Flexor digitorum brevis | Sports massage for foot pain, part 4

We continue with the fourth video in our sports massage of the foot, this time visiting the one of the deep intrinsic toe flexors: flexor digitorum brevis.

The flexor digitorum
brevis is a broad muscle that has three origins: the medial process of the calcaneal tuberosity, intermuscular septum, and plantar aponeurosis. It attaches proximally to the tuberosity
of the calcaneus and distally by separate
tendons, to the middle phalanx of each of
the four lesser toes.

This supports the arch of the foot and manages flexion for all toes except the great toe. It helps propel the body forwards during normal walking.

Pain and tenderness are projected from
trigger points in the flexor digitorum brevis to the
sole over the heads of the second to
fourth metatarsal bones with occasional
extension over the head of the fifth metatarsal
. The referred pain does
not extend back as far as the centre of the
sole, nor forward onto the toes. The bony
portion of the plantar forefoot can be sore
and tender, leading to the complaint of
sore foot symptoms.

For assessment, use passive extension
of the second, third, and fourth toe applied at the middle
phalanx. If it is painfully limited, the flexor digitorum brevis may be shortened by
trigger points.

For further confirmation, you can ask the patient to
press down hard against the examining
finger. This can test for significant weakness.
Palpation of the painful areas establishes
whether these areas also exhibit
tenderness that may be referred from trigger points. Since chronic trigger point tension in a muscle
induces tenderness at the attachment site, patients with trigger points in the
intrinsic flexors of the toes are likely to be
tender in front of the calcaneus where the
plantar aponeurosis attaches.

Note that this sometimes mimics plantar fasciitis symptoms.

Keep in mind when palpating the
flexor digitorum brevis it lies deep to the thick plantar aponeurosis so you need sufficient pressure to engage the trigger points.

Part 1:    • Extensor digitorum brevis and extensor hal...  
Part 2:    • Abductor hallucis | Sports massage for foo...  
Part 3:    • Abductor digiti minimi | Sports massage fo...  
Part 4:    • Flexor digitorum brevis | Sports massage f...  
Part 5:    • Adductor hallucis | Sports massage for foo...  
Part 6:    • Quadratus plantae | Sports massage for foo...  

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These videos are intended to be used for information purposes only and are not intended to be used for medical diagnosis or treatment or to substitute for medical diagnosis and/or treatment rendered or prescribed by a physician or trained healthcare professional. This information is designed as educational material and should not be taken as a recommendation for the treatment of any particular person or patient. Always consult your physician if you think you need treatment or if you feel unwell.