|look for supination, toes lifting off, assess actively and passively|
make sure the knees/hips stay still!
Lack of tibial IR is a very common dysfunction in the lower quarter. This is a chicken or the egg thing, it could be due to a lack of dorsiflexion, leading to ankle eversion in stance phase, causing tibial ER. This could also be caused by inhibited or weak gluteus medius, this causing facilitation in the TFL and causing more tone in the ITB. This could lead to a further cycle of loss of tibial IR.
A lack of tibial IR could also cause a loss or pain with
- knee flexion
- ankle dorsiflexion
I then teach the patient self tibial IR mobilization with movements, repetition and end range is key
After the IASTM, I perform some open chain then progress to closed chain MWM for tibial IR then teach the patient this for HEP. You should see some rapid changes in knee flexion, but less so for ankle dorsiflexion.
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