Extensor Digitorum Brevis and Extensor Hallucis Brevis

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 Digitorum Brevis and the Extensor Hallucis Brevis are superficial muscles of the foot.

Anatomical Attachments:

• Origin: Attach to the superior lateral surface of the calcaneus, also to the lateral calcaneal and the cruciate crural ligament.
• Insertion: The first tendon attachment, which attaches to the proximal phalanx of the great toe, by some authors is considered a distinct muscle referenced as the Extensor Hallucis Brevis. The other three tendons of the Extensor Digitorum Brevis unite with the lateral surface of the Extensor Digitorum Longus tendons, which provides extension for the 2nd, 3rd, and 4th toes.

Action: Extends the proximal phalanges of all the toes excluding the little toe.

Nerve Supply: Deep peroneal nerves (L4, L5, S1).

Vascular supply: Dorsalis pedis and lateral tarsal arteries.

• Primary: The pain refers to the mid dorsum of the foot.
• Satellite or associated triggers: Long extensor muscles of toes.

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Trigger Point Signs and Symptoms: The deep aching pain of the dorsum of the foot is the cardinal indicator of TrPs in the extensor group.

Trigger Point Activating and Perpetuating Factors: Shoes that are too small or tightly laced, which either result in the toes being turned down or a tourniquet type situation across the dorsum of the foot.

Differential Diagnosis: S1 Sciatic Nerve Lesion, (Segmental, Subluxation, Somatic dysfunction) L4 or L5 radiculopathy, Dislocation/Subluxation, Hip or knee discomfort secondary to antalgic gait, Avulsion fracture, Bruising to the dorsum of the foot, Strain of the foot, Diabetic neuropathy, Polyneuropathy, Reflex sympathetic dystrophy (Complex regional pain syndrome), Neurogenic arthropathy (Charcot’s joint), Osteoarthritis, Bursitis, Rheumatoid Arthritis, Gout, Turf toe (sprain), Hammer toe, Systemic infections or inflammation, Nutritional inadequacy, Metabolic imbalance, Toxicity, Side effects of medication.

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