Flexor Hallucis Brevis

The Flexor Hallucis Brevis is a deep intrinsic muscle of the foot.

Anatomical Attachments:

• Origin: Attaches to the medial part of the plantar surface of the cuboid bone and the lateral cuneiform bone.
• Insertion: Attaches to the medial and lateral side of the base of the first phalanx of the great toe.

Action: Flexes the MP joint of the great toe.

Synergist: Adductor hallucis.

Nerve Supply: Medial plantar nerves (L4, L5, S1).

Vascular supply: 1st plantar metatarsal artery.

• Primary: The pain refers to the head of the 1st metatarsal on both the plantar and the medial aspect of the foot, and it occasionally refers to the great toe and 2nd toe.
• Satellite or associated triggers: Deep intrinsic muscles of the foot.

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Trigger Point Signs and Symptoms: There is a difficulty in walking, paresthesia or edema of the foot, and deformity of the toes.

Trigger Point Activating and Perpetuating Factors: Wearing shoes that are too small, wearing a cast shoe for a long period of time, and injury to the foot or toes.

Differential Diagnosis: Plantar fasciitis, Plantar wart, Hallux valgus, Hammer toe, Turf Toe, Charcot’s arthropathy, Nerve entrapment, (Segmental, Subluxation, Somatic dysfunction) L4 radiculopathy, articular dysfunction, Frostbite, Diabetic neuropathy, Polyneuropathy, Osteoarthritis, Rheumatoid Arthritis, Gout, injured sesamoid bone, Paronychia (Ingrown toenail), Hip or knee discomfort secondary to antalgic gait, Osteoporosis, Bunions, Corns, Complex regional pain syndrome (Reflex sympathetic dystrophy), Systemic infections or inflammation, Nutritional inadequacy, Metabolic imbalance, Toxicity, Side effects of medication, With a positive Babinski’s toe sign suspect a Central nervous system (CNS) lesion.

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