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Extensor Digitorum Longus Muscle: Toe And Top Of The Foot Pain

Image of a man showing the extensor digitorum longus pain pattern.

The extensor digitorum longus muscle is a long muscle found in the lower leg. The muscle attaches to both bones in the lower leg, the shin bone (tibia) and the small bone (fibula), running down the front of the leg to connect to the top of the four small toes.

The muscle causes pain in the four small toes, the top of the foot that extends to the front of the ankle and lower leg.

The Location of the Extensor Digitorum Longus Muscle

Image of human skeletal legs showing the origin and insertion of the extensor digitorum longus muscle.

The extensor digitorum longus attaches to the shin bone (tibia) and 3/4 of the length of the small bone (fibula). The muscle goes down the leg blending into a tendon. The tendon splits into four branches that continue into the foot and connects to the tops of the four small toes.

The Extensor Digitorum Longus Actions Are Extension Of The 4 Small Toes, Dorsiflexion Foot, And Eversion Of The Foot

  • Pulls the four small toes up (extension)
  • Pulls the foot up toward the front of the body (dorsiflexion)
  • Assists in turning the sole of the foot outward (eversion)
  • Assists in maintaining balance

For detailed origin, insertion, and action information: Extensor Digitorum Longus Muscle Anatomy.

Extensor Digitorum Longus Muscle Pain And Symptoms

Symptoms include:

  • Pain in the top of the feet by the toes
  • Pain extends up toward the ankle and shin
  • Difficulty raising the foot (foot drop)
  • Numbness in the top of the foot
  • Foot cramps
  • Contributes to the development of hammertoe and claw toe

Extensor digitorum longus muscle dysfunction affects the foot, ankle, and lower leg. The most common symptom is pain and numbness in the top of the foot by the toes. If the muscle becomes short and tight, it can cause claw toes, which leads to permanent deformity of the toes if not treated. The muscle is also a significant contributor to leg and foot cramps.

But possibly the most concerning symptom is foot drop. Foot drop is the inability to bend the foot up toward the body. It can also lead to your foot suddenly dropping to the ground while walking or running and can cause tripping and falling. Trigger points in the muscle can contribute to foot drop. However, foot drop is also a symptom of other serious medical conditions and should be checked by a doctor.

The extensor digitorum longus muscle is affected and can affect these conditions.

 | CLAW TOE |  | FOOT DROP |  |  |   | HAMMER TOE |  |  |   |  

Other muscles that should be examined:

Products TWD Use and Recommend For Low Leg and Foot Pain

Image of a TENS UnitDoctors and physical therapists often recommend using a TENS unit at home to relax muscles and ease the pain. The Belifu TENS Unit Muscle Stimulator is highly recommended and an excellent choice for treating lower leg pain and other muscles in the body.

The Roxofit Calf Support/Shin Splint provides support and warmth to the lower leg muscles. This brace is recommended for support and compression of low leg muscles, including the muscles of the shins. If you suspect or have ever been diagnosed with blood clots, consult your doctor before using this brace.

Yoga Toes Gems are highly recommended for foot and lower leg pain. The separators stretch the muscles of the feet and many muscles of the lower leg. Used regularly, Yoga Toes do help straighten and align your toes. They can also be helpful for some cases of bunions, hammertoes, and claw toes. It can also help with issues of plantar fasciitis. For Men's shoe size ten+ and women's shoe size 12+, consider Yoga Toes For Men

Sombra Warming Gel  is recommended for relaxing muscles and relieving pain. It warms without the burning heat of other gels. An excellent choice for pain caused by trigger points, muscle/joint overuse and stiffness, and arthritis. Somba works well for foot and lower leg pain; it provides almost instant relief. (Not sold in stores)

Biofreeze Pain Relieving Gel  is an excellent pain-relieving gel recommended for those with sudden onset muscle pain or recent injuries. It is better to use than warm therapy gels and creams for muscle pain caused by inflammation as it cools the area much like ice. If your pain is from a recent injury, use Biofreeze. It is excellent to use on strained shins and sore ankles.

The Causes Of Extensor Digitorum Longus Pain

    • Stubbing the toes
    • Kicking a ball
    • Running, jogging, power walking
    • Repetitive up-and-down movements of the ankle
    • Pedaling a bike
    • Climbing stairs
    • Wearing shoes that are too small
    • Wearing high heels
    • Inactivity of the lower leg due to a cast

One of the most common extensor digitorum longus muscle injuries is stubbing your toes or jamming the toes while kicking a ball. The injuries cause the muscle to contract and shorten, leading to pain and the development of trigger points.

