0
$0.00

Tibialis Posterior Muscle: Anatomy, Function, and Its Importance to Movement and Posture

The tibialis posterior muscle is crucial for movement and posture in our lower legs. It helps with important ankle movements, like pointing your toes and turning your foot inward, which is essential for walking, running, and staying balanced.

Despite its important role, the tibialis posterior muscle is often overlooked compared to muscles like the quadriceps or hamstrings. In this post, we’ll explore what the tibialis posterior muscle is, what it does, and why it’s so crucial for both movement and posture.

What is the Tibialis Posterior Muscle?

The tibialis posterior is a deep muscle located in the lower leg, part of the posterior compartment. It lies beneath the soleus and gastrocnemius muscles, making it somewhat challenging to palpate directly.

This muscle originates from the posterior surfaces of the tibia and fibula, as well as the interosseous membrane that runs between these two bones. It then travels down the leg, wrapping around the medial malleolus (the bony prominence on the inner side of the ankle) before inserting into the navicular and medial cuneiform bones of the foot.

The flexor retinaculum, a strong fibrous band, covers the medial ankle and forms a canal for the passage of tendons and nerves, including the tibialis posterior tendon, thus reducing friction and providing support during movement.

Anatomy of the Tibialis Posterior Muscle

  • Location:
    • Deep muscle in the lower leg.
    • Part of the posterior compartment.
    • Situated beneath the soleus and gastrocnemius muscles, making it somewhat challenging to palpate directly.
  • Origin:
    • Posterior surfaces of the tibia and fibula.
    • Interosseous membrane between the tibia and fibula.
  • Pathway:
    • Travels down the leg.
    • Wraps around the medial malleolus (the bony prominence on the inner side of the ankle).
  • Insertion Points:
    • Navicular bone.
    • Medial cuneiform bone.
    • Intermediate cuneiform bone.
    • Lateral cuneiform bone.
    • Bases of the second, third, and fourth metatarsals.
  • Support Structure:
    • Covered by the flexor retinaculum, a strong fibrous band.

Functions of the Tibialis Posterior Muscle

The tibialis posterior muscle serves several crucial functions. Alongside this, flexor digitorum longus and flexor hallucis longus, located in the posterior compartment of the leg, also play significant roles in foot movement and stability. This includes:

  1. Foot Inversion: The primary role of the tibialis posterior is to invert the foot, turning the sole inward. This action is essential for maintaining balance and proper foot mechanics during walking and running.
  2. Plantar Flexion: It assists in plantar flexion, which is the action of pointing the toes downward. This movement is vital in activities such as walking, running, and jumping.
  3. Arch Support: The tibialis posterior plays a critical role in supporting the medial arch of the foot. This support helps maintain the foot’s structural integrity and prevents conditions like flat feet (pes planus).

Discover a practitioner near you.

Looking for a practitioner near you? Our extensive network of qualified professionals is here to help you.

key terms used in this explanation

Posterior Compartment: The back section of the lower leg, containing muscles that help with foot and toe movements.

Soleus and Gastrocnemius Muscles: The calf muscles are located at the back of the lower leg.

Tibia and Fibula: These are the two long bones in the lower leg. The tibia is the shinbone, and the fibula is a thinner bone parallel to it.

Interosseous Membrane: A deep fibrous sheet that connects the tibia and fibula, providing stability to the lower leg.

Medial Malleolus: The inner part of the ankle bone.

Navicular and Medial Cuneiform Bones: These are bones in the foot that help form the arch and assist in movement and stability.

Inversion: The movement of turning the sole of the foot inward.

Eversion: The movement of turning the sole of the foot outward.

Plantar Flexion: The action of pointing the toes downward.

Medial Arch: The inner arch of the foot helps absorb shock and maintain balance.

Pronation and Supination: Movements of the foot. Pronation is the inward roll, and supination is the outward roll.

Importance of Tibialis Posterior for Midfoot Wellbeing

Inversion and Eversion issues with Tibialis Posterior

The tibialis posterior muscle is vital for midfoot health, contributing to several key aspects that ensure the foot functions correctly and remains pain-free. Here’s a closer look at why this muscle is so crucial for the midfoot:

Arch Support

The tibialis posterior muscle is crucial for maintaining the foot’s medial arch. This arch is a critical structure in the midfoot that helps absorb shock and distribute weight evenly across the foot. A well-supported arch prevents the midfoot from collapsing, reducing the risk of conditions such as flat feet (pes planus).

