Flexor Digitorum 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 Flexor Digitorum Brevis is a superficial muscle of the foot.

Anatomical Attachments:

• Origin: Attaches to the medial process of the tuberosity of the calcaneus.
• Insertion: Attaches to the middle phalanx of all the toes excluding the great toe.

Action: Flexes the PIP joints of all the toes excluding the great toe.

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

Vascular supply: Medial plantar artery.

• Primary: The pain referral is predominately felt on the balls of the feet and can project slightly posterior to the instep and occasionally over the head of the 5th metatarsal. Usually, the plantar surface of the first and fifth metatarsal is not involved.
• Satellite or associated triggers: Flexor hallucis brevis, long flexors of the toes.

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Trigger Point Signs and Symptoms: Sore feet, with a tendency to limp, deep aching pain at rest.

Trigger Point Activating and Perpetuating Factors: Shoes that are too small, wearing a cast shoe for a long period of time, banging or stubbing the toes, falling.

Differential Diagnosis: (Segmental, Subluxation, Somatic dysfunction) L4 or L5 radiculopathy, Diabetic neuropathy, Polyneuropathy, Reflex sympathetic dystrophy (Complex regional pain syndrome), Plantar fasciitis, Plantar wart, Flat feet, Bunions, Congenital hypertrophy, Avulsion fracture, Bone spur, Hip or knee discomfort secondary to antalgic gait, Neurogenic arthropathy (Charcot’s joint), Osteoarthritis, Rheumatoid arthritis, Bursitis, Bulla (blister), Systemic infections or inflammation, Nutritional inadequacy, Metabolic imbalance, Toxicity, Side effects of medication.

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