Extensor Hallucis Brevis Trigger Point Foot Pain
The extensor hallucis brevis and extensor hallucis longus muscles help control the first metatarsal extension. They are the antagonist muscles to the flexor hallucis muscles. These muscles operate during every step we take or when trying to maintain balance while standing.
As with any small muscle and tendon they can become overwhelmed and injured with repetitive chronic stress. Especially when we initiate exercise programs that require more walking or running than we have become accustomed to performing. In addition acute trauma that stretches the big toe can cause sprains or ruptures in the tendons.
The pain radiates from the extensor hallucis brevis muscle and toward the great toe.
Smaller foot and ankle muscles play an important role in foot and ankle stability, especially the flexor hallucis brevis, flexor hallucis longus, extensor hallucis brevis, extensor hallucis longus, plantaris, interossei, flexor digitorum, extensor digitorum. These forgotten muscles help control foot mechanics during our walking or running gait.
We the foot strikes the ground these muscles absorb the impact. The foot arch is then stretched and these muscles help contract to absorb those forces and maintain proper joint alignment. After the foot is stretched the muscles then contract to help “spring” the foot forward during the toe off phase of walking. This cycle continues with every step. Small muscles do much of the work for maintaining foot and ankle joint positions. When the arch drops or over pronates excessive strain is applied to many soft tissues in the lower leg.
These forgotten muscles are often associated with larger injuries to the foot and ankle. People who are experiencing plantar fasciitis, achilles tendonitis, shin splints, and IT band most likely will have small injuries to the smaller foot and ankle muscles along with larger sprains and strains.
Foot mechanics and proprioception often deteriorate over time, which increases the likelihood of developing sprains and strains in the lower leg.
Therapeutic treatments for addressing soft tissue injuries involve massage therapy, manual therapy, trigger point therapy, Graston Technique, or Active Release Technique. These treatments increase blood flow, decrease muscle spasms, enhance flexibility, speed healing, and promote proper tissue repair.
When these treatments are incorporated into a treatment plan patients heal faster and are less likely to have long-term pain or soft tissue fibrosis or scar tissue in the injured muscle. These soft tissue treatments are incorporated with therapeutic exercise and flexibility programs.
NSAIDs are often prescribed for the initial acute injury stages. In severe cases that involve multiple joint regions, muscle relaxers or oral steroids can be given. Trigger point injections, botox, or steroid injections can be treatment options. Pain management is not usually required unless stronger medications or joint injections are required for treatment.
MRI and X-rays will not usually be ordered to evaluate mild to moderate muscle, tendon, and ligament injuries. Severe cases may utilize advanced imaging to rule out bone fractures, edema, nerve entrapments, tendon or muscle ruptures. NCV testing may be utilized in cases that also involve muscle, sensory, or reflex loss.
Likewise many trigger point injuries are associated with poor joint stabilization in the foot, knee, or hip. This leads to poor alignment and excessive forces being placed onto muscles and tendons. Iliotibial band Syndrome is common in runners who develop the injury because of weakness and poor stabilization of the leg and hip muscles. These runners will also have multiple trigger points in the quadriceps, psoas, gastroc, soleus, and gluteus medius.
Your chiropractor, physical therapist, occupational therapist, or physician will evaluate your condition and make a proper diagnosis and treatment recommendations. Ask them any questions you might have about your injury.
The lower extremity works as a comprehensive unit performing many of the repetitive tasks at home, work, and recreational sports. Injuries to one area of the musculature often indicate that additional damage has been incurred by other muscles.
Many therapeutic exercises can help restore proper strength and endurance to the leg muscles muscles. Isometric exercises are often the initial treatment exercises. Followed by single plane rubber band exercises for hip, knee, and ankle; flexion, extension, adduction, abduction, circumduction, inversion, and eversion. Dynamic exercises involving stability foam, rubber discs, exercise ball, and BOSU balls can be performed on the floor. The more unstable of the surface the more effort and stabilization is required of all the lower extremity muscles.
Vibration plates enhance neuromuscular learning throughout the ankle, knee, foot, hip, and back muscles. Additional strength exercises can be found on the hip, knee, and foot strengthening pages. More information for injuries and treatments for knee pain and foot pain.
Our Chandler Chiropractic & Physical Therapy clinic treats patients with a variety of muscle, tendon, joint, and ligament injuries. The clinic provides treatment for runners, tri-athletes, and weekend warriors in addition to common headache, neck, and back patients traditionally seen in Chiropractic, Physical Therapy, Massage Therapy clinics. We work with all ages and abilities of the residents in Phoenix, Tempe, Gilbert, Mesa, and Chandler AZ.