2. Tibialis Posterior

Origin: Posterior surface of tibia inferior to soleal line, interosseous membrane, and posterior surface of fibula

Insertion: Navicular tuberosity, cuneiforms, cuboid and bases of 2nd-4th metatarsal

Action:

  • Plantar flexion
  • Inversion

Innervation: Tibial nerve (L4/5)

Tibialis posterior.
Figure 4.4 Tibialis posterior, adapted by Uwe Gille from the original image by Henry Gray and Henry Vandyke Carter (Public domain).
Neurovascular bundle of the calf (posterior tibial artery and vein and tibial nerve).
Figure 4.5 Neurovascular bundle of the calf (posterior tibial artery and vein and tibial nerve), by Henry Gray and Henry Vandyke Carter (Public domain).

Needling

Position:

    • Supine with knee over bolster or therapist’s own knee
    • Prone

Palpation:

    • Supine: palpate the tender spots along the medial tibial border

Technique:

    1. Supine: Needle directly towards the medial posterior border of the tibia using the tibia as a backdrop – The muscle belly of tibialis posterior can be accessed around the middle 2/3 of the post/medial tibia
    2. Prone: Will need to needle perpendicularly through the medial aspect of the gastrocnemius and soleus using the tibia as a backdrop

Caution: Low

Needling Tibialis Posterior from an anterior medial to lateral direction and posterior in a perpendicular direction just medial to midline
Figure 4.6 Needling tibialis posterior from an anterior medial to lateral direction, original image by Nadine Crocker, CC BY-NC 4.0.
Figure 4.8 Needling Tibialis Posterior from an anterior medial to lateral direction and posterior in a perpendicular direction just medial to midline.
Figure 4.7 Needling tibialis posterior from a posterior direction just medial to midline, original image by Nadine Crocker, CC BY-NC 4.0.

Video 4.2 Needling tibialis posterior from supine, original video by Nadine Crocker, CC BY-NC 4.0.

License

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Sinew Channel Needling Copyright © 2026 by Nadine Crocker is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, except where otherwise noted.

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