Dominic Stone
The muscles that extend the toes are known as extrinsic and intrinsic muscles. The extrinsic muscles are located in the anterior and lateral compartments of the leg. The extensor digitorum longus is a pennate muscle situated at the front of the leg, which extends the lateral four toes. The extensor hallucis brevis is a thin muscle that extends the great toe. The extensor hallucis longus is a key muscle in the lower leg that extends the big toe at the metatarsophalangeal and interphalangeal joints.
| Characteristics | Values |
|---|---|
| Muscles that extend the toes | Extensor digitorum longus, Extensor digitorum brevis, Extensor hallucis brevis, Extensor hallucis longus, Abductor hallucis, Flexor digitorum brevis, Abductor digiti minimi |
| Extensor digitorum longus origin | Inferior part of the lateral tibial condyle, Proximal half of the medial surface of fibula, Anterior surface of the interosseus membrane |
| Extensor digitorum brevis origin | Calcaneus, Inferior extensor retinaculum |
| Extensor hallucis brevis origin | Calcaneus, Inferior extensor retinaculum |
| Extensor hallucis longus origin | Anterior surface of the fibula, Interosseous membrane |
| Abductor hallucis origin | Medial tubercle of the calcaneus, Flexor retinaculum, Plantar aponeurosis |
| Flexor digitorum brevis origin | Medial tubercle of the calcaneus, Plantar aponeurosis |
| Abductor digiti minimi origin | Medial and lateral tubercles of the calcaneus, Plantar aponeurosis |
| Extensor digitorum longus function | Dorsiflexion of the foot, Extension of the lateral four toes at the metatarsophalangeal joint |
| Extensor digitorum brevis function | Extension of the lateral four toes |
| Extensor hallucis brevis function | Extension of the great toe |
| Extensor hallucis longus function | Extension of the big toe at the metatarsophalangeal and interphalangeal joints, Inversion of the foot, Dorsiflexion of the ankle |
| Abductor hallucis function | Abduction and flexion of the great toe |
| Flexor digitorum brevis function | Flexion of the lateral four toes at the proximal interphalangeal joints |
| Abductor digiti minimi function | Abduction and flexion of the little toe |
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What You'll Learn
Extensor digitorum longus
Extending the toes is a function of both extrinsic and intrinsic foot muscles. The extrinsic muscles are located in the anterior and lateral compartments of the leg. The extensor digitorum longus (EDL) is one of four muscles in the anterior compartment of the lower leg. It is the most lateral muscle in the anterior compartment and lies laterally to the tibialis anterior and extensor hallucis longus. The EDL is a pennate muscle situated at the lateral part of the front of the leg. It arises from the lateral condyle of the tibia, the upper three-quarters of the anterior surface of the body of the fibula, the upper part of the interosseous membrane, the deep surface of the fascia, and the intermuscular septa between it and the tibialis anterior on the medial side, and the peroneal muscles on the lateral side.
The EDL's tendon passes under the superior and inferior extinator retinaculum of the foot, along with the fibularis tertius, and divides into four slips that run forward on the dorsum of the foot. These tendons are inserted into the second and third phalanges of the four lesser toes. The EDL is innervated by the deep fibular nerve (L5, S1), a branch of the common fibular nerve. The leg portion of the muscle is supplied by two arteries of the leg: the proximal part is supplied by the anterior tibial artery, and the distal part receives blood from the fibular artery. The tendons of the muscle are vascularized by the anterior lateral malleolar, lateral tarsal, metatarsal, plantar, and digital arteries.
The primary action of the EDL is to extend the lateral four toes at the metatarsophalangeal joint. When acting independently, it is unable to extend the entire length of the toes, extending only at the metatarsophalangeal joint, while at the interphalangeal joints, the toes remain flexed. However, when the EDL contracts together with the lumbricals, which are the main extensors of the interphalangeal joints, the muscle contributes to extension at every joint between the bones of the lateral four toes. Acting in synergy with the tibialis anterior, extensor hallucis longus, and fibularis tertius, the EDL participates in dorsiflexion of the foot when their proximal attachments are fixed.
The EDL is important for the gait cycle; the dorsiflexion angles and lifts the foot above the walking surface, while the toe extension keeps the toes extended until the heel hits the ground.
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Extensor digitorum brevis
The extensor digitorum brevis (EDB) is a small, thin muscle found on the upper surface of the foot, also known as the dorsum of the foot. This region contains the dorsal compartment of the foot, which houses the extensor digitorum brevis and extensor hallucis brevis. The EDB is richly vascularized and has a well-developed vascular network. It is supplied proximally by the branches of the fibular artery and branches of the anterior tibial artery. Distally, it is supplied by the dorsalis pedis artery and its branches.
The muscle belly of the EDB divides into four slips and respective tendons that pass anteromedially, from the lateral side towards the medial side of the foot. The most medial slip and tendon of the EDB usually constitute a distinct muscle named extensor hallucis brevis. The extensor hallucis brevis extends the great toe at the metatarsophalangeal joint. The lateral three tendons course anteriorly over the tarsal and metatarsal bones, to insert at the lateral aspect of the tendons of the extensor digitorum longus.
