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Quadratus Plantae Muscle: Heel Pain

Image of human foot showing the location of quadratus plantae muscle pain.

The quadratus plantae, also known as the flexor digitorum accessorius, is a muscle found in the bottom of the foot. It attaches to the heel joining the flexor digitorum longus tendon that connects to the four small toes. The muscle contributes to heel pain and is a primary contributor to plantar fasciitis.

The Location of the Quadratus Plantae

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The quadratus plantae is a two-headed muscle. Both heads attach to the heel (calcaneus) and connect to the flexor digitorum longus tendon and the long plantar ligament in the middle of the arch. The flexor digitorum longus tendon separates into four branches that connect to the four small toes.

The Quadratus Plantae Muscle Action Is Flexion Of The 2nd, 3rd, 4th, and 5th Toes

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The quadratus plantae muscle assists other muscles in bending (flexion) the small toes down.

For detailed origin, insertion, and action information: Quadratus Plantae Muscle Anatomy

Quadratus Plantae Pain And Symptoms

Symptoms include:

  • Sharp and stabbing pain in the heel
  • Tingling in the foot
  • Edema in the foot

The quadratus plantae muscle pain is localized in the heel. The pain is often so sharp and stabbing that you will avoid putting weight on the heel and walk on the ball of the foot. Along with the sharp pain, you may also experience tingling and numbness in the foot.

Another symptom the muscle may occasionally contribute to is edema in the foot. Edema is swelling caused by excessive fluid buildup and should be examined by a physician to rule out serious medical conditions.

The quadratus plantae 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 NatraCure Cold/Hot Therapy Wrap is just the right size to use on the bottom of your foot. You can use cold therapy throughout the day to reduce sharp stabbing pains during the day. At night you can use it for heat therapy to ease the pain so you can rest. The wrap can also be used for the ankle, wrist, elbow, and other areas of the body.

The Causes Of Quadratus Plantae Pain

    • Walking barefoot on rocks or hard surfaces
    • Walking, standing, or running on hard surfaces
    • Walking or running on uneven ground
    • High heels
    • Shoes that are too small
    • Wearing socks or stockings with tight bands
    • Foot immobilized due to cast or brace

Walking around barefoot can be good for the feet. However, a common heel pain contributor is stepping on something hard, like a rock, when barefooted. Likewise, standing, walking, and running on uneven or hard ground can be problematic. The quadratus plantae becomes stressed and bruised, causing pain and the potential for trigger point development.

The type and fit of your shoes also affect the muscles in the foot. If your shoes are too narrow or too short, pressure and stress are put on all foot muscles, especially those in the bottom of the foot, including the quadratus plantae. Wearing high heels throws the body weight onto the balls of the feet resulting in the quadratus plantae becoming short and tight.

A cast or stiff brace immobilizing the ankle and foot for an extended time leads to muscle imbalances and the development of trigger points, contributing to pain and stiffness.

How To Avoid the Development of Trigger Points In The Quadratus Plantae

The two most significant contributors that lead to quadratus plantae pain are stepping on hard objects while barefoot and wearing shoes that are too small.

When walking outside, a good rule of thumb is to wear shoes if you do not know the terrain. Stepping on rocks or other hard objects will cause bruising and often leads to the development of trigger points. If you are walking on unfamiliar ground or rough terrain, wear shoes with thicker soles to protect the bottom of the feet.

Likewise, standing or walking on hard surfaces for extended amounts of time will cause pain and possibly swelling of the feet. Wear supportive padded shoes if you often walk on tile, cement, and other hard surfaces. If you stand in one spot for long periods, consider getting a standing mat to give your feet, knees, and low back a break.

Wear shoes that fit. Shoes that are too narrow or too short will cause the muscle to become short and tight. Your shoes should be wide enough not to squeeze the foot and long enough that the toes are not touching the end of the shoe.

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Common Locations Of Trigger Points In The Quadratus Plantae Muscle

Human skeletal foot and quadratus plantae muscle showing the location of a trigger pointl
Photo of human foot showing the quadratus plantae muscle trigger point.

Check for this trigger point if you are experiencing pain in the heel.

Quadratus Plantae Muscle Self-Treatment Massage

The quadratus plantae is located deep in the foot. The trigger points are easily self-treated by using a massage ball to roll the bottom of the foot. Put the ball on the floor and roll the bottom of your foot, concentrating on the area in front of the heel. Do this treatment 2-3 times a day for 1-2 minutes per treatment. If you find an exceptionally tender spot, stop on that area and apply pressure for 10 seconds. Continue treatments until the pain and soreness are gone.

TWD recommends The Serenily Massage Ball Set. The set includes three balls and a roller for varying pressure and depth. For quadratus plantae pain, start with the smooth ball. The pressure should be tolerably painful; it hurts but also feels good. As more pressure is needed, use the nub ball and then graduate to the spiked ball. Keep the pressure applied at a "hurts so good" level.

How Long Before I Feel A Reduction In Pain?

Because the quadratus plantae is located deep in the foot, it may take several days of treatment to notice a reduction in pain. For successful treatment, continue treating the trigger point until all pain and soreness are gone. If your pain increases after treatment, stop treatments and consult a medical professional.

If you find trigger points in the quadratus plantae, 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