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Flexor Digitorum Brevis Muscle: Pain In The Ball of Foot

Image of human foot showing the flexor digitorum brevis pain pattern.

The flexor digitorum is located on the bottom of the foot, connecting the heel bone to the middle bones of the four small toes.

Though it is located in the center of the foot, it does not contribute to painful arches. The pain is most intense under the toes radiating out to the ball of the foot. The pain is described as feeling as if you are walking on sharp pointed rocks or pieces of broken glass.

The Location of the Flexor Digitorum Brevis

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The flexor digitorum brevis is located on the bottom of the foot in the center of the arch. It connects the heel bone (calcaneus) to the middle bones (middle phalanx) of the four small toes.

The Flexor Digitorum Brevis Muscle Actions Bending The Small Toes Down

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The flexor digitorum brevis muscle bends the four small toes down.

For detailed origin, insertion, and action information: Flexor Digitorum Brevis Anatomy.

Flexor Digitorum Brevis Pain And Symptoms

Symptoms include:

  • Pain in the ball of the foot just under the four small toes
  • Pain is often described as a feeling of walking on sharp-pointed rocks
  • Deep aching pain while resting
  • Tendency to limp while walking
  • Arch supports and orthotics make the pain worse

Flexor digitorum brevis pain can be relentless. While walking or standing, it may feel like sharp rocks or glass are digging into the ball of your foot under the toes. The pain is often enough to make you limp while walking. When resting with your weight off your feet, the sharp pain is replaced by deep aching pain in the foot.

People with flat feet and fallen arches usually have pain that can be traced to this muscle. An indicator that the flexor digitorum brevis is the cause of your pain is orthotics, and arch supports increase your pain. Shoes that provide arch support can also aggravate the muscle.

The flexor digitorum brevis muscle is affected and can affect these conditions.

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Other muscles that should be examined:

Products TWD Use and Recommend For Foot Pain

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 chronic foot 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 sprains and strained and sore ankles.

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

The Serenily Massage Ball Set  includes a smooth ball, two spiked balls, and a roller, which will give you maximum treatment for various aches and pains in your feet and other areas of the body. The balls vary in flexibility to provide needed pressure. The roller can be used for hot or cold treatments. The set comes with instructions and exercises. Rolling your feet takes just a few minutes each day and can provide excellent results for foot, lower leg, hip, and back pain.

The Causes Of Flexor Digitorum Brevis Pain

    • Walking on uneven ground
    • Stubbing toes
    • Shoes that are too narrow and pinch toes together or are not long enough for toes to lay comfortably
    • A pronated foot (walking on the inside of the foot)

Hikers and trail runners often experience muscle pain in the bottom of the feet, including the flexor digitorum brevis muscle. Uneven terrain overwork the muscles in an attempt to maintain body balance.

The constant pressure of standing and walking on hard, unyielding surfaces also contributes to pain in the flexor muscles of the foot, causing pain and swelling of the feet and lower legs.

However, ill-fitting shoes are probably the top reason for foot pain. Shoes that are too narrow the shoes squeeze the foot and toes. If you wear shoes that are too short, the toes curl up to avoid jamming into the shoe's toebox.
High-heeled shoes throw the body's weight onto the front of the foot. The angle of the heel is higher than the forefoot, keeping the flexor digitorum brevis in a short, contracted state which affects gait and balance. Foot and toe deformities can develop over time if heels are worn a lot.

Pronation of the foot also affects the flexor digitorum brevis. A pronated foot collapses to the inside resulting in a person walking on the inside of the foot.

Flexor Digitorum Interesting Facts

  • Pain in the ball of the foot is the most common complaint of foot pain.
  • Pain in the ball of the foot is often thought to be Metatarsalgia.
  • Though the muscle is located in the arch, it does not contribute to pain in the arch.
  • If arch supports increase pain in the ball of the foot, the problem is most likely the flexor digitorum brevis.
  • Flexor digitorum brevis muscle pain is often diagnosed as plantar fasciitis.

How To Avoid the Development of Trigger Points In The Flexor Digitorum Brevis Muscle

You will have problems with pain in the flexor digitorum if you wear shoes that are too short. When the toes curl to fit into the shoe, the muscle stays contracted, or in other words, shortened and "bunched up." Make sure your shoes are long enough that the toes never touch the end of the toe box.

Shoes that are too narrow will squeeze the toes together, straining the muscle. Not only will your feet hurt, but they will also swell, which makes the pain more intense. Wear shoes that are wide enough that they do not bind or feel tight on the foot. You should be able to wiggle your toes a bit in the shoes.

If you wear high-heel shoes frequently, the muscles in the bottom of the feet suffer. High heels cause painful feet and contribute to a lot of ankle, knee, hip, and low back pain. Wear lower heel shoes for part of the day. If that is not possible, take the heels off and walk around barefoot to give the muscles of the feet a chance to stretch out and relax.

If you are a hiker, trail runner or often walk on uneven or rough terrain, wear shoes that support and protect your feet and ankles.

Pronation of the foot is when the foot and inside ankle collapses inward toward the other foot. Pronation has many causes, including a previous injury to the foot and ankle, muscle imbalances in the foot, ankle, and low leg muscles, arthritis, obesity, and nerve conditions. Pronation contributes to foot, knee, hip, and low back pain. To properly treat the pronation of the foot, the cause must first be determined and may require medical intervention.

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Common Locations Of Trigger Points In The Flexor Digitorum Brevis Muscle

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Check for these trigger points if you are experiencing pain on under the toes and ball of the foot.

Flexor Digitorum Brevis Muscle Self-Treatment Massage

The flexor digitorum is easy to treat using massage balls. TWD recommends The Serenily Massage Ball Set. It is a set of 2 balls and a roller used for varying pressure and depth. The roller can be warmed to relax tight muscles or put in the freezer to reduce pain and inflammation. The balls can be used on many muscles throughout the body to relieve muscle pain and tightness. The set includes an instructional booklet.

To treat the flexor digitorum brevis, place the roller or one of the balls on the floor and roll the bottom of your foot. Concentrate your rolling on the belly of the muscle, from the heel to the beginning of the ball of the foot. Even though the pain is across the ball of the foot and under the toes, the muscle belly is the source of your pain. Use light pressure, slowly increasing the pressure to a tolerable level. Your pain level should not be excruciating but should "hurt so good." Roll your foot two or three times a day for 1-2 minutes per foot.

Stop and hold the pressure for 10 seconds if you find an exceptionally painful spot, as it is likely a trigger point. Keeping pressure on the spot will help to deactivate it. Continue treatment until the pain is gone and all tender points are eliminated.

How Long Before I Feel A Reduction In Pain?

You should begin to feel a reduction in pain and increased flexibility after 2-3 days of consistent treatments. You must continue treatments until all pain and soreness are gone; otherwise, the pain will return and may be worse than before.

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

Muscles With Similar Foot Pain Patterns

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References:

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