Foot and Toe Pain

Usual Suspects:

  1. The muscles of the lower leg
  2. The muscles of the foot
  3. The ligaments and bones of the foot

The Imbue Pain Relief Patch temporarily relieves minor aches and pains of muscles and joints. In the diagrams below, the X’s show the locations of common trigger points (localized muscle strain), and the colored shading shows the pain pattern each trigger point produces. This pain is often several inches (or more) away from the trigger point at which it originates. When a trigger point is to blame for your pain, applying the Imbue Pain Relief Patch at the site of the trigger point sometimes yields better results than applying it where you typically feel the pain.

The muscles of the lower leg are very frequently the cause of pain in the foot and toes. They should always be examined, even if the problem seems to be all in the foot or began with a trauma to the foot. Abrupt or intense movements of the foot can often strain the muscles of the lower leg. Sometimes the muscles of the foot are involved, in which case the involved muscle is usually (but not always) right where the pain is felt. Finally, the many small bones of the foot form numerous joints that may cause pain, either at the bone or the ligaments that bind them together. For these sorts of structural problems, the best use of the Imbue Pain Relief Patch is typically right over the painful area.

There are many muscles of the leg and foot that may be involved in foot and toe pain, so we will let the pictures do most of the talking. In the diagrams that follow, you see some of these muscles and the places where they tend to form trigger points (shown as X’s) when they’re strained or irritated. These trigger points produce the pain patterns indicated by the colored shading. The diagrams should give you a general sense of where to examine.

Rather than just hunting down the trigger points that look relevant to your pain based on the diagrams, we recommend examining your whole leg and foot. Part of why this is important is because many of these muscles have overlapping pain patterns. If you stop looking as soon as you find one muscle that seems to be causing your pain, you may miss other involved muscles. It doesn’t take long, and you may discover significant areas of tension that you would not have suspected. Press firmly and methodically. If you find a significantly tender spot, place the Imbue Pain Relief Patch here.

Foot and Toe Pain Due to the Muscles of the Lower Leg

These muscles can be thought of in two groups. First, we have the muscles at the front and outer portion of the leg, which tend to refer pain to the shin, the front of the ankle, and the top of the foot and toes. Second, we have the muscle of the calf. Trigger points in these muscles tend to refer pain to calf, Achilles tendon, heel, and the sole of the foot.

Tibialis Anterior:

This is the most prominent muscle of the front of the lower leg, to the outside of the shin bone. You can feel it contract when you raise your toes toward your head. Trigger points in tibialis anterior occur just to the outside of the sharp crest of the shin. These points may produce tightness and achiness down the front of the leg, and also pain at the front of the ankle, the top of the foot, and the big toe. When feeling for trigger points in this muscle, start right below the knee, against the shin bone, and gradually work downward almost to the ankle. Then move slightly more outward and repeat this process.

Extensor Digitorum Longus:

This muscle runs down the front of the lower leg beneath tibialis anterior and helps raise the four smaller toes. It primarily causes pain or numbness on the top of the foot and sometimes into the toes, but it may also produce discomfort at the lower portion of the front of the leg. Compared to the trigger points of tibialis anterior (above), these trigger points will be a bit more toward the side of the leg. (They usually occur about midway between the front and side surfaces of the leg.)

Extensor Hallucis Longus:

This muscle runs from the outer leg bone (fibula) to the big toe and helps raise (extend) the big toe and the front of the foot. The fibula forms the outer ankle bone at its lower end, so begin by following this bone upward along the side of the leg, pressing firmly as you go along. This trigger point can be found somewhere in the lower half of the leg, either right over the fibula or against its front edge. It causes pain mainly in the big toe and the long bone (metatarsal) that it connects to in the foot.

Peroneus Longus:

Peroneus longus runs along the entire length of the outer leg bone (fibula) and works to turn the foot outward (eversion) and flex it downward. Trigger points in this muscle typically produce pain and weakness at the outer ankle and sometimes pain at the outer leg. Sometimes, when this muscle is tight it can squeeze the nerves that serve the lower leg, ankle, and foot, causing numbness in this area (shown in yellow). There may also be weakness making it difficult to lift the front of the foot.

Tibialis Posterior:

Tibialis posterior runs from the calf to the arch of the foot and helps to flex the foot downward. Besides causing pain in the calf and Achilles tendon, a trigger point in this muscle can send pain into the sole of the foot.

Gastrocnemius:

This powerful muscle (along with the soleus, below) forms the characteristic bulge of the upper calf. It flexes the foot downward and also helps bend and stabilize the knee. The trigger point in this diagram – just a couple inches below the knee crease and at the very back of the calf or slightly to the inside – produces pain in the arch of the foot, and also the calf and inner ankle. Remember that trigger points don’t necessarily produce pain in the entire shaded area; this muscle may produce pain in the sole without there being any pain in the calf.

