Exercises / Leg & ankle

Resisted foot adduction (tibialis posterior)

Strength
Leg & ankle
Elastic band

Sliding the forefoot inward against a band with the heel as a pivot. The most selective tibialis posterior exercise on MRI.

Also called tib post exercise, resisted inversion, closed chain foot adduction.

Log this in Hazumo

Where you stand

No published distribution for this exercise yet. We add one only from a peer-reviewed study.

Muscles worked

Filled: primary. Outlined: secondary.

How much

Typical strength dose: 2-3 sets of 8-12 repetitions at a load that is hard by the last repetition, 2-3 days per week (ACSM novice guideline). Adjust to symptoms.

Start: Sitting with the foot on the floor (closed chain)

Steps

Sit with the foot flat on a smooth floor; loop a band around the forefoot pulling it outward.
Keeping the heel still, sweep the forefoot inward (adduction) against the band.
Return slowly.

Cues

Heel is the pivot
Keep the arch lifted

Common mistakes

Rotating the whole leg at the hip
Toes curling

Used for

Posterior tibial tendon dysfunction (stage I-II)
Flexible flatfoot
Medial tibial stress syndrome

Evidence (2)

Closed-chain resisted foot adduction activated tibialis posterior more selectively than heel raises or open-chain supination.1
Orthoses, stretching and progressive resistive exercise were used in a 12-week RCT for stage I-II PTTD.3

Harder

Standing calf raise (knee straight)

References (3)

Kulig K, Burnfield JM, Requejo SM, Sperry M, Terk M. Med Sci Sports Exerc. 2004;36(5):862-867. Selective activation of tibialis posterior: evaluation by magnetic resonance imaging
Neumann DA. Elsevier. Kinesiology of the Musculoskeletal System: Foundations for Rehabilitation. 3rd ed.
Kulig K, Reischl SF, Pomrantz AB, et al. Phys Ther. 2009;89(1):26-37. Nonsurgical management of posterior tibial tendon dysfunction with orthoses and resistive exercise: a randomized controlled trial