Activation and Strengthening of Tibialis Anterior

 Tibialis Anterior

The Tibialis anterior is a main dorsiflexor of the foot. But due to various pathological and biomechanical changes in our body, we tend to use other syregist dorsiflexors rather than Tib. Anterior. This leads to the inactivation of Tibialis Anterior and that can cause various medical conditions.

Causes & Effects

The main causes include,

• Hemiplegia
• Parkinsons
• Bad Gait pattern
• Effusion/ Edema 

The adverse effects include,

• Overactivity of toe extensors
• Defect in Anticipatory postural adjustment (APA)
• Contralateral tensor fascia latae (overactive)
• Medial tibila stress syndrome (Shin splints)

Palpation

In order to palpate the Tibialis Anterior of a patient,

• First get him in supine lying and place a resisting hand on the medial side of the distal foot.
• By putting the resistance we resist the Dorsiflexion and Inversion (By Tib Anterior).
• As the patients dorsiflexes, the tendon of Tib Anterior is easily visible on the anterior/medial side of the ankle.
• We palpate the muscle here and then trace it back to its origin at the lateral tibial condyle.

Activation and Strengthening

Preparations of the exercise;

• Have the patient in somewhat long sitting position.
• We use bands in this exercise, so first tie a knot on one of the supports of the table to make a loop.
• We put the patient's foot inside the loop, and place the loop at the base of foot.
• So that, less moment arm produces less resistance and the talar joints may not be affected.
• In order to inhibit the toe extensors from doing the work, we flex the toes as we go into dorsiflexion.
  
  
  

Stages of Exercise

1. First stage includes, dorsiflexion with toes flexion as the foot goes into dorsiflexion. Hold the muscle there.
2. Improve the hold time at least upto 30 seconds.
3. Now have your patient to be supported on his elbows, Now we dorsiflex, flex the toes and lock the knee in extension (hold).
   
   
   
4. Then do the above and squeeze the quads. (hold)
5. Then do the above and squeeze the gluts. (hold)

Strengthening Exercise

We use bands to resist the dorsiflexion and inversion and then do the movements in order to strengthen the Tibialis Anterior.

Benefits of Exercise

• The tibialis anterior is a very major decelerator of the foot during gait. It is the sole muscle that prevents foot slap and controls the planterflexion during the gait (Better HEAL STRIKE).
• These exercises can impact the commonly underactive muscles of the lower limb and activate them.
• Better Anticipatory Postural Adjustment (APA) which in turn relaxes the ITB of its overactivity.