Extensor Hallucis Longus

Pointer Plus The Pointer Plus is an easy to use trigger point (TP) locator which incorporates a push button stimulation feature to immediately treat Trigger point pain.

The Extensor Hallucis Longus is an anterior muscle of the leg.

Anatomical Attachments:

• Origin: Attaches to the middle 1/2 of the anterior shaft of the fibula and the interosseous membrane
• Insertion: Attaches to the base of the distal phalanx of the great toe.

Action: Extends the great toe and aids in the dorsiflexion of the foot.

Synergist: Extensor digitorum longus, Tibialis anterior, Peroneus tertius.

Antagonist: Gastrocnemius, Flexor digitorum longus, Flexor hallucis longus, Peroneus longus and brevis, Tibialis posterior, Soleus, Plantaris.

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Nerve Supply: Deep Peroneal Nerve (L4, L5, S1).

Vascular supply: Anterior tibial artery.

• Primary: The pain refers to the dorsum of the foot, over the distal aspect of the first metatarsal, and the base of the great toe, extending upward over the dorsum of the foot and leg.
• Satellite or associated triggers: Extensor digitorum longus, tibialis anterior.

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Trigger Point Signs and Symptoms: Pain on the top of the foot extending to metatarsophalangeal joints, foot drop or pain during walking, cramps during the night.

Trigger Point Activating and Perpetuating Factors: Direct trauma, persistent dorsiflexion (as in operating vehicles or equipment with their feet), persistent running, or walking on unleveled surfaces.

Differential Diagnosis: (Segmental, Subluxation, Somatic dysfunction) L4 or L5 Radiculopathy or S1 neuropathy, Diabetic neuropathy, Charcot’s arthropathy, Muscular Dystrophy, Tendinitis, Rupture of tendon, Hammer toes or claw toes, Bone cancer, Gout, Osteoarthritis, Bursitis, Rheumatoid arthritis, Diffuse cerebral dysfunction, Systemic infections or inflammation, Nutritional inadequacy, Metabolic imbalance, Toxicity, Side effects of medication.

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