The Medial Foot
The Medial Foot
Ben Benjamin, PhD
Question: Which frequently injured muscle-tendon unit is the primary structure responsible for supporting the arch of the foot?
Answer: The posterior tibialis muscle-tendon unit. The posterior tibialis, often referred to as one of the "stirrup muscles," is responsible for supporting the ankle and the arch of the foot, as well as for inverting the foot. The tendon attaches at the medial arch of the foot, wraps around the medial ankle, and moves up the inner calf to the muscle which is deep within the calf, just posterior to the tibia. This muscle-tendon unit helps us to walk, run and change direction quickly.
An injury to the tendon at its attachment to the navicular bone causes intense pain at the medial arch. An injury to the body of the tendon usually causes considerable pain and sometimes swelling just behind the medial ankle. An injury to the muscle belly (which often occurs during running) causes pain at the medial aspect of the lower leg and is referred to as posterior shin splints.
Orthopedic massage usually is an effective treatment for injuries to the posterior tibialis muscle-tendon unit. Friction therapy to the tendon works well if the injury is not too severe. When the muscle belly is injured, you must massage it using a good deal of pressure to get through the gastrocnemius and the soleus muscles. In cases of frequent injury, also be alert for any misalignment of the foot and/or laxity in the medial ankle ligaments, which might be placing excess stress on this structure.
With a clear understanding of posterior tibialis injury, experienced massage therapists are well equipped to help clients with this common and troublesome condition.