Strain in the Tibial and Plantar Nerves with Foot and Ankle Movements and the Influence of Adjacent Joint Positions

Abstract

We studied the influence of different positions in neighboring joints on strain in the tibial and plantar nerves during ankle and toe movements. Tibial nerve strain at the ankle was measured during ankle dorsiflexion in ten cadavers; plantar nerve strain was measured during toe extension. Tibial nerve strain increased with ankle dorsiflexion (mean increase: 3.9%) and strain was higher when the nervous system was pretensioned by either knee extension or hip flexion (p < or = .011). Strain was even higher when the nerve bed was elongated at both the hip and knee (p < or = .006) before performing dorsiflexion. A similar trend was observed for the plantar nerves with ankle positioning. In conclusion, the change in nerve strain is strongly influenced by positions in neighboring joints. This insight into nerve biomechanics provides a foundation for progressive mobilization exercises for disorders such as tarsal tunnel syndrome.