Medial Plantar Nerve: Difference between revisions

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'''Original Editor '''- [[User:Asma Alshehri|Asma Alshehri]]


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== '''Description'''<br> ==
==Description==
[[File:Gray833.png|alt=|right|frameless|390x390px]]
The medial plantar nerve is the larger one of the two terminal branches of the tibial nerve<ref name=":0">De Maeseneer M, Madani H, Lenchik L, Kalume Brigido M, Shahabpour M, Marcelis S, De Mey J, Scafoglieri A. [https://d1wqtxts1xzle7.cloudfront.net/43175196/De_Maeseneer_RGPHS_2015-libre.pdf?1456704498=&response-content-disposition=inline%3B+filename%3DMUSCULOSKELETAL_IMAGING_Normal_Anatomy_a.pdf&Expires=1676916375&Signature=BM~Cbw6BG7TmOW8JRYmb3MmXKlDAtlBfXuoyFabTix42lcLI7KU5YU-O4hpJxOrYl4HYfZplzRd6g2qAjiWIzfXxRH4bsZlf0FA1eMrXyG8Ak1epkO2mCciDxxfLxI8wpRz3KGKY4rcMHseuW-5BoZjWocOvuG~D1NkgjlQW88LDVfRA9bUvacU17B-xuo-h7dEFGsqHstFUtz-UbkOAYelDM9gBiAolQGScudVra9sNwYpKyFQhORcsjFJyjgFDSE~o2lYS36yt0fxq9iiS3tOQaNbi2rAK7nlpgxF0suh8u5JM1L9fhW8K00~8OYQ2mhWOnnBroCfXUvPYjIqyIQ__&Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA Normal anatomy and compression areas of nerves of the foot and ankle: US and MR imaging with anatomic correlation.] Radiographics. 2015 Sep;35(5):1469-82.</ref>, it covers most of the sole of the foot and supplies multiple intrinsic muscles of foot.&nbsp;


The medial plantar nerve is the larger one of the two terminal branches of the tibial nerve, it covers most of the sole of the foot and supply multiple muscles which functioning on the toes.&nbsp;
==Anatomy==
==== General Course of Nerve: ====
The medial plantar nerve originates under the flexor retinaculum<ref name=":1">Hacking, C. (2022) ''Medial plantar nerve: Radiology reference article'', ''Radiopaedia Blog RSS''. Radiopaedia.org. Available at: https://radiopaedia.org/articles/medial-plantar-nerve (Accessed: February 20, 2023).</ref>, crosses the lateral surface of posterior tibial artery and runs anterior to the lateral plantar nerve<ref name=":0" />. Proximally, this nerve runs between the quadratus plantae and abductor hallucis muscles and continues until it is in close proximity to the master knot of Henry<ref name=":0" />. More distally, it courses along the medial border of the flexor digitorum brevis muscle and then divides into the articular, muscular, and cutaneous branches<ref name=":0" />.  


== '''Anatomy&nbsp;''' ==
==== Branches: ====


=== General Course of Nerve: ===
'''Cutaneous branches''': Plantar digital nerves run to the sides of the medial three and the medial half of the fourth toe and extend onto the dorsum of the foot.  


It arises under the flexor retinaculum and runs forward deep to the abductor halluces, then it comes to lies in the interval between the abductor halluces and the flexor digitorum brevity. &nbsp;
'''Muscular branches'''


=== Branches: ===
'''Articular branches'''  


<u>Cutaneous branches:</u> plantar digital nerves run to the sides of the medial three and the medial half of the fourth toe. The nerves extend onto the dorsumand supply the nail beds and the tips of the toes.<br>  
==Function==
Cutaneous branches supply most of the skin on the anterior two-thirds of the sole as well as the adjacent surfaces of the medial three and one-half toes, including the big toe<ref name=":1" />. 


<u>Muscular branches:</u> it gives a branches to these four muscles, abductor hallucis, flexor digitorum brevis, the flexor hallucis brevis and the first lumbrical muscle.
Muscular branches supply the abductor hallucis, flexor hallucis brevis, flexor digitorum brevis and first lumbrical muscles<ref name=":0" />.  


== Function ==
Articular branches supply the articulations of the tarsus and metatarsus<ref name=":0" />.  


=== Innervates ===
== Pathology/Injury  ==


=== Movements produced  ===
'''Medial plantar nerve entrapment'''


=== Functional contributions ===
Compression of the medial plantar nerve can occur  deep to the flexor retinaculum, adjacent to the master knot of Henry<ref name=":0" /> or in the distal tarsal tunnel<ref name=":2">Feger, J. (2022) ''Medial plantar nerve entrapment: Radiology reference article'', ''Radiopaedia Blog RSS''. Radiopaedia.org. Available at: https://radiopaedia.org/articles/medial-plantar-nerve-entrapment (Accessed: February 20, 2023).</ref>. This may occur due to repetitive foot eversion and is sometimes referred to as "jogger's foot"<ref name=":0" />. Other causes of entrapment include space-occupying lesions, previous surgery or tenosynovitis of the flexor hallucis longus and flexor digitorum longus tendons<ref name=":2" />.  


