Jordi Sanchez-Ballester

FRCSEd FRCS Trauma & Orth

Consultant Foot, Ankle & Knee Surgeon

Fairfield Independent Hospital, St Helens

Spire Cheshire

Fairfield Independent Hospital

Crank Rd

St Helens

Merseyside WA11 7RS

01744 739311

Spire Cheshire Hospital

Chris Davies

Fir Tree Close

Warrington WA4 4LU

0845 602 2500

Medico Legal

Nuria Roig

07894 717377

St Helens & Knowsley

Claire Lomax

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



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


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


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