Flexor Hallucis Longus Tendonitis: [Causes, Symptoms & Best Treatment]
Flexor Hallucis Longus Tendinitis can cause pain in 3 areas: #1 is the big toe, #2 in the back of the ankle, and #3 in the bottom of the arch.
Flexor Hallucis Longus Tendonitis Overview:
- Flexor Hallucis Longus Tendinitis: The flexor hallucis longus muscle-tendon unit starts from the back of your leg.
- It runs along the inside of your ankle to the bottom of your foot and inserts into the bottom end of your big toe.
- It is the muscle that is primarily responsible for bending your big toe.
- Whenever this muscle is flexed, it shortens, pressing the big toe firmly against the ground. This puts stress across the muscle, which it is normally used to.
- The problem arises when the tendon rubs improperly against something, is overused, or too much weight is stressed upon it.
- This leads to a state known as inflammation, where the tendon starts to break down and heal itself.
Flexor Hallucis Longus Tendonitis Causes:
- Flexor hallucis tendonitis is usually caused by gradual wear and tear of the tendon due to irritation or overuse.
- It is widespread in people who often push off with their big toe, such as a ballerina dancer.
Flexor Hallucis Longus Tendonitis Symptoms:
- Flexor hallucis tendonitis usually is most evident during extremely forceful bending of the big toe joint in a downward direction.
- As the condition becomes more severe, it will also be felt in the mornings, after periods of inactivity, until you can get the blood flow and work through the pain.
- The pain will gradually worsen over time if it is not corrected.
- There could also be impingement of flexor hallucis longus in the back of the ankle.
- This condition is diagnosed by a physical exam by your podiatrist and confirmed by ruling out other common conditions through X-ray and MRI.
Treatment of Flexor Hallucis Tendonitis:
- Taping: A method of taping called Low Dye Taping can be a cheap and easy way to see if it is a biomechanical problem that is easily correctable.
- Ice: This is not just about pain! It will decrease the inflammation and decrease the time needed to heal. Put ice in a bag and apply it for 15-20 minutes every 1-2x per day until it starts getting better. Leave some cloth between the ice and the skin.
- Elevation: Like above, it is more than about pain. Recline in a chair and elevate your foot while watching tv. The more, the better. Elevation can take days or weeks off your healing time.
- Pain medication: Ibuprofen or other anti-inflammatories are amazing at reducing inflammation. This is not just for pain! The goal is to continue it regularly for 1-2 weeks, not for pain but to raise anti-inflammation levels in your blood so that it has a chance to heal.
- Tight Calf Muscles – Stretching your calves is crucial in relieving the pain in the second toe. WATCH VIDEO
- Combine Them– Icing, elevation, non-weight bearing, and pain medication gives you the best chance at healing as quickly as possible.
Podiatrist Treatment of Flexor Hallucis Longus Tendinitis:
- Get an X-ray.
- Get an MRI.
- These imaging tests can rule out the presence of an ossicle called the Os Trigonum, which may be irritating the flexor hallucis longus.
Home Flexor Hallucis Longus Tendonitis Treatment:
- There are usually two phases to the bottom of the foot pain treatment.
- The two phases of treatment include controlling the acute inflammation and correcting the biomechanics, which led to the problem in the first place.
- If the tendons and ligaments are inflamed, they are almost frozen in place and cannot function properly.
- Once the inflammation is decreased, we need to correct the biomechanical causes to ensure that they can never become overworked and inflamed again!
- This doesn’t matter whether it’s plantar fasciitis, plantar fibroma, the sore bottom of the foot, or even Achilles tendon pain. Treatment is all roughly very similar.
Massage & Ice Products:
- Ice is an excellent option that can be safe for almost everyone.
- There is some debate about whether icing is worth doing, but this can help limit the need for medications and keep your options open for chronic pain.
- This works great for your arch, less for the ball of the foot.
- The more muscle and ligament tissue there is, the better ice will work there.
Menthol Based Gels:
- Biofreeze is one of our favorites.
- These gels have been studied to work 2x as long as ice.
- This works great for the ball of the foot.
- This can be very effective for the bottom of the heel and Achilles tendon sore regions.
- These can work great for loosening your muscles.
- This allows less tightness and pressure on the ball of your foot.
- This is very effective for the arch, the gastrocnemius, calf muscle, and the hamstring and thigh muscles.
- This also works very well for the gluteus muscles if you are having butt cheek or hip pain.
Removing The Stress:
- The key is to prevent future pain.
- If you can get rid of the pain and swelling, this will let you start walking normally.
- If you can walk normally, the vast majority of your pain should gradually start to go away.
- The best way to ensure that your plantar fascia, foot, and ankle ligaments are not overworked is to support them.
- The best way to support them is to use great orthotics and great shoes.
- Some people may also need to rely on supportive ankle braces and other supportive modalities.
Get Great Shoes:
- Getting a great supportive pair of shoes will ensure that the pressure is removed from the heel and plantar fascia region.
- This is especially important if you have plantar fasciitis, heel spur pain, or Achilles tendonitis.
- Consider shoes combined with a good supportive orthotic for the best pain relief!
- The following link will show you what our favorites are.
Get Great Orthotics:
- These are our recommended orthotics.
- There are different types of different shoes.
- Women’s shoes usually need a less bulky orthotic but allow for less correction.
- A full-length orthotic requires a running shoe, boot, or comfortable walking/dress shoe.
- We recommend doing everything you can to get a good supportive shoe that can fit a full-length orthotic.
- This is the best way to maximize your orthotics for great results.
Best Full-Length Orthotics:
- These will only work in wider shoes or a good supportive running shoe.
- This will not work in sandals, flats, or most women’s dress shoes.
Best Dress Shoe Orthotics:
- These are a great choice for dress orthotics.
Best 3/4 Length Orthotics:
- These are great options for women’s dress shoes and thinner shoes.
- These are not the most supportive pair of orthotics.
Get A Great Dynamic Stretch:
- It is possible to stretch on your own, but these products can also really help!
- This will take pressure off of the ball of your foot.
- We personally prefer this method of stretching.
Get A Great Static Stretch:
- These devices are great for stretching while you are resting.
- This will also help take pressure off of the ball of your foot.
- This works great for plantar fasciitis.
- The night splint or stretch splint can be used while watching TV or at night time.