Foot Massage - Treating Foot Pain

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Deep Muscles of the Foot:
These comprise: quadratus plantae, adductor hallucis, flexor hallucis brevis, dorsal interossei, plantar interossei.

Origin:
Quadratus plantae: medial head—medial surface of calcaneus; lateral head—lateral border of inferior surface of calcaneus.

Adductor hallucis: oblique head—bases of 2nd, 3rd, and 4th metatarsals. Sheath of peroneus longus tendon; transverse head— plantar metatarsophalangeal ligaments of 3rd, 4th, and 5th toes. Transverse metatarsal ligaments. Antagonist: abductor hallucis.

Flexor hallucis brevis: medial part of plantar surface of cuboid bone. Adjacent part of lateral cuneiform bone. Tendon of tibialis posterior. Antagonist: extensor hallucis longus.

Dorsal interossei: adjacent sides of metatarsal bones. Antagonist: plantar interossei.

Plantar interossei: bases and medial sides of 3rd, 4th, and 5th metatarsals. Antagonist: dorsal interossei.

Insertion:
Quadratus plantae: lateral border of tendon of flexor digitorum longus.

Adductor hallucis: lateral side of base of proximal phalanx of great toe.

Flexor hallucis brevis: medial part—medial side of base of proximal phalanx of great toe; lateral part—lateral side of base of proximal phalanx of great toe.

Dorsal interossei: bases of proximal phalanges: 1st—medial side of proximal phalanx of 2nd toe; 2nd to 4th—lateral sides of proximal phalanges of 2nd to 4th toes.

Plantar interossei: medial sides of bases of proximal phalanges of same toes.

Action:
Quadratus plantae: flexes distal phalanges of 2nd to 5th toes. Modifies oblique line of pull of flexor digitorum longus tendons to bring it in line with long axis of foot.

Adductor hallucis: adducts and assists in flexing metatarsophalangeal joint of great toe.

Flexor hallucis brevis: flexes metatarsophalangeal joint of great toe.

Dorsal interossei: abduct (spread) toes. Flex metatarsophalangeal joints.

Plantar interossei: adduct (close together) toes. Flex metatarsophalangeal joints.

Nerve
Quadratus plantae, adductor hallucis, dorsal interossei, plantar interossei: lateral plantar nerve, S1, 2.

Flexor hallucis brevis: medial plantar nerve, L4, 5, S1.

Basic Functional Movement:
Examples: holding a pencil between toes and ball of foot; helping to gather up material under foot by involving great toe; making a space between great toe and adjacent toe; facilitating walking.

Referred Pain Patterns:
Quadratus plantae—heel pain; adductor hallucis—forefoot pain; flexor hallucis brevis—pain around 1st metatarsophalangeal joint; dorsal/plantar interossei—2nd digit pain (anteroposterior).

Indications:
Foot/heel pain, pain in 1st metatarsophalangeal joint, bunions/hallux valgus, pain in 2nd toe, forefoot pain, stiffness in tissues (inability to use orthotic support), problems with walking, numbness in foot, hip/knee/ankle pain, heel spur, plantar fasciitis (quadratus plantae).

Causes:
Arthritic toes, poor footwear (heels) or orthotics, sports (e.g. swimming, walking, jogging, running, sprinting), hypomobile ankles, toe clawing, trauma, chilling in wet socks/cold water.

Differential Diagnosis:
Morton’s neuroma. Metatarsalgia. Plantar fasciitis. Heel spur. Stress fracture. Articular (joint) dysfunctions. Injured sesamoid bones. Lumbar radiculopathy (foot drop). Hallux valgus. Calcaneal compartment syndrome. Gout. Arthritis.

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