The EDB extends the first four digits at the metatarsophalangeal joint and assists in extending the second, third, and fourth digits at the interphalangeal joint. The EDB assists the extensor digitorum longus in extending the metatarsophalangeal and interphalangeal joints of the second, third, and fourth toes. It also assists the extensor hallucis longus and brevis in the first toe metatarsophalangeal extension.
The EDB muscle flap can be used for small defects and infection prevention of bones and joints following traumatic injuries. The EDB tendon, along with a dorsal foot flap, can be used to repair soft tissue and tendon defects on the dorsal hand.
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Extensor hallucis longus
The Extensor Hallucis Longus (EHL) is a thin muscle that extends from the middle third of the fibula to the distal phalanx of the big toe (hallux). It is located in the anterior compartment of the lower leg, alongside three other muscles: the extensor digitorum longus, tibialis anterior, and fibularis tertius muscles. The EHL is positioned between the tibialis anterior and the extensor digitorum longus.
The EHL is a key muscle responsible for extending the big toe at both the metatarsophalangeal and interphalangeal joints. It is the only muscle responsible for the extension of the interphalangeal joint, so decreased dorsiflexion of the great toe is indicative of EHL weakness. This weakness can cause the toe to fold under the foot when putting on socks or shoes, leading to tripping. Additionally, EHL tightness can result in a claw toe deformity.
The EHL also has accessory actions in other joints. It assists in the inversion of the foot and dorsiflexion of the ankle, working together with muscles from the anterior compartment of the leg. This dorsiflexion is crucial for walking and running, as it lifts the foot above the walking surface.
The EHL is innervated by the deep fibular nerve (root value L5 and S1). Its primary blood supply comes from the anterior tibial artery and its branches, with additional supply from the branches of the fibular artery. The venous blood from this compartment is drained by the anterior tibial vein, which empties into the popliteal vein.
To target the EHL muscle, an exercise called "Big Toe Lift" can be performed. This involves raising the big toe while keeping the other toes flat on the floor. It is important to avoid letting the foot roll out or scrunching the little toes. This exercise improves isolation and range of motion.
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Flexor digitorum brevis
The flexor digitorum brevis is a broad muscle found deep in the sole of the foot. It is one of the central plantar muscles of the foot. It is also referred to as flexor digitorum communis brevis. It is situated lateral to the abductor digiti minimi and medial to the abductor hallucis muscles. The flexor digitorum brevis is in charge of the toe flexion at the metatarsophalangeal joints of the lateral four digits.
The flexor digitorum brevis originates from three sites: the medial process of calcaneal tuberosity, the plantar aponeurosis, and the intermuscular septum. Its large muscle belly spans across the medial side of the plantar aspect of the foot. The muscle fibres divide into four slits, each giving off its own tendon for one of the lateral four toes. The tendons course over the respective plantar surfaces of the lateral four metatarsal bones and proximal phalanges.
The flexor digitorum brevis is supplied by the medial plantar nerve (S1 and S2), which is a terminal branch of the tibial nerve. The muscle is vascularized by the branches of the posterior tibial artery, namely the medial plantar and lateral plantar arteries. The majority of blood from the flexor digitorum brevis is drained by the medial plantar vein, which drains into the anterior and posterior tibial veins.
The flexor digitorum brevis is crucial for the gait cycle, as it works in synergy with the flexor digitorum longus to maintain balance by keeping the toes in firm contact with the ground. It also supports the longitudinal arch of the foot and stabilizes the foot while walking or running.
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Abductor hallucis
The abductor hallucis is an intrinsic muscle of the foot. It is a small and slender, yet powerful muscle that has three origin points and one insertion point. It is located on the medial side of the sole, where it contributes to a small soft tissue bulge. It originates from the medial process of the calcaneal tuberosity, flexor retinaculum, and plantar aponeurosis. The muscle fibres run anteriorly and medially, forming a tendon at the level of the body of the first metatarsal bone. The tendon then courses along the medial border of the first metatarsophalangeal joint to insert at the base of the proximal phalanx of the great toe.
The abductor hallucis is innervated by the medial plantar nerve, which is a terminal branch of the tibial nerve. The blood supply for the abductor hallucis comes from two arteries: the medial plantar artery and the first plantar metatarsal artery. The main action of the abductor hallucis is the abduction and flexion of the great toe at the first metatarsophalangeal joint. This action helps to preserve the central position of the big toe during walking and also aids in maintaining the medial longitudinal arch of the foot while walking.
The abductor hallucis is the most medial muscle of the foot, running medially to the flexor hallucis brevis muscle. The plantar surface of the muscle is covered by the plantar aponeurosis, while its dorsal surface is related to the tendon of the flexor digitorum longus, medial plantar artery, and nerve. The originating fibres of the abductor hallucis and calcaneus build a space called the porta pedis, which serves as a tunnel for the lateral and medial plantar nerves and vessels to pass through.
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