Stability and Balance

The tibialis posterior provides stability to the midfoot by controlling the motion of the foot. This muscle helps prevent excessive pronation (inward rolling of the foot) or supination (outward rolling of the foot). Proper control of these movements ensures that the midfoot remains stable during various activities, reducing the risk of injuries.

Alignment and Mechanics

The tibialis posterior muscle helps maintain proper alignment and mechanics of the midfoot by supporting the arch and controlling foot movements. This alignment is essential for the efficient transfer of forces during walking, running, and other weight-bearing activities. Good alignment also helps prevent overuse injuries and improves overall foot function.

Prevention of Overuse Injuries

A strong and well-functioning tibialis posterior muscle can prevent overuse injuries such as posterior tibial tendon dysfunction (PTTD). PTTD occurs when the tibialis posterior tendon becomes inflamed or torn, leading to pain and difficulty walking. Maintaining the health of this muscle can prevent such conditions, including posterior tibial tendon insufficiency, and ensure the wellbeing of the midfoot.

In summary, the tibialis posterior muscle plays a pivotal role in maintaining the structural integrity, stability, and proper function of the midfoot. Ensuring its strength and health is essential for overall foot health and preventing various midfoot-related issues.

Importance of Tibialis Posterior to Movement

The tibialis posterior muscle is indispensable for efficient and effective movement. Its involvement in foot inversion and plantar flexion means it is actively engaged during activities that require pushing off the ground, such as walking, running, and jumping. Without the proper functioning of this muscle, movements can become uncoordinated, and the risk of injury increases.

Moreover, the tibialis posterior aids in stabilizing the foot during dynamic activities. When you walk or run, the muscle (with the help of other muscles such as Tibialis Anterior) helps control the motion of the foot, ensuring that it moves in a smooth, controlled manner. This stability is crucial for preventing excessive pronation (rolling inward of the foot) or supination (rolling outward of the foot), both of which can lead to various lower limb injuries. Tibialis posterior dysfunction can significantly impact this stability, often resulting in conditions like flat feet and contributing to pain and dysfunction in the ankle region.

Importance of Tibialis Posterior to Posture

The tibialis posterior muscle plays a crucial role in maintaining the medial arch of the foot, which directly impacts posture and the entire kinetic chain. The kinetic chain refers to the interconnected system of muscles, bones, and joints that work together to produce movement. Here’s how the tibialis posterior and foot health influence overall postural integrity:

Medial Arch Support and Shock Absorption

The foot’s medial arch acts as a natural shock absorber, helping distribute body weight evenly across the lower limbs. The tibialis posterior muscle is essential for keeping this arch elevated and stable. 

Proper arch support allows for efficient weight distribution and shock absorption during movement, preventing excessive stress on other parts of the kinetic chain, such as the knees, hips, and lower back.

Impact of a Weak or Dysfunctional Tibialis Posterior

When the tibialis posterior muscle is weak or dysfunctional, it can collapse the medial arch, resulting in flat feet. Flat feet can cause a chain reaction of postural issues, starting with overpronation (excessive inward rolling of the foot). Overpronation alters the alignment and biomechanics of the entire lower limb, leading to:

  • Knee Misalignment: Overpronation can cause the knees to turn inward, leading to “knock knees” (genu valgum). This misalignment increases the risk of knee pain and injuries, such as patellofemoral pain syndrome or anterior cruciate ligament (ACL) injuries.
  • Hip and Pelvic Imbalance: The altered foot mechanics and knee alignment can affect the hips and pelvis. Overpronation can cause the hip to rotate inward, leading to an imbalance in the pelvic region. This imbalance can result in hip pain, tightness, and conditions like iliotibial band syndrome.
  • Lower Back Strain: The imbalances and misalignments in the lower limbs and pelvis can extend to the lower back. The compensatory patterns developed due to flat feet and overpronation can lead to chronic lower back pain and an increased risk of conditions such as lumbar strain or herniated discs.

