Hi, I’m Dr. Eric Cobb of Z-Health Performance.
Today, we’re going to be talking about medial ankle pain and shin splints.
I’m going to go through two of my favorite exercise to help deal with this condition.
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So the muscle that we’re going to be focusing on today for these particular exercises is the Tibialis Posterior or Posterior Tib.
You can actually look that up and see where it runs in the leg.
I’m not going to do an anatomy lesson.
The main thing that I want you to know is that this muscle is involved in plantar flexion.
So in other words, pointing the toes down and then inverting the ankle, as if you were moving toward an ankle sprain. The other thing that this muscle does is it helps stabilize the medial arch of the foot. So many people that have, maybe overpronation, they have a dropped navicular, or they have what’s called a posterior tibial tendon dysfunction.
These can all show up as medial ankle pain. So this is a very important muscle for us to know how to address. The first exercise I want to cover is going to be pretty simple. You need a ball. I’m using one of my favorite ones from my juggling set because it’s nice and soft. So the first exercise is a calf raise, but it’s going to be focused on the Tibialis Posterior.
The way that we’re going to do this is we’re going to use something for balance. Now I’m using a stick from Stick Mobility here, because I don’t want to film by a wall.
If you can stand by a wall, stand by a wall, particularly in the beginning as we do this exercise.
What you’re going to do is you’re going to take the ball, you’re gonna put it down, and you want it to be between your heels.
It needs to be behind and below your medial malleolus, which is your inside ankle bone.
So we’re going to take it all the way to the back here.
Some people when they teach this exercise, say, “hey, you can externally rotate your feet a little bit.” I do a couple different variations with feet externally rotated and feet in neutral.
So I’m going to start you with just a little bit of external rotation.
Now, the first thing that you’re going to do is you’re just going to grab the ball with your feet and you’re going to elevate just a little bit.
Now, as you begin going further up into the calf raise, you’re going to squeeze your heels together to hold onto the ball.
That’s going to cause your ankles to move like this. They’re going to invert. Alright? So again, we lift.
We squeeze the ball with our heels and then we elevate.
Try to keep all of your toes on the ground in the beginning just to make sure that you have some stability.
As you get stronger with the exercise, you can do this keeping your toes off the ground, and you’ll feel the contraction even more strongly because we’re removing a couple of the muscles that assist the tibialis posterior as we do that. So this is the first exercise.
It’s very powerful. Normally, when you do this, because this muscle should have a lot of endurance, you want to aim for a relatively high repetition count. Probably in the twenty to forty range. You can also focus on a slow lowering to make it a little bit more effective. Alright?
So that’s exercise number one.
The second exercise I want to go through with you is one of my favorite band exercises for this particular muscle.
You’re going to need an exercise band. I’m using a FlexVit band because I like how thick it is and it’s very comfortable on the foot.
In order to do this effectively, you’re going to have to double the band up as I have, and I’m going to put it underneath, for this exercise, my left foot, and we’re going to be focusing on my right posterior tibialis.
I’m going to cross my legs and I’m going to pull the band basically over the midfoot.
You can play with different positions of the band depending on how much leverage you want to create. Now from here, you want to get into a nice comfortable sitting posture, but make sure that you’re staying nice and tall.
We don’t want a lot of pressure or stress on your low back as you do this. In the beginning, I’m going to allow my foot to basically be in neutral.
I’m not going to point my toes. I’m not going to pull my toes up. Basically neutral.
What I want to do is allow the band to pull my foot toward the ground, and then I’m simply going to lift it up.
But again, imagining that ball is here, I’m trying to invert my ankle. Alright? So as you do this, you’re going to feel, for many people, a pretty intense activation of this particular muscle.
Some people get foot cramps almost immediately. So if you start to cramp up anywhere, obviously, stop and shake it out. So we’re going to do ten to twenty reps here.
We’re then going make it a little bit more complex by getting into that nice tall seated position, pointing our toes down. Remember, plantar flexion.
We’re going to hold that planar flexion as we repeat that exercise.
You can also again focus on a slow lowering and maybe faster contraction up. So we’re going to do ten to twenty repetitions in the first round, ten to twenty repetitions in the second round.
Most people, when I have them do these two exercises, even if they’ve been experiencing some pretty significant ankle pain on the on the inside, or shin splints, as soon as they start walking when they’re done, they’ll say, “wow, my feet feel very different.” Alright. So go slowly with these.
Obviously, always clear these things with your health care team, but I think you’ll find these very effective, so please let us know how they work for you.
