
The human body is a complex structure with many muscles, tendons, and joints working together to enable movement. One of the most important muscles in the human body is the one that controls the big toe, which is known as the hallucis muscle. This muscle is responsible for various movements of the big toe, including flexion, extension, and dorsiflexion. The hallucis muscle is also involved in maintaining the arch of the foot and plays a crucial role in balance and posture, ultimately facilitating walking. Understanding the function of this muscle and its related pathologies is essential for comprehending gait abnormalities and their treatment.
| Characteristics | Values |
|---|---|
| Name of muscle that controls the big toe | Extensor hallucis longus muscle |
| Type of muscle | Thin skeletal muscle |
| Location | Between the tibialis anterior and the extensor digitorum longus |
| Function | Extends the big toe, dorsiflects the foot, assists with foot eversion and inversion |
| Attachments | Originates from the middle portion of the anterior surface of the fibula and adjacent interosseous membrane of the leg |
| Innervation | Deep fibular nerve (L5), a branch of the common fibular nerve |
| Associated muscles | Flexor hallucis brevis, adductor hallucis, flexor digitorum longus, tibialis posterior, extensor digitorum longus, tibialis anterior |
| Conditions | Hallux saltans, FHL tendinitis |
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What You'll Learn

Extensor hallucis longus
The extensor hallucis longus (EHL) is a thin skeletal muscle that controls the extension of the big toe. It is located in the anterior compartment of the lower leg, between the tibialis anterior and the extensor digitorum longus muscles. The EHL passes deep through the extensor retinaculum and inserts at the base of the distal phalanx of the big toe.
The primary function of the EHL is to extend the big toe at the metatarsophalangeal and interphalangeal joints. This extension is crucial for walking and running. In addition to its primary function, the EHL also assists with foot eversion and inversion and dorsiflexion of the ankle. The muscle receives its blood supply mainly from the anterior tibial artery and its branches, as well as from the branches of the fibular artery.
Weakness in the EHL muscle can cause the toe to fold under the foot when putting on socks or shoes and can lead to tripping. Hyperextension of the great toe can also cause pain and calluses, or corns, on the dorsal surface of the interphalangeal joint. To improve the strength and range of motion of the EHL, exercises such as big toe lifts, heel raises with the big toe extended, and towel curls can be performed.
The EHL muscle is innervated by the deep fibular nerve (L5 and S1), and it acts in three foot joints: the talocrural, metatarsophalangeal, and interphalangeal joints. The anterior tibial vessels and deep fibular nerve pass between the EHL and the tibialis anterior muscle. The tendon of the EHL can be seen on the dorsal aspect of the big toe when it is extended, and this space between the tendons is clinically important as an entry point for injections or aspiration procedures in the ankle joint.
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Extensor hallucis brevis
The extensor hallucis brevis is a short and slender muscle located in the dorsum of the foot. It originates from the superior aspect of the calcaneus, just posteriorly to the calcaneocuboid joint. It courses medially over the dorsum of the foot, giving off a tendon that inserts onto the base of the proximal phalanx of the hallux (big toe).
The extensor hallucis brevis is the most medial dorsal foot muscle. It is covered by the deep layer of fascia of the foot, which is a continuation of the deep fascia of the leg (crural fascia). Within the dorsal foot compartment, the extensor hallucis brevis courses deep to the inferior flexor retinaculum and extensor digitorum longus tendons, while it covers the dorsalis pedis artery and deep fibular (peroneal) nerve.
The main function of the extensor hallucis brevis is to assist in the extension of the big toe at the metatarsophalangeal joint. This action returns the big toe from a flexed position to a neutral position, or pulls it above the ground if the contraction continues (hyperextension). This movement is important in gait, as raising the big toe clear of the ground facilitates walking and running.
The extensor hallucis brevis works in synergy with the extensor hallucis longus muscle, which is a thin skeletal muscle situated between the tibialis anterior and the extensor digitorum longus. The extensor hallucis longus also extends the big toe and dorsiflects the foot. It ends as a tendon of insertion, which passes through a distinct compartment in the inferior extensor retinaculum of the foot.
The extensor hallucis brevis is innervated by the deep fibular (peroneal) nerve (root value L5-S1). The blood supply for this muscle comes from the dorsal artery of the foot, which is a continuation of the anterior tibial artery.