Soleus:

Beneath the gastrocnemius is the broader, flatter soleus muscle. It acts to push the foot downward (flexion). The soleus forms trigger points in several places. This one, at the lower end of the muscle and slightly toward the inside of the calf, refers pain to the Achilles tendon, the heel, and sometimes to the inner ankle.

Flexor Digitorum Longus:

This muscle is responsible for curling the four smaller toes and helping them to press against the ground. A trigger point in this muscle mainly causes pain in the sole of the foot, but it may also produce an ache down the inside of the calf. Its trigger point is found against the back of the central bone of the lower leg (the tibia), a few inches below the knee crease and slightly toward the inside of the leg.

Flexor Hallucis Longus:

This muscle helps the big toe curl or push downward (flexion). Its trigger point is found just above the back of the heel and it can cause pain and numbness in the big toe.

When hunting for trigger points in the calf, just feel the whole calf thoroughly. Besides using your fingers and thumbs to dig in here, you can cross your calf over the opposite knee and press on your leg to push the calf into the knee. This provides nice broad pressure. Alternatively, you can use a Thera Cane, or place a ball (a lacrosse ball is best) under the calf while resting the leg on a firm chair or bench.

Foot and Toe Pain Due to the Muscles of the Foot

There are many small muscles in the foot. While a trigger point in one of these muscles may refer pain to another part of the foot, these pain patterns are generally simple compared to the leg muscles. The diagrams below are provided to give you an idea of the major trigger point locations on the foot and what kind of pain and numbness they can create. We recommend methodically pressing on every part of the foot, rather than focusing only on the muscles that appear to producing your pain. If you find any painful points, especially if they reproduce the pain you have been experiencing, do some massage and apply the Imbue Pain Relief Patch here.

Abductor Hallucis:

This muscle moves the big toe away from the other four toes (abduction) and helps it press down against the ground. These trigger points produce pain and/or numbness at the inside of the heel and possibly the inner ankle.

Adductor Hallucis:

This muscle pulls the big toe toward the other four toes (adduction). Its trigger points produce pain and/or numbness in the ball of the foot.

Flexor Hallucis Brevis:

This muscle is responsible for flexing the big toe (curling or pushing it downward). Its trigger points cause pain in the ball of the foot behind the big toe and sometimes in the toe itself.

Quadratus Plantae:

This deep muscle helps to curl (flex the toes). Its trigger point is right in front of the bottom of the heel and it produces sharp pain under the heel.

Flexor Digitorum Brevis:

This muscle helps the four smaller toes to curl or press against the ground (flexion). Its trigger points, a bit in front of the bottom of the heel, produce pain at the ball of the foot.

Flexor Digiti Minimi Brevis:

This muscle helps the little toe to press down and stabilize the foot. Its trigger point is a bit back from the ball of the foot, in line with the little toe. It produces pain at the outside of the sole.

Abductor Digiti Minimi:

This muscle is responsible for moving the little toe outward – away from the other toes (abduction). Trigger points in this muscle cause pain in the ball of the foot in line with the little toe, sometimes into the little toe itself, and sometimes to the outer foot and ankle.

Interossei:

These muscles occur between the five long bones of the feet. These muscles should be felt from both the top of the foot and the sole. Press deeply in the spaces between the bones. These trigger points produce pain or numbness that may actually spread over the whole foot and even up the shin.

Extensor Digitorum Brevis & Extensor Hallucis Brevis:

These muscles lift (extend) the five toes. Their trigger points are found beneath the long tendons that run over the top of the foot, and they produce pain in the local area.

For Numbness of the Foot, Also Consider the Piriformis:

The piriformis muscle is a band that runs from the edge of the sacrum (the triangular bone at the base of the spine) outward to the top of the thigh bone (the greater trochanter of the femur). Active trigger points in this muscle usually produce pain in the hip, buttock, and back of the thigh (see red shading in the diagram). Also, by squeezing the sciatic nerve, it can cause intense nervy pain, numbness, tingling, and sensitivity all the way down the leg and into the foot. The two primary trigger point regions of the piriformis are just against the outside edge of the sacrum (see inner X in diagram) and just inside the back of the hip joint (outer X), though it is worth examining the whole area inside the box. To do this, you’ll need a friend who can press firmly and methodically here, or you can use a Thera Cane or a ball (tennis or lacrosse).

If using a ball, lie on the floor and place the ball in the region where the X’s are on the diagram. Then slowly roll around to press on the whole upper buttock area, making note of any especially painful spots. You can also do this by placing the ball between your buttock and a wall (see diagram). When you find painful spots, do some massage and place the Imbue Pain Relief Patch here.

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