Surgical Tutorial – Tibial Nerve Decompression at the Soleus. Compression of the tibial nerve by the tendinous leading-edge of the soleus is rare but under recognized. The tibial nerve is decompressed by dividing the soleus arch found deep within the lower leg. The surgical approach involves proceeding between the lateral and medial gastrocnemius muscles. The soleus muscle is then identified deep to the gastrocnemius muscles, at which the tibial nerve is identified proximal to this muscle. The tibial nerve dives deep to the soleus arch, at which the compression point is found.