Tibialis Posterior: Difference between revisions
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[[File:Tibialis-posterior-location.jpg|right|frameless|626x626px]]The '''Tibialis Posterior''' is located deep in the posterior compartment of the lower leg and situated between the [[Flexor digitorum longus|Flexor Digitorium Longus]] and the [[Flexor hallucis longus|Flexor Hallucis Longus]]. It is a key stabilising muscle supporting the medial [[Arches of the Foot|arch of the foot]]. | [[File:Tibialis-posterior-location.jpg|right|frameless|626x626px]]The '''Tibialis Posterior''' is located deep in the posterior compartment of the lower leg and situated between the [[Flexor digitorum longus|Flexor Digitorium Longus]] and the [[Flexor hallucis longus|Flexor Hallucis Longus]]. It is a key stabilising muscle supporting the medial [[Arches of the Foot|arch of the foot]]. | ||
=== Origin <ref name=":0">Drake RL, Vogl W, Mitchell AWM. Gray's Anatomy for Students. 2nd Ed. Philadelphia: Churchill Livingstone Elsevier, 2010.</ref> | === Origin === | ||
The origin of the muscle is<ref name=":0">Drake RL, Vogl W, Mitchell AWM. Gray's Anatomy for Students. 2nd Ed. Philadelphia: Churchill Livingstone Elsevier, 2010.</ref>: | |||
Proximal postero-lateral aspect of the tibia. | Proximal postero-lateral aspect of the tibia. | ||
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Mid portion: Situated in the deep posterior compartment of the lower leg and runs proximal to the medial malleoli where it is secured by the flexor retinaculum. | Mid portion: Situated in the deep posterior compartment of the lower leg and runs proximal to the medial malleoli where it is secured by the flexor retinaculum. | ||
=== Insertion | === Insertion === | ||
The major insertion is onto the [[navicular]] and the plantar slip attaches to the medial cuneiform | The major insertion is onto the [[navicular]] and the plantar slip attaches to the [[Cuneiforms|medial cuneiform]] bone<ref name=":0" />. | ||
=== Nerve | === Nerve === | ||
[[Tibial Nerve|Tibial Nerve (L4-S3)]] | [[Tibial Nerve|Tibial Nerve (L4-S3)]]<ref name=":0" /> | ||
=== Artery<ref name=":0" /> | === Artery === | ||
[[Tibial Artery]]<ref name=":0" /> | |||
== Function == | == Function == | ||
To plantarflex and invert the [[Ankle & Foot|ankle]]. It also plays an important role in stabilising the medial longitudinal arch. Tibialis posterior dysfunction can lead to flat feet in adults. | To plantarflex and invert the [[Ankle & Foot|ankle]]. It also plays an important role in stabilising the medial longitudinal [[Arches of the Foot|arch]]. Tibialis posterior dysfunction can lead to flat feet in adults. | ||
|{{#ev:youtube|9N_eR8Pojuw|400}} <ref>nabil ebraheim. Anatomy Of The Tibialis Posterior Muscle - Everything You Need To Know - Dr. Nabil Ebraheim. Available from: https://www.youtube.com/watch?v=9N_eR8Pojuw [last accessed: 25/6/18]</ref> | |{{#ev:youtube|9N_eR8Pojuw|400}} <ref>nabil ebraheim. Anatomy Of The Tibialis Posterior Muscle - Everything You Need To Know - Dr. Nabil Ebraheim. Available from: https://www.youtube.com/watch?v=9N_eR8Pojuw [last accessed: 25/6/18]</ref> | ||
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* [[Posterior Tibial Tendon Dysfunction|Tibialis Posterior Tendon Dysfunction]] (TPTD) is thought to be the likely cause in most cases of adult acquired flatfoot<ref>Semple R, Murley GS, Woodburn J, Turner DE. Tibialis posterior in health and disease: a review of structure and function with specific reference to electromyographic studies. J Foot Ankle Res. 2009;2:24. doi: 10.1186/1757-1146-2-24. </ref> | * [[Posterior Tibial Tendon Dysfunction|Tibialis Posterior Tendon Dysfunction]] (TPTD) is thought to be the likely cause in most cases of adult acquired flatfoot<ref>Semple R, Murley GS, Woodburn J, Turner DE. Tibialis posterior in health and disease: a review of structure and function with specific reference to electromyographic studies. J Foot Ankle Res. 2009;2:24. doi: 10.1186/1757-1146-2-24. </ref> | ||
