Jordi Sanchez-Ballester

FRCSEd FRCS Trauma & Orth

Consultant Foot, Ankle & Knee Surgeon

Fairfield Independent Hospital, St Helens

Spire Cheshire

Bone-Surgeon.co.uk

Fairfield Independent Hospital



Crank Rd

St Helens

Merseyside WA11 7RS


01744 739311

Spire Cheshire Hospital

Chris Davies


chris8davies@tiscali.co.uk


Fir Tree Close

Warrington WA4 4LU


0845 602 2500

Medico Legal

Nuria Roig


nuriaroigca@hotmail.com


07894 717377

St Helens & Knowsley

Claire Lomax


claire.lomax@sthk.nhs.uk


0151 290 4234

Tibialis Posterior Pathology Transfer



Post-op Days 1 – 6 Weeks


Immobilized in equinus and valgus

Crutches – non weight bearing (NWB)

Active range of motion (AROM) hip and knee

Wiggle toes

Straight leg raises (SLR) x 4 directions

Short arc quad (SAQ)

Upper body exercises (seated or bench only – no pushups)

LE stretches – Hamstring, quads, ITB, hip flexors

Elevation


Goals

Pain management

Prevent swelling



Weeks 6 – 10


Cam walker – full weight bearing (FWB)

Continue appropriate previous exercises

Scar massage/mobilization with oil/cream

Ankle AROM – Calf pumping, alphabet, rotations

Light Theraband ex x 4

Towel crunches and side-to-side

Steamboats (Theraband x 4 while standing on involved LE) in cam walker

Mini-squats, Wall squats, Total gym

Proprioception ex – Double leg BAPS

Gastroc/Soleus stretching


Goals

Full DF / PF

No adhesions


Weeks 10 – 16

Transition from cam walker to ankle brace

Continue appropriate previous and following exercises without brace

Strengthening ex, emphasize medial ankle mm

Theraband with increasing resistance

Elgin

Double leg heel raises – emphasize involved side

Leg press, knee ext, Hamstring curl, hip weight machines

Forward, retro and lateral step downs

Proprioception ex – single leg BAPS, ball toss, body blade

Stationary bike  

Pool therapy



DOWNLOAD: Tibialis Posterior Pathology Transfer Protocol leaflet