From the Research
The tibial nerve provides sensory innervation to the posterior and medial aspects of the lower leg, the heel, the sole of the foot, and the plantar surface of all five toes, with its terminal branches showing variations in their pattern, including bifurcation and trifurcation, as noted in the most recent study 1. The sensory distribution of the tibial nerve is crucial for assessing injuries or neuropathies, which may present as numbness, tingling, or pain in these areas.
- The tibial nerve supplies sensation to the skin of the medial malleolus, the medial calcaneus, the entire plantar surface of the foot, and the distal plantar aspect of all toes.
- The nerve is a branch of the sciatic nerve, originating from spinal segments L4-S3, and travels down the posterior compartment of the leg before dividing into the medial and lateral plantar nerves behind the medial malleolus.
- Understanding this distribution is essential for proper neurological examination of the lower extremity and for diagnosing conditions such as tarsal tunnel syndrome, where the tibial nerve becomes compressed as it passes through the tarsal tunnel, as discussed in previous studies 2, 3, 4, 5. The most recent study 1 highlights the importance of considering the variations in the branching pattern of the tibial nerve, particularly in relation to the medial calcaneal nerve, when performing invasive procedures or decompression measures in the medial ankle region.
- The study notes that the area beyond 3 cm proximal to 3 cm distal to the malleolar-calcaneal axis can be considered a safe zone for performing invasive procedures.
- The origin of the inferior calcaneal nerve is relatively less variable, mostly arising as a branch of the lateral plantar nerve, and sometimes as a direct branch from the tibial nerve before termination.