Nerve
Tibial nerve
Main nerve to posterior leg muscles and the plantar foot
High-yield
A proximal tibial lesion can weaken calf plantarflexion and toe flexion. Ankle-level tarsal tunnel compression occurs beyond the branches to the calf, so it does not produce the same pattern of weakness.
Overview
The tibial nerve continues from the tibial component of the sciatic nerve through the back of the knee and leg. Around the medial ankle it enters the tarsal tunnel, and its plantar branches supply muscles and skin in the sole.
Reference facts
- Root value
- L4–S3, carried in the tibial division of the sciatic nerve
- Course
- Crosses the popliteal fossa, passes under the soleal arch and descends in the deep posterior leg; travels behind the medial malleolus beneath the flexor retinaculum toward its plantar branches
- Motor
- Posterior leg muscles, including the calf, popliteus, tibialis posterior and long toe flexors; most intrinsic foot muscles through the medial and lateral plantar nerves
- Sensory
- Plantar foot and toes through plantar branches, heel through calcaneal branches, and a contribution to posterior-leg and lateral-foot sensation through the sural pathway
Clinical correlation
Tarsal tunnel syndrome may cause burning, tingling or numbness in the sole and toes, sometimes with intrinsic foot-muscle weakness. These symptoms need anatomical localization; they are not equivalent to complete tibial paralysis.
Frequently asked questions
What are the roots of the tibial nerve?
The tibial nerve arises from L4–S3, carried in the tibial division of the sciatic nerve.
What muscles does the tibial nerve supply?
Posterior leg muscles, including the calf, popliteus, tibialis posterior and long toe flexors; most intrinsic foot muscles through the medial and lateral plantar nerves.
What is the sensory distribution of the tibial nerve?
Plantar foot and toes through plantar branches, heel through calcaneal branches, and a contribution to posterior-leg and lateral-foot sensation through the sural pathway.
What is the course of the tibial nerve?
Crosses the popliteal fossa, passes under the soleal arch and descends in the deep posterior leg; travels behind the medial malleolus beneath the flexor retinaculum toward its plantar branches.