The extensor hallucis longus muscle attaches to the small bone in the lower leg. It continues down the front of the leg connecting to a bone in the big toe. Trigger points in the muscle cause pain and cramping in the big toe and top of the foot.

Contents of Article

    Where Is The Extensor Hallucis Longus Muscle?

    Extensor Hallucis Longus Muscle Showing Trigger Point Location

    The extensor hallucis longus attaches to the small bone of the lower leg (fibula) and going down the front of the leg to connect to a bone located on top of the big toe (distal hallucis phalanx).

    What Movements Does It Control?

    • Pulls the big toe up
    • Bends the foot by the ankle up toward the front of the body
    • Assists to turn the sole of the foot inward, toward the other foot
    • Assists to maintain balance

    For detailed anatomy information: Extensor Hallucis Longus Muscle Anatomy


    Extensor Hallucis Longus Muscle Trigger Points Symptoms:

    Extensor Hallucis Longus Referred Pain Pattern
    • Pain in the top of the foot by the toes
    • Difficulty raising the foot
    • Numbness in the top of the foot
    • Pain in the big toe
    • Recurrent foot cramps at night
    • Pain can travel up to the ankle, which is described to feel like bone pain
    • Contributes to the development of hammertoe and claw toe
    • Contributes to “foot slap.”

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    What Causes Extensor Hallucis Longus Trigger Points To Develop?

    • Stubbing the toes
    • Kicking a ball
    • Pedaling a bike
    • Climbing stairs
    • Walking in sand
    • Wearing high heels
    • Inactivity of the lower leg due to a cast
    • People who spend hours driving with their foot on the gas pedal

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    Yoga Toes Gems are highly recommended for anyone dealing with foot and lower leg pain. The separators not only stretch the muscles of the feet but also 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. I prefer the Yoga Toes Gems because they are more supple, comfortable, and easier to use. To increase therapeutic treatment, relax while wearing Yoga Toes and then use the massage balls (below) to further massage and relax the muscles of your feet.

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    Extensor Hallucis Longus Trigger Point Treatment

    It is natural to rub and press on the top of the foot and big toe when trigger points flare in the extensor hallucis longus because that is where it hurts. However, to provide lasting pain relief, the trigger point in the shin must be deactivated.

    If you are interested in learning how to treat trigger point muscle pain, The Trigger Point Therapy Workbook will teach you what you need to know. The book provides diagrams and instructions on how to find and treat TrPs throughout the body.

    Another option is to find a massage therapist, physical therapist, or chiropractor who has trigger point training. They can show you how to find and treat the specific area.

    Trigger points in the extensor hallucis longus muscle respond best to several 1-2 minute treatments spread throughout the day. Treat the TrP until you can apply pressure on the area and pain and symptoms do not occur.

    Sombra Warm Therapy 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 over-use and stiffness, and arthritis. If you have reoccurring leg or foot cramps, you should keep Somba on hand; it provides almost instant relief. (Not sold in stores)

    Biofreeze Pain Relieving Gel is an excellent pain-relieving gel recommend for those who have 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 sprains, strained and sore ankles.

    How Long Before I Feel A Reduction In Pain

    The good news is that you will begin feeling relief quickly. If you are experiencing foot cramps in the top of the foot and big toe, massaging this TrP will relax the muscle and stop the cramp.

    You need to continue treating the trigger point until you do not feel the knot and the area is not painful when pressure is applied.

    Interesting facts:

    If allowed to remain chronically tight, the extensor hallucis longus can lead to hammertoe. Permanent deformity of the toes can result if the muscles are not treated.

    TWD Recommends

    Sore shins or calves? Feel as if shin splints are coming on? The ProStretch Calf Stretcher & Foot Rocker can help! The stretcher/rocker stretches and helps to relax most of the muscles in the lower leg and foot. Used by physical therapists to treat sore shins and calves as well as foot pain and plantar fasciitis.

    Extensor hallucis longus muscle pain and symptoms can be similar to, contribute to, and be affected by these medical diagnoses:

    • L4 or L5 Radiculopathy
    • Hammer toes
    • Claw toes
    • Gout


    Other muscles that should be considered and examined:

    Satellite trigger points associated with the extensor hallucis longus muscle:

    Trigger points in the muscle will cause TrPs to develop in other muscles. These are known as satellite trigger points. You will need to check these muscles for additional TrPs.

    • Peroneus Longus
    • Peroneus Brevis
    • Peroneus Tertius
    • Tibialis Anterior

    Muscles That May Contribute To These Conditions:

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    Muscles With Similar Pain Patterns

    Extensor Digitorum Longus
    Tibialis Anterior