Functional Leg Length Discrepancy

The tibialis posterior can also influence functional leg length discrepancy. In this condition, one leg appears shorter than the other due to muscle imbalances or postural issues rather than an actual difference in bone length. When the tibialis posterior muscle is weak or dysfunctional, leading to a collapsed medial arch and overpronation, it can cause one foot to flatten more than the other. This uneven flattening can create an apparent difference in leg length, affecting gait and posture.

  • Impact on Gait: A functional leg length discrepancy can cause an uneven gait, leading to further compensatory patterns in the body. This can place additional stress on the knees, hips, and lower back, exacerbating pain and increasing the risk of injury.
  • Postural Imbalance: The body may compensate for the discrepancy by tilting the pelvis, which can lead to a cascade of postural imbalances. This can affect the spine’s alignment, resulting in scoliosis (a sideways curvature of the spine) or other postural deviations.

Maintaining a Neutral and Balanced Posture

Proper functioning of the tibialis posterior muscle is essential for maintaining a neutral and balanced posture. By supporting the medial arch, this muscle helps ensure that the feet provide a stable foundation for the body. A stable foundation reduces the risk of compensatory patterns and musculoskeletal problems throughout the kinetic chain.

  • Foot Health and Overall Posture: Healthy feet with well-maintained arches allow for proper alignment of the ankles, knees, hips, and spine. This alignment ensures efficient movement patterns and reduces the risk of strain and injury. Proper foot mechanics and alignment also promote better balance and stability during daily activities and physical exercises.
  • Preventing Chronic Pain and Injuries: By maintaining the health and strength of the tibialis posterior muscle, individuals can prevent the collapse of the medial arch and avoid the cascade of postural issues leading to chronic pain and injuries. Regular strengthening exercises, proper footwear, and attention to foot mechanics can significantly enhance overall postural integrity.

Overall, the tibialis posterior muscle is pivotal in maintaining the medial arch and ensuring the stability and alignment of the entire lower limb. Its proper functioning is crucial for overall foot health, influencing the entire kinetic chain and overall postural integrity. By focusing on the health of this muscle, individuals can promote better posture, prevent compensatory patterns, and reduce the risk of chronic pain, musculoskeletal problems, and functional leg length discrepancies.

Common Issues with the Tibialis Posterior

Posterior Tibial Tendon Dysfunction (PTTD)

Tibialis posterior tendon dysfunction, also known as adult-acquired flatfoot, occurs when the posterior tibial tendon becomes inflamed or torn. This condition can lead to the gradual flattening of the foot’s arch, resulting in flat feet. Symptoms include pain along the inner side of the foot and ankle, swelling, and difficulty walking.

Tendinitis

Tendinitis is the inflammation of the tendon, often caused by overuse or repetitive stress. The posterior tibial artery supplies blood to the tibialis posterior muscle, and its role is crucial in the context of tendinitis, as adequate blood flow is essential for healing. It can result in pain, tenderness, and swelling along the course of the tendon, particularly around the ankle and foot. Activities like running, jumping, or prolonged walking can exacerbate the symptoms.

Tendon Tears or Ruptures

The posterior tibial tendon can wholly or partially tear due to trauma or degeneration. When comparing imaging characteristics, the Achilles tendon often shows different patterns of degeneration and tear compared to the tibialis posterior tendon. A tear or rupture often leads to severe pain, swelling, and a noticeable loss of foot arch support. In severe cases, it can result in a complete collapse of the foot’s arch.

Overpronation

Overpronation, where the foot rolls inward excessively while walking or running, can strain the tibialis posterior muscle and tendon. This strain can lead to pain and dysfunction over time, contributing to conditions like PTTD.

Flat Feet (Pes Planus)

A weakened or dysfunctional tibialis posterior muscle can lead to flat feet. The muscles and tendons are essential for supporting the medial arch of the foot. When they fail to provide adequate support, the arch can collapse, resulting in flat feet and associated discomfort.

Shin Splints

Shin splints refer to pain along the shinbone (tibia) and can be related to overuse or excessive stress on the tibialis posterior muscle. This condition often occurs in athletes or individuals who engage in high-impact activities without proper conditioning.

Tarsal Tunnel Syndrome

Tarsal tunnel syndrome occurs when the tibial nerve, which runs along the tibialis posterior tendon, becomes compressed. This compression can cause pain, numbness, and tingling along the inner ankle and foot. Issues with the tibialis posterior muscle and tendon can exacerbate the condition.

