**2.10 Tibialis posterior (TP)**

Although we recommend US guidance for it, it may be injected with practice. The child should lie supine with hip and knee slightly flexed and externally rotated, so that the medial leg face upwards, Now just distal to the hallway of the leg, insert the needle just (0.5 to 1 cm) behind the tibia from the medial leg and advance it parallel to the tibia, first flexor digitorum Longus is traversed then will reach the tibialis posterior. Passive toe extension and flexion initially the passive eversion at the ankle will confirm the needle position.

## **2.11 Flexor digitorum Longus (FDL)**

Positioning same as above (TP). In the mid-leg, this muscle lies anterior to soleus and posterior to tibia. Insert the needle at mid-leg just posterior to the tibia from the medial side and advance laterally parallel to the posterior tibia, It is the first muscle in the needle path, needle movement is appreciated well if we passively extend the 2nd to 4th toe. The needle will go in the tibialis posterior if we go more lateral. So, we can inject both FDL and TP in one go of a needle. If needle entry is more posterior, one can be mistakenly injected into the soleus (**Figure 8**).
