly return to the starting position.

- Perform 3 sets of 10-12 reps on each foot.

3. Arch Lifts

This exercise strengthens the muscles that support your arch, including the tibialis posterior.

How to do it:

- Stand with your feet flat on the floor.

- Focus on lifting your arch off the ground without curling your toes. Imagine pulling your arch up toward the ceiling.

- Hold this position for a few seconds, then relax.

- Perform 3 sets of 10 reps.

Additional Tips for Supporting Tibialis Posterior Health

- Wear supportive footwear: Proper shoes with good arch support can help reduce strain on the tibialis posterior, especially during high-impact activities like running or walking long distances.

- Stretch regularly: In addition to strengthening exercises, stretching the calf muscles and Achilles tendon can prevent stiffness and support mobility in the lower leg.

- Progress gradually: If you’re just starting out, make sure to ease into these exercises and avoid overloading the tibialis posterior too quickly. Gradual progression helps prevent strain and injury.

Strengthening the tibialis posterior is essential for maintaining healthy, pain-free movement in your feet and lower legs. By targeting this often-neglected muscle, you can reduce pain, improve stability, and protect yourself from future injuries. Incorporating the exercises above into your routine, along with good footwear and regular stretching, will keep your tibialis posterior strong and resilient.

If you struggle with ongoing foot or ankle pain, strengthening the tibialis posterior could be the missing piece of the puzzle! Consult a physical therapist if you have hip, knee or ankle pain.