Anatomical Study of the Innervation of the Tibialis Anterior Muscle and its Correlation with Miofascial Trigger Points: Preliminary Results

• Published in: The FASEB journal Vol. 36 Suppl 1
• Main Authors: Akamatsu, Flávia E, de Alencar, Cesar R, Hojaij, Flávio, Andrade, Mauro, Jacomo, Alfredo L
• Format: Journal Article
• Language: English
• Published: United States 01.05.2022
• ISSN: 1530-6860
• DOI: 10.1096/fasebj.2022.36.S1.L7680

Myofascial syndrome is a common cause of chronic musculoskeletal pain. It is associated with movement restriction and is characterized by myofascial pain syndrome (MPS). Myofascial trigger points (MTPs) represent tender areas of the muscle where painful symptoms are elicited whenever stimulated. Although pathophysiology of MTPs is unclear, some authors report that they coincide with motor plates at the innervation zone (IZ). Trigger points of the tibialis anterior muscle are located at the anterior third of the muscle. Our study aimed to describe the innervation of the tibialis anterior muscle and relate it to clinically described MTPs. Tibial anterior muscles from five cadavers were dissected from their origins to observe the exact point where the deep fibular nerve penetrates the muscle belly. The entry points were mapped using a Cartesian graph. Statistical analysis was performed with Poisson marginal distribution and identity linkage function followed by Bonferroni multiple comparisons. Significance was set in p <0.05. Areas I and II had most of the deep fibular nerve branches, with a mean of 5 sites (42%) and 4 sites (33%) respectively. Area 3 and 4 had a mean of 2 (17%) and one (8%) respectively. In accordance with the clinical literature, the branches of the deep fibular nerve in the tibialis anterior muscle seem to correspond to the described areas of the MTPs. Anatomical correlations between MTPs may be a useful tool for a better understanding of the physiopathology of these disorders and may provide a rational basis for their treatment.