Therapeutic goals
Reduction of pain and inflammatory phenomena.
Improved flexibility of the musculotendinous complex of the ankle.
Specific strengthening of the tibialis posterior and the stabilisers of the foot arch.
Improved neuromuscular control of the foot and ankle.
Correction of biomechanical problems (particularly excessive pronation).
Prevention of recurrence and a gradual return to sporting activities.
Techniques used
Pain-relieving physiotherapy modalities as indicated. Massage therapy and myofascial release of the posterior compartment muscles. Soft tissue mobilisation of the tibialis posterior tendon.
Progressive stretching of the triceps surae. Stretching of the fibular muscles and the posterior chain. Ankle and foot mobility work (dorsiflexion and subtalar mobility).
Progressive strengthening of the tibialis posterior, intrinsic foot muscles, triceps surae and ankle stabilisers. Eccentric work with control of pronation.
Single-leg balance exercises. Work on wobble boards or proprioceptive cushions. Control of ankle-knee-hip alignment during foot contact.
Progressive retraining in walking and then sports activities. Work on foot loading control and stability of the foot arch. Advice on load management and prevention.
Exercise programme
- Foot inversion against band resistance
- Plantar flexion with inversion against an elastic band
- Calf raises on both legs, then on one leg
- Heel raises while maintaining the foot arch
- Short foot exercise (activation of the intrinsic foot muscles)
- Picking up objects with the toes
- Walking on tiptoe
- Eccentric work with control of pronation
Protocol details
Injury related to this protocol
Ce protocole de rééducation est spécifiquement conçu pour la prise en charge de tibialis posterior tendinopathy.
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