Tibial internal rotation mobilisation with movement (MWMs)

​Tibial internal rotation passive range should be 20 degrees. 
o    Start in half kneeling. 
o    Grasp the proximal tibia with both hands. 
o    Rotate the tibia/ankle/foot internally as much as possible. 
o    Maintain rotation by hand, then lunge forward over the ankle such that the knee flexes whilst maintaining internal rotation. 
o    Ensure the knee tracks lateral to the foot.
o    Remember to diaphragmatically breathe at end range of motion. 

o    Apply a hot pack, or 5-6 minute warm up, prior to mobilisation and perform a “Towel-rolled fulcrum for quadruped rock to assist knee flexion” exercise.

Implications: 

o    Tibial internal rotation is normally at least 20 degrees. It is necessary for handling change of direction, adjusting to uneven surfaces and coupled with dorsiflexion and knee flexion in swing phase of running.

Tibial rotation, mobility, functional exercise