* In foot drop (High steppage gait) as a result of deep [[Common Peroneal Nerve|peroneal nerve palsy]], transferring the posterior tibialis tendon to the dorsum of the foot is a surgical tendon transfer procedure carried out to compensate for the loss of dorsiflexion due to [[Tibialis Anterior|tibialis anterior]] paralysis.<ref>Yeganeh A, Motaghi A, Shahhoseini G, Farahini H. New method for fixation point of tibialis posterior tendon transfer. Med J Islam Repub Iran. 2013;27(4):163-167.</ref> | * In [[foot drop]] (High steppage gait) as a result of deep [[Common Peroneal Nerve|peroneal nerve palsy]], transferring the posterior tibialis tendon to the dorsum of the foot is a surgical tendon transfer procedure carried out to compensate for the loss of dorsiflexion due to [[Tibialis Anterior|tibialis anterior]] paralysis.<ref>Yeganeh A, Motaghi A, Shahhoseini G, Farahini H. New method for fixation point of tibialis posterior tendon transfer. Med J Islam Repub Iran. 2013;27(4):163-167.</ref> | ||
== Assessment == | == Assessment == |
Revision as of 09:09, 3 May 2021
Description[edit | edit source]
The Tibialis Posterior is located deep in the posterior compartment of the lower leg and situated between the Flexor Digitorium Longus and the Flexor Hallucis Longus. It is a key stabilising muscle supporting the medial arch of the foot.
Origin[edit | edit source]
The origin of the muscle is[1]:
Proximal postero-lateral aspect of the tibia.
Proximal postero-medial aspect of the fibula and the interosseous membrane
Mid portion: Situated in the deep posterior compartment of the lower leg and runs proximal to the medial malleoli where it is secured by the flexor retinaculum.
Insertion[edit | edit source]
The major insertion is onto the navicular and the plantar slip attaches to the medial cuneiform bone[1].
Nerve[edit | edit source]
Artery[edit | edit source]
Function[edit | edit source]
To plantarflex and invert the ankle. It also plays an important role in stabilising the medial longitudinal arch. Tibialis posterior dysfunction can lead to flat feet in adults.
|
Clinical relevance[edit | edit source]
- Tibialis Posterior Tendon Dysfunction (TPTD) is thought to be the likely cause in most cases of adult acquired flatfoot[3]
- In foot drop (High steppage gait) as a result of deep peroneal nerve palsy, transferring the posterior tibialis tendon to the dorsum of the foot is a surgical tendon transfer procedure carried out to compensate for the loss of dorsiflexion due to tibialis anterior paralysis.[4]
Assessment[edit | edit source]
Resisted Muscle Test:
Strengthening exercises for Tibialis Posterior:
References[edit | edit source]
- ↑ 1.0 1.1 1.2 1.3 Drake RL, Vogl W, Mitchell AWM. Gray's Anatomy for Students. 2nd Ed. Philadelphia: Churchill Livingstone Elsevier, 2010.
- ↑ nabil ebraheim. Anatomy Of The Tibialis Posterior Muscle - Everything You Need To Know - Dr. Nabil Ebraheim. Available from: https://www.youtube.com/watch?v=9N_eR8Pojuw [last accessed: 25/6/18]
- ↑ Semple R, Murley GS, Woodburn J, Turner DE. Tibialis posterior in health and disease: a review of structure and function with specific reference to electromyographic studies. J Foot Ankle Res. 2009;2:24. doi: 10.1186/1757-1146-2-24.
- ↑ Yeganeh A, Motaghi A, Shahhoseini G, Farahini H. New method for fixation point of tibialis posterior tendon transfer. Med J Islam Repub Iran. 2013;27(4):163-167.
- ↑ Sheena Livingstone. Tibialis Posterior Muscle Test. Available from: http://www.youtube.com/watch?v=7cEJD-9aBTk [last accessed 25/6/18]
- ↑ PolkStatePTA. Tibialis Posterior. Available from: http://www.youtube.com/watch?v=f-vVv59NNBI [last accessed 25/6/18]