Maximus Gage
The human body is a fascinating network of muscles, ligaments, and bones, all working together to enable movement. One such muscle is the extensor hallucis longus, which is responsible for extending the big toe, also known as the hallux. This muscle originates from the fibula and attaches to the base of the big toe, allowing for crucial movements such as walking and running. In this article, we will delve into the anatomy and functions of the extensor hallucis longus muscle and explore its role in maintaining our mobility and balance. We will also discuss related muscles such as the abductor hallucis and flexor hallucis brevis, which contribute to the complex mechanics of the human foot.
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What You'll Learn
Extensor Hallucis Longus
The extensor hallucis longus is a thin skeletal muscle that extends the big toe. It is a deep-lying extrinsic muscle, located in the anterior compartment of the lower leg, beneath the extensor digitorum longus. The extensor hallucis longus is also situated between the tibialis anterior and the extensor digitorum longus.
The muscle originates from the anteromedial aspect of the fibula, extending to the anterior aspect of the interosseous membrane of the leg, between the fibula and tibia. From here, the muscle moves towards the foot, ending in a tendon. This tendon passes through the dorsal aspect of the foot, reaching its insertion point at the base and dorsal surface of the distal phalanx of the big toe. The tendon can be seen on the dorsal aspect of the big toe, when the muscle extends it. The extensor hallucis longus also assists with foot eversion and inversion.
The extensor hallucis longus has a crucial role in walking and running. It works with other muscles from the anterior compartment of the leg to dorsiflex the foot at the ankle joint. When the foot is fixed on the ground, the muscle pulls the body forward, preventing a loss of balance and falling backwards.
Weakness of the extensor hallucis longus can cause the toe to fold under the foot when putting on socks or shoes, leading to tripping. Hyperextension of the muscle can also cause pain and calluses on the dorsal surface of the interphalangeal joint.
To strengthen the extensor hallucis longus, exercises such as big toe lifts, big toe extension with heel raises, short foot exercises, and towel curls can be performed.
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Extensor Hallucis Brevis
The extensor hallucis brevis is innervated by the deep fibular nerve (root value L5-S1). Its blood supply comes from the dorsal artery of the foot, a continuation of the anterior tibial artery.
The primary function of the extensor hallucis brevis is to assist in the extension of the big toe at the metatarsophalangeal joint. This movement is crucial for walking and running, as it helps to raise the big toe off the ground. When the extensor hallucis brevis contracts, it returns the big toe to a neutral position, and further contraction results in hyperextension, pulling the toe above the ground.
The extensor hallucis brevis works in synergy with the extensor hallucis longus to achieve these movements. The two muscles belong to the group of dorsal foot muscles.
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Abductor Hallucis
The abductor hallucis is a small, slender yet powerful muscle that aids in the flexion and abduction of the big toe. It is located on the medial side of the sole, forming the soft tissue prominence observed on the region. It is an intrinsic muscle of the foot and is part of the superficial layer of the plantar foot muscles.
The abductor hallucis has three origin points and one insertion point. It originates from the medial process of the calcaneal tuberosity, the flexor retinaculum, and the plantar aponeurosis. The muscle fibres then run anteriorly and medially, forming a tendon at the level of the body of the first metatarsal bone. The tendon courses along the medial border of the first metatarsophalangeal joint, inserting on the medial aspect of the base of the proximal phalanx of the large toe.
The abductor hallucis is innervated by the medial plantar nerve, a branch of the tibial nerve. Its blood supply comes from two arteries: the medial plantar artery and the first plantar metatarsal artery.
The abductor hallucis plays an important role in stabilising the medial longitudinal arch of the foot during walking. This action helps to maintain the central position of the big toe, and if this function is hindered, it may result in deformities such as hallux valgus.
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Flexor Hallucis Brevis
The flexor hallucis brevis (FHB) is a small intrinsic muscle of the foot. It is located deep within the sole, on the medial aspect. It is one of the muscles in the third layer of plantar muscles, which also includes the adductor hallucis (oblique and transverse heads) and the flexor digiti minimi brevis.
The flexor hallucis brevis is composed of a medial and lateral muscle belly, with the medial head being the larger of the two. The medial head arises from the lateral division of the tibialis posterior tendon and the middle band of the medial intermuscular septum. The lateral head arises from the medial part of the plantar surface of the cuboid bone, posterior to the groove for the fibularis longus tendon, and the adjacent surface of the lateral cuneiform bone. The tendons of the flexor hallucis brevis attach at the proximal phalanx of the great toe (hallux), with the medial head inserting medially and the lateral head inserting laterally.
The flexor hallucis brevis is innervated by the medial plantar nerve, with spinal segments S1 and S2. It is supplied by branches of the posterior tibial artery. The main function of the flexor hallucis brevis is to flex the great toe at the metatarsophalangeal joint, with assistance from the flexor hallucis longus. It is also involved in maintaining the medial longitudinal arch of the foot and assists with the toe-off phase of gait, providing increased push-off.
Dysfunction of the flexor hallucis brevis can result in pain in the ball of the foot when extending the big toe, difficulty and pain during gait, and toe deformities. This may be due to muscle injury or sesamoiditis, which can occur when the second toe is longer than the other toes, from walking or running on uneven ground, or from wearing high heels or ill-fitting shoes.
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Adductor Hallucis
The two heads of the adductor hallucis are the transverse and oblique heads, which have different origins but share a common insertion. The oblique head consists of lateral and medial parts, both of which originate from the bases of metatarsal bones 2-4, cuboid, lateral cuneiform bones, and the tendon of fibularis longus. The transverse head originates from the plantar metatarsophalangeal ligaments of toes 3-5 and the deep transverse metatarsal ligaments between the respective toes.
The adductor hallucis is responsible for adducting and flexing the great toe (hallux) and contributes to maintaining the transverse and longitudinal arches of the foot. This action plays an important role in walking by reinforcing the forefoot as the centre of gravity for body weight before the heel lifts up.
The adductor hallucis muscle is innervated by the deep branch of the lateral plantar nerve (S2, S3), which stems from the tibial nerve. The main vascular source for this muscle is the posterior tibial artery and its branches.
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Frequently asked questions
The extensor hallucis longus muscle is responsible for extending the big toe.
The extensor hallucis longus muscle is a deep-lying extrinsic muscle found in the anterior compartment of the lower leg.
The primary function of the extensor hallucis longus muscle is to extend the big toe, which is crucial for walking and running. It also assists in foot eversion, inversion, and dorsiflexion.
