Long flexor of the big toe. Extension of the toes Extension of the long extensor of the big toe

16.05.202127.05.2017

muscles thumb brushes recover from injury quite quickly - within one to two weeks. However, with sufficiently serious and / or chronic injuries of the thumb, damage to the structure of its tendons is often observed. Tendons are practically avascular structures, their blood supply is minimal. They recover from damage about six times slower than muscles. In addition, it is quite difficult to limit the mobility of the thumb during daily activities in order to allow damaged tendons to fully recover and prevent their re-injury.

That is why in the process of recovery after such injuries it is extremely important the right approach to therapy. The sooner treatment begins, the faster recovery occurs. My first recommendation is not to start therapy immediately after an injury. You should wait at least 3-4 days to allow the scar tissue to fully form, and then you can apply techniques that include friction (friction massage). During the first few days after injury, you can resort to a light and shallow massage - this will help relieve pain and inflammation.

FRICTION APPLICATION

Based on my experience, I can confidently say that the most effective in the treatment of injuries of the tendons of the thumb demonstrate techniques that include friction. You can use your thumb or middle and index fingers to apply frictions. It is best to change your fingers frequently so as not to injure yourself.

Remember that pressure should only be applied in one direction. After you have worked the tendon with frictions in one direction, change the direction of the frictions to the opposite. This will help you avoid fatigue, ensure that all fibers of the tendon are evenly affected, and reduce the likelihood of discomfort at the client.

Work the tendon fibers in one direction for 4-5 minutes, rest a bit and start working in the other direction - in total you should spend about 8-10 minutes on this.

As the client's condition improves, the duration of therapy can be reduced. After applying the friction massage, you can gently stretch your thumb, hand and forearm.

DETERMINATION OF THE DAMAGED AREA AND THERAPY OF INJURIES OF THE TENDONS OF THE LONG AND SHORT EXTENDERS OF THE THUMB

Determining the damaged area of the tendon of the long or short extensor thumb is a very simple matter. Ask the client to extend the thumb so that the entire structure is in tension. Then apply friction strokes of low or medium intensity across the tendon fibers of the short or extensor longus thumb (depending on the nature and location of the injury). Do this at various points along the tendon to pinpoint the location of the damaged fibers. Since pain in these injuries does not radiate to nearby structures, the location of damaged fibers can be easily determined by the localization of pain sensations.

Once you have determined which part of the tendon is damaged, ask the client to relax the finger and then proceed with the friction massage. Each stroke should completely cross the damaged area.

This approach is applicable in the treatment of any tendon injury. Remember that it is necessary to determine the location of the damaged area quickly enough - with tendon injuries, prolonged stress
contraindicated.

DETERMINATION OF THE DAMAGED AREA AND THERAPY OF INJURIES OF THE SHORT AND LONG FLEXOR TENDONS OF THE THUMB

The tendons of the long and short flexors of the thumb are not so easily amenable to therapy, and it is also quite difficult to determine the damaged area. We will focus on the flexor hallucis longus tendon, as this tendon is the most commonly injured.

With one hand, hold the pad of the thumb as shown in the picture and ask the client to try to bend the finger. With the other hand, palpate the damaged tendon located in the middle part of the thumb eminence (closer to the index finger) along its length until you find the localization of pain. The client must hold the finger in tension for a while to give you the opportunity to find the damaged area. Once you have identified the damaged part of the tendon, the client can relax the finger. Perform friction at an angle of 90 degrees to the tendon fibers for 4-5 minutes, rest and repeat this action. The total duration of therapy should be 8-10 minutes, excluding one or two breaks.

DETERMINATION OF THE DAMAGED AREA AND THERAPY OF INJURIES OF THE TENDONS OF THE LONG AND SHORT MUSCLE THAT REDUCE THE THUMB

With injuries of the muscles that remove the thumb, the tendon of the long muscle that removes the thumb of the hand, located immediately behind the tendon of the short extensor thumb, most often suffers. That is why we will focus on this particular tendon.

