the posterior tibial nerve block provides amazing anesthesia to the sole of the foot where very few other limited options are available to perform the block I'm going to use the pal scanner here on a nerve setting and I'm going to place it in the transverse orientation just proximal to the medial malis and posterior to it my first Target with imaging is the tibial artery here which I'm going to identify as a pulsatile structure and in most patients the nerve will rest just posterior to that artery I could either do the block here or I like to track that nerve just slightly more proximal to get me a bit more purchase above the Achilles tendon and allow me to insert my needle from the posterior aspect coming in along the screen and being able to bathe that nerve with anesthesia once the Block's inserted the patient will soon start to get anesthesia to the sole of the foot really allowing me to control their pain or to facilitate whatever other procedure it is like a fore and body or laceration repair that I need to do on the sole of the foot