Hammer Toe Muscles…

hammer toes and foot pain

Hammer toes and foot pain are caused by trigger points in the long toe extensors (extensor digitorum longus and flexor hallucis longus). You may not be bothered by your hammer toes but they are an important symptom of imbalance for a skilled myofascial therapist.

Although these toes look pretty good, you may also feel pain from these muscles on the top of the foot and extending into the top of the toes. To get more familiar, we’ll call these muscles the “long toes extensor” and the “big toe extensor”.

In addition, some people with trigger points in these muscles experience night cramps in their calves. In children, these can be experienced as growing pains.

If we have myofascial dysfunction in these long toe extensors, it can impact our foot mechanics, our ability to adapt to the ground as we walk or plant our foot in sports activities. If you are a dancer, gymnast, aerialist or other similar performer, shortened toes extensors will limit your ability to point your toes. Why haven’t we heard about these muscles?

Activation of the Long Toe Extensors

hammer toes and foot pain long toe extensor trigger point referral

Most often, you might activate trigger points in the long toe extensors by tripping or falling.

In addition, excessive running can do it. Or catching the ground when kicking a ball…or walking in sand or on uneven ground that you not used to can also do it. It can be similar to turf toe. Read more...

If your ankle is immobilized after a fracture or sprain that can activate these trigger points.

Wearing high heels causes trigger point activations by keeping your long toe extensors stretched throughout the day. This makes them work harder. They easily become overloaded and develop taut bands and trigger points.

Keeping your foot in plantar flexion, as with your right foot when driving, will lead to other troubles. The shortening of your soleus and gastroc reduce dorsiflexion. This can chronically overload the toe extensors. You may encounter a similar mechanism if you tuck your feet under your chair or if they do not reach the ground.

Finally, if you have experienced spinal issues at the L4-L5 level or anterior compartment syndrome you can also develop trigger points in the long toe extensors.

Hammer Toes and Foot Pain

If you are developing hammer toes, that is another indication that you may have trigger points in your long toe extensors. Read more...

First, in the classic hammer toe, the first joint of your toe is extended (where it meets your foot), the second joint is flexed and the farthest joint is also extended. There are variations on the hammer toe. But, if you have a claw toe the first joint is extended and the next two are flexed. If you have a mallet toe, only the farthest joint at the tip is flexed.

This happens because you develop muscle imbalances while compensating for other problems.

Extensor Subsitution and Hammer Toes

This means your long toe extensors are contracting during the swing phase of your gait. Read more...

But, these long toes flexors have a big mechanical advantage over the small lumbrical muscles in the feet. Your toes are hyperextended during the swing phase and heelstrike. In addition, as the condition progresses, they may remain that way, even when weight bearing.

Your long toe extensors do this because they are trying to provide more than their normal effort in dorsiflexion. But if this is unopposed by weak lumbricals, your extended toes keep occuring with every step.

Anything that increases plantar flexion can cause a vicious cycle. For many of us, this actually starts with a response to taut bands or trigger points in our long toe flexors! Wearing shoes too much, especially in childhood, may also contribute to disuse atrophy of your lumbricals.

Hammer toes and foot pain can often be corrected without surgery or invasive procedures if treated early.

You can find more information on the anatomy and function of the long toes extensors is in the Extras section at the end of this article.

Myofascial Treatment of Hammer Toes and Foot Pain

Structural Variations

Hypermobility in the bones of your feet causes flat feet. Of course, if you truly have hypermobile feet your should support your arch properly. However, some people who believe they have flat feet are merely pronating. In contrast, the bones in your feet may not move enough. Ultimately, this causes muscular overload. In this case, your foot should be mobilized.

Self Compressions

A roller like the Tiger Tail is helpful to warm up the muscles. First, gently roll the entire lower leg, aiming to increase circulation and warm the muscles up. Then, gradually increase pressure. https://www.pressurepositive.com/massage-tools/the-original-index-knobber-w-ball.htmlContinuing, begin to work a little deeper, searching for tender areas and trigger points. Move more closely to the toe extensor trigger points about 1/3 and 2/3 of the way up the front of the shin.

Then, when you feel you have found it, stop rolling and experiment with gently rocking and and wiggling of the roller on this area, while continuing to maintain pressure, until any pain subsides and the muscle releases. Finally, if you need more targeted pressure, consider using something like a Index Knobber.

