Muscle Testing and Strengthening of Lower Limb Muscles

QUESTION

13. Have a partner sit on a treatment table such that their knees are flexed with the lower legs and talocrural joints hanging over the edge.  Place your hand on the plantar surface of their foot to provide manual resistance while they attempt to move their talocrural joint into plantar flexion against your resistance.

A. What muscles can be tested or strengthened in this manner?

B. During this exercise, which one of the triceps surae is MOST capable of generating maximal tension and why?

14. Please describe how to strengthen the tibialis anterior without the use of any additional external resistance.

ANSWER

Muscle Testing and Strengthening of Lower Limb Muscles

Muscles Tested or Strengthened

In the described exercise, the muscles primarily tested or strengthened are the muscles of the ankle joint, specifically those responsible for dorsiflexion and plantar flexion. The main muscles involved include the triceps surae (gastrocnemius and soleus) responsible for plantar flexion, and the tibialis anterior responsible for dorsiflexion.

 Most Capable of Generating Maximal Tension

Among the triceps surae muscles, the gastrocnemius is the one that is most capable of generating maximal tension during the described exercise. The gastrocnemius muscle is a biarticular muscle that crosses both the knee and ankle joints. Due to its dual origin and larger size, the gastrocnemius has a greater physiological cross-sectional area (PCSA) compared to the soleus. This greater PCSA allows the gastrocnemius to generate more force, making it more capable of producing maximal tension during plantar flexion against resistance. Additionally, the gastrocnemius is more active during exercises that involve knee extension, such as the one described, due to its dual-joint function.

Strengthening the Tibialis Anterior

Strengthening the tibialis anterior, the muscle responsible for dorsiflexion and inversion of the foot, can be achieved without the use of external resistance through the use of body weight and gravity. Here’s a simple exercise that can help strengthen the tibialis anterior:

Ankle Dorsiflexion Against Gravity

Starting Position: Begin by sitting on a chair with your feet flat on the ground.
Exercise Execution: Lift your toes off the ground, raising the front part of your foot while keeping your heels on the ground. This motion is dorsiflexion.
Hold and Lower: Hold the dorsiflexed position for a few seconds, feeling the contraction in the tibialis anterior. Then, lower your toes back to the ground.
Repetitions and Sets: Perform 2-3 sets of 10-15 repetitions on each foot.

By performing this exercise regularly, the tibialis anterior can be effectively strengthened to improve dorsiflexion strength and support proper foot alignment and balance.

In conclusion, the described exercise involving manual resistance for plantar flexion primarily tests or strengthens the triceps surae muscles and the tibialis anterior. Among the triceps surae muscles, the gastrocnemius is most capable of generating maximal tension due to its larger size and dual-joint function. Strengthening the tibialis anterior can be achieved using body weight and gravity through ankle dorsiflexion exercises, helping to maintain balance and foot alignment.

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