Speaking of jamming the toes, shoes that are too short, where the toes jam up against the end of the shoe, will definitely cause problems with the extensor digitorum longus muscle. Shoes that are too short, making the toes bend up to fit into the shoe, can also lead to claw toes which can permanently deform the foot and toes. Shoes that are too narrow and squeeze the foot are also problematic for the muscle and will lead to pain and soreness.

Another problematic shoe is high heels. High heels throw off the body's balance, putting all your weight on the balls and toes of the feet. This unnatural stance affects the feet and lower legs and contributes to knee, hip, and low back pain.

The repetitive bending and straightening of the ankle overwork the extensor digitorum muscle. Truck drivers often complain of cramping and pain in the top of the foot, ankle, and shin on the foot that they use to brake and push the gas pedal. People who climb or run stairs also experience this pain.

How To Avoid the Development of Trigger Points In The Extensor Digitorum Longus Muscle

  • The importance of proper footwear cannot be emphasized enough. Shoes that are too short will make the toes bend upwards to avoic smashing into the end of the shoe, leading to pain and the development of claw toes. Your toes should never touch the end of the toebox; if they do, size up!
  • Shoes that are too narrow and squeeze the foot will lead to pain. Make sure the shoe does not bind the foot and your toes have enough room to wiggle around. 
  • Save those high heels for special occasions.
  • Wear shoes suitable to your activity and sport.
  • Develop a strengthening and stretching program concentrating on the feet and lower legs. Balanced muscles will keep pain at bay.
  • Pay attention to the objects around you and don't stub your toes!

Interesting Facts About The Extensor Digitorum Longus

  • Contributor to cramps in the toes, top of the foot, and front of the lower leg
  • Trigger points and chronic tightness in the extensor digitorum longus contribute to claw toes. If this condition is not resolved, it can lead to deformity of the toes and constant pain in the foot.

Sports that contribute to extensor digitorum muscle pain

Sports that require quick changes in direction and sudden fast starts and stops.

    • Soccer
    • Basketball
    • Tennis
    • Gymnastics
    • Dance
    • Martial Arts

Sports that require repetitive jumping.

    • Basketball
    • Volleyball
    • Hurdles
    • High Jump
    • Broad Jump
    • Gymnastics


Common Locations Of Trigger Points In The Extensor Digitorum Longus Muscle

Human legs and muscle showing possible locations of extensor digitorum longus trigger points.
Image of a man showing locations of extensor digitorum trigger points.

Check for these trigger points if you are experiencing pain in the big toe, ankle, and shin.

Extensor Digitorum Longus Muscle Self-Treatment Massage

Though extensor digitorum longus trigger point pain is felt at the top of the foot and toes, the treatment is applied in the belly of the muscle in the shin. Once the trigger point(s) are deactivated (gone), the pain in the foot will decrease.

To find trigger points in the extensor digitorum muscle:

  1. Begin your search a hand's width below the knee and an inch toward the outside of the leg.
  2. Search the belly of the muscle for extremely sore points. You may feel a small knot or tight band.
  3. Stop and hold pressure on the point for 10 seconds, then continue with your search. The pressure should not be overly painful and should fall into the range of "hurts so good."
  4. Whether you find trigger points or not, massage the muscle and the lower leg muscles for pain and tension relief. Start below the knee, working down the leg with medium pressure.
  5. Do not use pressure directly on the bone; concentrate on the muscles on each side of the shin bone.

Another option is to find someone trained in trigger point therapy to show you how to find the TrP and apply the treatment. Many massage therapists, chiropractors, and physical therapists have the specified training.

How Long Before I Feel A Reduction In Pain?

The extensor digitorum longus lies close to the surface of the skin and responds quickly to treatment. You may feel a reduction in pain within 1-2 days. But it is important to continue treatments until the muscle does not produce pain or soreness when pressure is applied, which can take 2-6 weeks, depending on the severity of the trigger points and muscle tightness.

If you find trigger points in the extensor digitorum longus, you will want to check these muscles for additional trigger points, known as satellite trigger points. 

The Trigger Point Therapy Workbook will teach you what you need to know if you want to learn how to treat trigger point muscle pain. The book provides diagrams and instructions on how to find and treat TrPs throughout the body. Highly recommended for those who want to learn about muscle and referred pain.

Muscles With Similar Foot And Low Leg Pain Patterns



Clay, J. H., Allen, L., Pounds, D. (2015). Clay & Pounds' Basic Clinical Massage Therapy: Integrating Anatomy and Treatment (3rd ed.). Philadelphia, PA: Lippincott Williams & Wilkins

Finando, D., Finando, S. , (2005). Trigger Point Therapy for Myofascial Pain: The Practice of Informed Touch (1st ed.) Rochester, VT: Healing Arts Press.

Muscolino, J., (2016) Kinesiology: The Skeletal System and Muscle Function (3rd ed.). Maryland Heights, Missouri: Mosby.

Image Credits: Dreamstime