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Flexor hallucis brevis
The flexor hallucis brevis is a small intrinsic muscle of the foot. It is located deep within the sole, on the medial aspect. It is composed of a medial and lateral muscle belly, with the tendons attaching at the proximal phalanx of the great toe (hallux). The muscle's primary function is to flex the great toe at the metatarsophalangeal joint.
The medial head of the flexor hallucis brevis arises from the tendon of the posterior tibialis tendon, while the lateral head arises from the medial part of the plantar surface of the cuboid bone. The fibres converge into a single muscle belly, which attaches to the base of the proximal phalanx of the great toe. The medial head is the larger of the two heads. The medial and lateral heads of the flexor hallucis brevis are innervated by the medial plantar nerve, with spinal segments S1 and S2 represented in both heads.
The flexor hallucis brevis is involved in maintaining the medial longitudinal arch of the foot. Dysfunction of the muscle can cause pain in the ball of the foot when extending the big toe, difficulty and pain during gait, and toe deformities. Aggravation of the muscle may occur when wearing high heels or ill-fitting shoes.
The flexor hallucis brevis is one of the muscles in the third layer of four layers of plantar muscles. It is found in the medial compartment, together with the abductor and adductor hallucis muscles. The muscle forms a common tendon with the abductor hallucis muscle, with the tibial sesamoid bone sitting within this tendon.
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Adductor hallucis
The adductor hallucis is located in the sole of the foot. It is a key intrinsic muscle of the foot, responsible for adducting and flexing the big toe (hallux) and reinforcing the forefoot as the centre of gravity for body weight before the heel lifts up. It also contributes to maintaining the transverse and longitudinal arches of the foot.
The two heads of the adductor hallucis join together before inserting on the lateral side of the base of the first digit's proximal phalanx. The distal attachment point joins with the flexor hallucis brevis tendon on the fibular sesamoid. The oblique head consists of lateral and medial parts, which originate from the bases of metatarsal bones 2-4, cuboid, lateral cuneiform bones, and tendon of fibularis longus. The medial part blends with the tendon of flexor hallucis brevis on the lateral sesamoid bone of the great toe. The lateral part meets with the tendon of the transverse head of adductor hallucis. The transverse head originates from the plantar metatarsophalangeal ligaments of toes 3-5 and deep transverse metatarsal ligaments.
A traumatic rupture of the adductor hallucis is uncommon but can lead to hallux varus deformities.
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Flexor hallucis longus
The flexor hallucis longus (FHL) is a powerful muscle that is located on the fibular side of the posterior aspect of the leg. It is part of a group called the deep flexors of the calf, which also includes the popliteus, flexor digitorum longus, and tibialis posterior muscles. The flexor hallucis longus arises from the posterior two-thirds of the fibula and descends on the fibular side of the leg. It then crosses over the posterior ankle to emerge on the sole of the foot, where it passes anteriorly to insert on the great toe (hallux).
The primary action of the flexor hallucis longus is flexion of the great toe, but it also has other functions such as plantar flexion and foot inversion. This muscle is also important for maintaining the medial longitudinal arch of the foot. The extensor hallucis longus acts as an antagonistic muscle to the flexor hallucis longus.
The flexor hallucis longus tendon passes through the tarsal tunnel and curves around a bony landmark called the sustentaculum tali. Friction at this site can cause pain on the posteromedial aspect of the ankle, and overuse can lead to inflammation and irritation, a condition known as "dancer's tendinitis." Hallux saltans is another condition that can develop from overusing the FHL muscle, resulting in a nodule that produces a popping effect during contraction.
Tendonitis of the FHL can occur due to repetitive sporting or physical activities, and it can be challenging to treat with conservative management. In some cases, patients may be referred to an orthopedic surgeon for arthroscopic surgery to address FHL tendon issues.
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Frequently asked questions
The muscle that controls the big toe is called the flexor hallucis longus muscle (FHL).
The FHL is located on the fibular side of the leg. It arises from the inferior two-thirds of the posterior surface of the fibula.
The FHL is responsible for flexing the big toe. It also assists with foot eversion and inversion.
Common issues that can occur with the FHL include FHL tendinitis, inflammation, irritation, and microtears in the tendon. These issues can be treated with rest, physical therapy, ice therapy, ultrasound therapy, splints, and anti-inflammatory medication.
Yes, the abductor hallucis, extensor hallucis brevis, and adductor hallucis muscles are also associated with movements of the big toe.











