Have the client abduct the thumb to locate the tendon. It is located slightly anterior and posterior to the extensor pollicis brevis tendon. Have the client move their thumb from side to side so that you can separate the abductor pollicis longus tendon and the extensor pollicis brevis tendon. They are located very close, therefore, in order to find the tendon of the abductor muscle, a little effort should be applied. Once you have located the tendon, palpate it to pinpoint the damaged area or areas. The main sign of damage is local pain. Once you have located the damaged areas, ask the client to relax the thumb and proceed with therapy.

DETERMINATION OF THE DAMAGED AREA AND THERAPY OF INJURIES OF THE TENDONS OF THE ADDUCTIVE THUMB MUSCLE

Place your thumb on the medial interphalangeal joint of the thumb, and ask the client to bring the finger to the other fingers.
Use your thumb or other fingers of the other hand to palpate distally and proximal to the interphalangeal joint. Palpate the tendon fibers to locate areas of pain, then ask the client to relax the finger and get to work. As the client's condition improves, include strengthening exercises that the client can do at home. If these exercises cause pain or discomfort, then it is not time to move on to this phase of therapy. Wait at least another week. Start with simple isometric exercises like the ones I'll describe below.

EXERCISES FOR THE CLIENT

I will describe these exercises using only one hand as an example. Have the client place the pad of their index finger on the thumbnail and then try to straighten the thumb, holding it in tension for a few seconds. Then ask the client to place upper part index finger under the pad of the thumb, and then try to bend the thumb, holding it in tension for a few seconds. After that, the client should place the tip of the index finger on the medial part of the thumb between its tip and the first joint, and then try to bring the thumb to the other fingers. The client should then place the tip of their index finger on side surface thumb and try to move it aside.

These exercises allow you to train your thumb in four planes without using any additional sports accessories. I recommend repeating these isometric exercises 5 approaches 4-5 times during the day. I believe that this is the most accessible and effective method strengthening the muscles and tendons of the thumb.

Dr. Ben E. Benjamin

Source: www.massage.ru

Anatomy

The long extensor of the fingers refers to the muscles of the lower leg, or rather, to its anterior group. It is located outside of the anterior tibial muscle. The muscle goes down, turning into a narrow tendon, which is amazingly strong. Further, it diverges into 4 beams: each is designed for a separate finger. It is attached at the level of the proximal phalanx. At the point of attachment, the beam diverges into 3 small parts, which make it possible to set in motion any part of the foot.

The mobility of the thumb is carried out by the work of several muscles at the same time. This complex structure is necessary, as it is he who helps to maintain balance and the ability to walk upright. The long flexor of the big toe is a muscle that belongs to the posterior group of the lower leg. Its growth begins in the region of the lower 2/3 of the fibula. It goes down the limb to the sole and turns into a tendon. On the foot, it grows a little into the tendon responsible for the movements of the remaining fingers. So it turns out that the movements of all phalanges depend to one degree or another on his work. It is fixed on the nail phalanx.

Muscles responsible for flexion and extension of the fingers

The extensor muscles in the lower extremities are appropriately named and do heavy work on a daily basis during movement. These include:

tibialis anterior,
long extensor,
thumb extensor.

The calf extensors are very strong and important for the ability to walk straight.

bending

The long flexor makes it possible during movement (when a person is walking or running) to push off the floor in the right way. He also participates in the supination of the foot - the ability to stand on the toe and maintain balance.

The long flexor of the thumb is named for its functions: it helps to bend it, and can also affect the entire metatarsus due to the features of its structure. Like other muscles of the lower leg, it is involved in the work of the foot, helping it to bend, as well as adducting and supinating. Also, the presence of this tendon makes the longitudinal arch of the foot stronger.

Extension

The long extensor is included in the group of muscles of the lower leg, located in front, closer to the inside. In addition to its direct purpose, this tendon extends the foot. To do this, it works together with the 3rd peroneal muscle. In the case of rigid fixation of the foot, it will bring the lower leg closer to it.

The long extensor of the thumb is responsible for the ability to straighten the big toe, and also sets the foot in motion, raising its front edge.

