When blocking the tibial nerve of hemiplegics, monitoring of M. & H. wave from M. Triceps surae is very useful to help block it exactly and with less dosage of phenol.
It also makes it possible to selectively block α-efferent or γ-efferent fiber.
From the view-point of strength-duration curve of M. & H. wave and H/M ratio, physiologically better results were obtained when phenol solution was injected where H & H-M wave were noted eliminating the points where only M wave was noted, suggesting the injected phenol solution reacts locally and doesn't infiltrate around there.
Three groups of the innervated muscles (1, Triceps surae, 2, Tibialis posterior, 3, Flexor hallucis longus & brevis, Flexor digitorm longus & brevis) can be also selectively blocked, which makes it possible for example, to relieve the pains caused by hammer toes with the less muscle power decrement of Triceps surae.
The recurrence of spasticity depends not only on the previous spasticity itself but also on the potential of the antagonists. The muscle power potential of the ankle dorsiflexors makes it easier and longer to continue the reduced tonus of Triceps surae.
Neuritic pains of the innervated muscles have been noted in 20% of the blocked patients, but they are reduced to 10.6% by using physiologically isotonic solution. (2% phenol & 0.25% NaCl)

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(1) Not all the rotator cuff muscles were active during the mover or synergist actions on the shoulder movements. Certain muscles came into use for specific shoulder movements. Supraspinatus performs an important function during abduction and is active as synergist during flexion and extension, but it is inactive during adduction, external rotation and internal rotation.
Infraspinatus performs an important function during external rotation and is active as a synergist during flexion, extension and abduction, but it is inactive during adduction and internal rotation. Subscapularis was the only muscle that was active during internal rotation without exertion during shoulder movements and was active as a synergist during other movements.
Teres minor porforms an important function during external rotation and extension, and was active as a synergist during flexion, abduction and adduction, and inactive during internal rotation.
(2) Deltoideus (pars clavicularis), pectoralis major, latissimus dorsi and coracobrachialis were inactive during internal rotation, and subscapuralis was the only muscle that was active during this movement without exertion.
(3) Infraspinatus and teres minor performs important function during external rotation, but deltoideus (pars spinata) was inactive during this movement.
(4) Teres minor was not always functioning the same as infraspinatus. Teres minor was particularly active during the latter half of abdunction and during adduction, but infraspinatus was active during abduction and inactive during adduction.
(5) Teres major was not always functioning the same as latissimus dorsi. Teres major was particularly active during extension and adduction, but latissimus dorsi was active during flexion, extension, abduction and adduction.
(6) It is believed that the active condition of the participating muscles differs in relation to the time taken to carry out a shoulder movement.

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