== Pathology/Injury ==
Symptoms include: 
 
* paraesthesia of the medial sole and at the navicular tuberosity<ref name=":0" /> 
* paraethesia of plantar aspect of the first and second toes<ref name=":2" />  
* pain/tenderness of the medial plantar arch and heel<ref name=":2" /> 


== Physiotherapy Techniques ==
== Physiotherapy Assessment ==


=== Palpation  ===
Observation:


=== Examination  ===
Local observation for the sole of the foot is the first step of examination - take note of differences compared with the unaffected side.


=== Physiotherapeutic Techniques  ===
Palpation:


== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed])  ==
You can assess the sensation of the areas supplied by the medial plantar nerve and palpate the related area to check any problems relating to the sensation (either hyper sensitivity or impaired sensation) and/or the tenderness degree.
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== Resources  ==
Muscle testing:


*
Resisted muscle testing of the muscles innervated by the medial plantar nerve motor muscular branches.
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== References  ==
== References  ==
<references />


References will automatically be added here, see [[Adding References|adding references tutorial]].


<references />
[[Category:Anatomy]]

Latest revision as of 13:04, 26 February 2024

 

Original Editor - Asma Alshehri

Lead Editors - Asma Alshehri, Kim Jackson, George Prudden, Shaniel Walters, Rachael Lowe, Tony Lowe, WikiSysop, Jaroslaw Pospiech and Wendy Snyders  

Description[edit | edit source]

The medial plantar nerve is the larger one of the two terminal branches of the tibial nerve[1], it covers most of the sole of the foot and supplies multiple intrinsic muscles of foot. 

Anatomy[edit | edit source]

General Course of Nerve:[edit | edit source]

The medial plantar nerve originates under the flexor retinaculum[2], crosses the lateral surface of posterior tibial artery and runs anterior to the lateral plantar nerve[1]. Proximally, this nerve runs between the quadratus plantae and abductor hallucis muscles and continues until it is in close proximity to the master knot of Henry[1]. More distally, it courses along the medial border of the flexor digitorum brevis muscle and then divides into the articular, muscular, and cutaneous branches[1].

Branches:[edit | edit source]

Cutaneous branches: Plantar digital nerves run to the sides of the medial three and the medial half of the fourth toe and extend onto the dorsum of the foot.

Muscular branches

Articular branches

Function[edit | edit source]

Cutaneous branches supply most of the skin on the anterior two-thirds of the sole as well as the adjacent surfaces of the medial three and one-half toes, including the big toe[2].

Muscular branches supply the abductor hallucis, flexor hallucis brevis, flexor digitorum brevis and first lumbrical muscles[1].

Articular branches supply the articulations of the tarsus and metatarsus[1].

Pathology/Injury[edit | edit source]

Medial plantar nerve entrapment

Compression of the medial plantar nerve can occur deep to the flexor retinaculum, adjacent to the master knot of Henry[1] or in the distal tarsal tunnel[3]. This may occur due to repetitive foot eversion and is sometimes referred to as "jogger's foot"[1]. Other causes of entrapment include space-occupying lesions, previous surgery or tenosynovitis of the flexor hallucis longus and flexor digitorum longus tendons[3].

Symptoms include:

  • paraesthesia of the medial sole and at the navicular tuberosity[1]
  • paraethesia of plantar aspect of the first and second toes[3]
  • pain/tenderness of the medial plantar arch and heel[3]

Physiotherapy Assessment[edit | edit source]

Observation:

Local observation for the sole of the foot is the first step of examination - take note of differences compared with the unaffected side.

Palpation:

You can assess the sensation of the areas supplied by the medial plantar nerve and palpate the related area to check any problems relating to the sensation (either hyper sensitivity or impaired sensation) and/or the tenderness degree.

Muscle testing:

Resisted muscle testing of the muscles innervated by the medial plantar nerve motor muscular branches.

References[edit | edit source]

  1. ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 De Maeseneer M, Madani H, Lenchik L, Kalume Brigido M, Shahabpour M, Marcelis S, De Mey J, Scafoglieri A. Normal anatomy and compression areas of nerves of the foot and ankle: US and MR imaging with anatomic correlation. Radiographics. 2015 Sep;35(5):1469-82.
  2. ↑ 2.0 2.1 Hacking, C. (2022) Medial plantar nerve: Radiology reference article, Radiopaedia Blog RSS. Radiopaedia.org. Available at: https://radiopaedia.org/articles/medial-plantar-nerve (Accessed: February 20, 2023).
  3. ↑ 3.0 3.1 3.2 3.3 Feger, J. (2022) Medial plantar nerve entrapment: Radiology reference article, Radiopaedia Blog RSS. Radiopaedia.org. Available at: https://radiopaedia.org/articles/medial-plantar-nerve-entrapment (Accessed: February 20, 2023).
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