Tibialis Posterior Preventive Measures and Treatment

To maintain the health of the tibialis posterior muscle and tendon and prevent these issues, consider the following measures:

  • Strengthening Exercises: Strengthening the tibialis posterior through specific exercises can enhance its function and support.
  • Proper Footwear: Wearing supportive shoes with adequate arch support can prevent overpronation and provide stability.
  • Stretching: Regularly stretching the muscles and tendons of the lower leg can improve flexibility and reduce the risk of injury.
  • Orthotics: Custom orthotics can provide additional support and correct biomechanical issues contributing to dysfunction.
  • Rest and Recovery: Allowing adequate rest and avoiding overuse can prevent inflammation and tendon injuries.
  • Medical Intervention: In cases of severe pain or dysfunction, seeking medical advice is crucial. Treatments may include physical therapy, anti-inflammatory medications, or, in some cases, surgery.

Understanding these potential issues and taking proactive steps to maintain the health of the tibialis posterior muscle can significantly reduce the risk of injury and ensure better foot function and overall mobility.

Finally

The tibialis posterior muscle, though often overlooked, is a cornerstone of lower limb function and postural integrity. Its roles in foot inversion, plantar flexion, and arch support are vital for smooth, coordinated movement and maintaining proper posture. Strengthening and maintaining the health of this muscle can prevent injuries and contribute to overall biomechanical efficiency, underscoring its importance in both movement and posture.

Understanding and appreciating the tibialis posterior muscle’s functions and significance can lead to better preventative care and targeted therapeutic strategies for those experiencing lower limb issues. Whether you are an athlete, a fitness enthusiast, or someone simply looking to improve their postural health, paying attention to the tibialis posterior muscle can make a substantial difference.

Resources

Articles:

Impact on Gait and Functional Leg Length Discrepancy

  • Evidence-Based Diagnosis and Treatments of Posterior Tibialis Tendinopathy
    • Research featured in Current Physical Medicine and Rehabilitation Reports discusses how tibialis posterior tendon dysfunction (TPTD) affects gait mechanics. The study found that individuals with TPTD exhibit altered foot kinematics compared to healthy controls, leading to functional leg length discrepancies. These discrepancies cause uneven gait patterns, further stressing the lower limb joints and contributing to musculoskeletal pain and postural deviations. Proper management of TPTD through strengthening exercises and orthotic interventions can help mitigate these effects and improve overall gait and posture​

 

Tibialis Posterior in Health and Disease

    • Research published in the Journal of Foot and Ankle Research highlights the crucial role of the tibialis posterior muscle in maintaining foot stability and the medial longitudinal arch. Electromyographic (EMG) studies demonstrate that the tibialis posterior muscle is actively engaged during walking, particularly in the stance phase, which helps stabilize the foot and support the arch. Dysfunction of this muscle can lead to conditions such as posterior tibial tendon dysfunction (PTTD), which is a common cause of adult-acquired flatfoot. This condition underscores the importance of the tibialis posterior in foot mechanics and overall lower limb stability

PLEASE NOTE

PostureGeek.com does not provide medical advice. This information is for educational purposes only and is not intended to be a substitute for professional medical attention. The information provided should not replace the advice and expertise of an accredited health care provider. Any inquiry into your care and any potential impact on your health and wellbeing should be directed to your health care provider. All information is for educational purposes only and is not intended to be a substitute for professional medical care or treatment.

About the author

Nicholas Barbousas is the founder of PostureGeek.com and an experienced therapist with extensive expertise in human movement and physical conditioning. With over 30 years in the profession, he specializes in Rolfing Structural Integration, utilizing proven methods to enhance body alignment and functional health. As an educator and author, Nick has developed comprehensive programs in manual therapy, myofascial release, and fitness training, advancing the practice of manual and movement therapies through his contributions to PostureGeek.com.

Join our conversation online and stay updated with our latest articles.

Find Expert Posture Practitioner Near You

Discover our Posture Focused Practitioner Directory, tailored to connect you with local experts committed to Improving Balance, Reducing Pain, and Enhancing Mobility.

Receive the latest news

Subscribe Now To Our Newsletter

Get the latest News, Tips, and Research on posture awareness straight to your inbox.