Other Techniques

Because these muscles are quite deep it is more difficult to reach with massage techniques than some other muscles in the calf. Therefore, they are not very responsive to kinesio taping, ultrasound or other superficial techniques. However, we easily can target trigger points in these muscles with acoustic compression therapy.

Stretches

claw toes and foot pain long toe flexorsThe long toe extensors are quite easy to stretch. Begin seated and gently flex and extend the toes. Next, grasp the toes and gently flex them firmly. Work the big toe separately. For this and the remaining stretches, try this technique: Alternate gently extend against resistance, relax and ‘pick up the slack’. Try this three times, slowly.

Another way to deepen toe extensor stretches is to use the floor. Be careful and don’t do this too forcefully.

Of course, you should stretch your toe flexors at the same time. They are covered in detail in another post. However, many people experience cramping when stretching the extensors. claw toes and foot pain long toe flexors stretchSo, you can fix that with a flexor stretch. So that means that it is usually better to stretch the toe extensors first.

Strengthening

You may benefit from simple strengthening exercises for your toe extensors.

Some strength training approaches use calibrated resistance band training. You may be able to scan the QR Code with your phone to go directly to the video if you’re reading from a pdf or print out.

Other Recommendations

Avoid wearing high heels.

On long drives, you should consider stopping and walking around for 10-15 minutes. This will help overcome the effects of hours of immobilization.

If you are a runner, take a break. This includes treadmills and ellipiticals. Substitute swimming, rowing or cycling for aerobic activity for a while.  You may also be working on deconditioned leg and foot muscles during this time.

Next, resume running on an ellipitcal, if possible. This reduces strain on your toes. Finally, you can move up to a treadmill or other flat, level surface. Avoid slanted or uneven surfaces.

In general, your long toe extensors will feel better if you keep them in a neutral position at night. Try to avoid tight or heavy bed coverings.

A pillow or bolster placed at the foot of the bed may help to gently keep the feet in a neutral position. We do not recommend devices that pull, push or fix the feet into a particular position during sleep.

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Seriously, if you are looking for massage therapy that actually does your body good–that changes its function for the better and actually makes pain go away–then this is the place you need to come. Not Massage Envy. Not a chiropractor. You need trigger point from knowledgeable experts in the craft.

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Of course, everyone is different and many of us have additional challenges and complications. Naturally, we tailor our treatment plans to the individual, but there are common foundations to this work with everyone.

If you are having similar issues, you may find that a just few treatment sessions helps! We will identify and treat root causes of your individual case. We also offer professional treatment modalities and techniques in a professional setting.

All treatment is performed by licensed professionals with additional training and certifications in advanced techniques. This includes trigger point therapy, fascial stretching, neuromuscular and movement therapy, kinesio taping, myofascial release, cupping, acoustic compression, self-care classes and more. We often combine several of these techniques into a single session..

No one wants chronic pain! We can work together with you to help sort out the issues.

Click here or all us at 630-858-0000 today to make an appointment!

If reading from a pdf or printout, you may use this QR code to view the entire article on your phone with complete with links and videos:

https://WestSubPainRelief.com/hammer-toes-foot-pain

Extra – Anatomy of the Long Toe Extensors

It is helpful to review a little bit of the anatomy to understand how these muscles work. In this illustration the other muscles have been removed for clarity. The long toe extensors are located VERY deep to all of them. Each of muscles attaches to the front of the tibia, the fibula and the tissue in between them and proceeds down toward the foot.

The tendon of the long toes extensor muscle (extensor digitorum longus) attaches to the tips of topside of each of the 2nd-4th toes. This muscle provides most of the power in toe extension.

In addition, we can see that the big toe extensor (extensor hallucis longus) runs straight across the top of the foot and attaches to the tip of th topside of the big toe.

Extra – Function of the Long Toe Extensors

First, the long toes extensor helps with pure dorsiflexion and eversion of your foot balancing the inversion caused by tibialis anterior. It extends the four smaller toes.

The big toe extensor also helps with dorsiflexion but inverts your foot and extends the big toe.

When walking or running, your long toe extensors help in controlling the movement of your foot toward the floor immediately following heel strike. During the swing phase of your gait both muscles provide clearance by also helping to pull up on the foot. In addition, when standing, they help control postural sway to the back.

“The peak activity is just before or during the release/contact with the ball…”

Interestingly, during sports activities involving the upper body, the long toes extensor activates to help fix your foot when throwing, during golf swing, tennis stroke or baseball swing.

If your long toe extensors are chronically engaged due to trigger points you may develop hammer toes and foot pain.

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