How to offload Tibialis Posterior when running
Most running injuries are caused by overload to a tissue. You can help reduce this overload in several ways:
- strengthen other structures around the injured area
- reduce the load going through the injured tissue
- reduce the distance/intensity to a manageable level
- cross training so you avoid doing the repetitive movement that caused the injury
- improve ROM at a joint further up/down the chain
The last blog looked at the Tibilais Posterior and how that can be overloaded. Its main role as we know is to support the arch of the foot. Poor running style often involves an overstride and a heavy heel strike (as shown in the pic below)
The video below shows a heavy heel strike creating an excessive load through the tibialis posterior
As the body moves over the foot, the tibialis posterior has to help support the heavily loaded arch and then assist the calf muscles in pushing the body up over the foot. This isn’t what these muscles are designed to do. During running they should act like springs; as the foot makes contact with the ground the force goes down into the ground then comes back up (Newtons 3rd Law) Stored energy is available at each foot strike so we shouldn’t have to rely on the lower leg muscles to create energy to push us up over our foot. One way you can help reduce the load on your lower leg muscles is to work on improving your running form to help reduce the load on the Tibilais Posterior. Your aim is to reduce the time in contact with the ground and make each foot fall as light as possible with a mid foot landing. The Tibilais Posterior then has less force to overcome and is using its spring like qualities (as shown in the pic below)
The video above shows a faster cadence at the same speed and a more midfoot landing.
Some simple tips to improve your running form to help offload your Tibilais Posterior are:
1- increase your cadence- if you increase your cadence by 10 % you can decrease the braking force and peak force going through your hips and knees. Using a metronome is a good way to help increase your cadence
2- run taller- feel like you are being drawn up from your spine.
3- run lighter- aim to pick your ankles up quicker to aid a faster cadence and try to spend as little time in contact with the ground as possible
4- imagine you are running on hot coals
With all these elements in place; reduced training, load, strengthening exercises, knowledge of why your injury has happened, gait retraining and a bit of patience you can begin your rehab journey. As with any rehab journey it isnt always plain sailing and there are ups and downs along the way but perseverance and patient and the two key elements to a successful outcome.
If you are concerned about ongoing arch pain or want help to improve your gait then KHPhysiotherapy offers assessment services for both injuries and running gait.
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