Posterior Tibialis: Attaches proximally to post aspect of tibia and distally attaches to almost everything under the foot (cuboid, navicular, cuneiforms).  During pronation (loading phase) it eccentrically controls tibial advancement in the sagittal plane(SP), tibial internal rotation in the transverse plane(TP) and eccentrically controls lateral to medial loading of the foot in the frontal plane(FP).

Soleus: Attaches proximally to post surface of tibia and distally forms achilles tendon to attach slightly medial on the calcaneus.  During the loading phase it eccentrically controls tibial advancement in the sagittal plane, tibial internal rotation in the transverse plane and calcaneal eversion in the frontal plane.

In most anatomy classes it is taught that the function of the posterior tibialis. is to plantar flex (point) and invert the foot and the soleus plantar flexes the foot.  Unfortunately, when your foot is on the ground this does not and cannot happen as was explained above.  After an injury or surgery many people walk on a bent knee.  Assuming they have full passive extension, the problem is a posterior tibialis and soleus that are not functioning properly.  When the foot hits the ground and begins to pronate, the soleus is ecc. controlling calcaneal eversion (FP), the post. tib. and soleus are ecc. controlling tibial advancement(SP) and internal rotation(TP) and the tib. post. is controlling the lateral to medial loading of the foot.  This all occurs through late mid stance of gait (normal pronation).  Then the foot/leg begin to supinate (unload) in order to lock up the joints to push off on a rigid lever.  The soleus inverts the calcaneus while the post. tib. and soleus concentrically “pull” back on the tibia and externally rotate it.  Meanwhile momentum is carrying the rest of the body “over the top” and thats what creates knee extension during gait.  It really has nothing to do with the quad, which is taught in school to extend the knee.  School anatomy really didnt prepare me or others to treat movement dysfunction and injury in the real world.  Thank goodness I was fortunate to meet Gary Gray early in my career.  He really opened my eyes to true “functional anatomy.”  For that I am grateful.

It is truly a never ending journey.

Get Strong! Stay Strong!

Chris

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Comments
  1. judith hoare says:

    Very interesting. i have high arched feet but one is wider and weaker than the other. I THINK – is could be insidious onset of PTD or Adult acquired flatfoot. Do you have any idea of how I could strenthen the posterior tibail tendon? It seems weak in one foot and have turned in knee and weak glutes – chicken and egg problem i reckon? Which caused which – but a sad weak hurting foot is a real pain and although a female 55 yr will not be perfect, I don’t want early disability! Views very welcome!!

  2. chriskolba says:

    If you have a flat foot in standing, you don’t have high arches, even though you may see an arch in the non weightbearing position. First you need to attack your hip and corect the muscle imbalances. The butt is the power house and controls forces and motion in the lower leg. We do a lot of single leg activity to work the hip, leg and foot. We use alternating and bilateral arm motion to challenge leg/hip muscles. Start w/ simple alternating biceps curls, lateral raises and overhead presses. Progress to various level reaching ex. w/ arms and opp. foot. Multiplanar lunges w/ various arm drivers to influence the lower extremity are good .Cable resisted and assisted walks, steps and lunges are useful also. I culd go on and on but hopefully this gives you some ideas.
    Good luck and work it hard.
    Chris

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