Muscle performance tests

The calf extensors can lose their strength due to a number of reasons. You can check its condition and performance using simple tests that the doctor conducts during the examination:

With one hand, you need to hold the metatarsus in the usual position, and with the other, gently but firmly bend your toes. A person should strive to unbend them. If he succeeds, the highest mark is 4 or 5.
The person lies on his back, a soft roller is placed under his knees. The metatarsus is held by force. At the same time, he should try to straighten his fingers. If he succeeds, the highest mark is 3.
The position is the same. The doctor feels the tendon, while the person should try to straighten his fingers. If he succeeds, the highest mark is 1.

In a normal state, a person receives 5 points. The strength may decrease if the tissues do not receive adequate nutrition or innervation has occurred.

Causes of muscle dysfunction

The foot extensors can lose strength or suffer other damaging effects for a number of reasons:

atrophy with age due to disruption of tissue nutrition,
pathologies in the work of the endocrine system,
connective tissue diseases,
fermentopathy,
polyneuritis,
complications after injury
too much physical activity.

The main cause of the lesion is tendinitis. This is an inflammatory disease of the tendons that can affect nearby muscle tissues. Dystrophic destruction can become chronic, which is very dangerous and almost incurable.

Also, pain in the foot can occur due to the deposition of salts and the formation of growths on the bone tissue. The reason for this may be the use of certain drugs, etc.

Diagnostics

The extensor hallucis longus or the entire metatarsus may be damaged. On examination, the doctor notes "spanking" when walking or dragging. The doctor performs palpation, as well as a series of tests that help assess the nature of the damage. If muscles have been damaged, weakness and soreness may occur when exercising with or without resistance. If there is weakness of the entire metatarsus, including the little finger, compression of the nerve is possible.

The muscles of the thumb of the hand recover from injury quite quickly - within one to two weeks. However, with sufficiently serious and / or chronic injuries of the thumb, damage to the structure of its tendons is often observed. Tendons are practically avascular structures, their blood supply is minimal. They recover from damage about six times slower than muscles. In addition, it is quite difficult to limit the mobility of the thumb during daily activities in order to allow damaged tendons to fully recover and prevent their re-injury.

That is why in the process of recovery after such injuries, the correct approach to therapy is extremely important. The sooner treatment begins, the faster recovery occurs. My first recommendation is not to start therapy immediately after an injury. You should wait at least 3-4 days to allow the scar tissue to fully form, and then you can apply techniques that include friction (friction massage). During the first few days after injury, you can resort to a light and shallow massage - this will help relieve pain and inflammation.

FRICTION APPLICATION

Remember that pressure should only be applied in one direction. After you have worked the tendon with frictions in one direction, change the direction of the frictions to the opposite. This will help you avoid fatigue, ensure that all tendon fibers are evenly affected, and reduce the likelihood of discomfort for the client.

Work the tendon fibers in one direction for 4-5 minutes, rest a bit and start working in the other direction - in total you should spend about 8-10 minutes on this.

As the client's condition improves, the duration of therapy can be reduced. After applying the friction massage, you can gently stretch your thumb, hand and forearm.

DETERMINATION OF THE DAMAGED AREA AND THERAPY OF INJURIES OF THE TENDONS OF THE LONG AND SHORT EXTENDERS OF THE THUMB

Determining the damaged area of the tendon of the long or short extensor thumb is a very simple matter. Ask the client to extend the thumb so that the entire structure is in tension. Then apply frictional strokes of low or medium intensity across the fibers of the tendon of the short or long extensor of the thumb (depending on the nature and location of the injury). Do this at various points along the tendon to pinpoint the location of the damaged fibers. Since pain in these injuries does not radiate to nearby structures, the location of damaged fibers can be easily determined by the localization of pain sensations.

Once you have determined which part of the tendon is damaged, ask the client to relax the finger and then proceed with the friction massage. Each stroke should completely cross the damaged area.

DETERMINATION OF THE DAMAGED AREA AND THERAPY OF INJURIES OF THE SHORT AND LONG FLEXOR TENDONS OF THE THUMB

DETERMINATION OF THE DAMAGED AREA AND THERAPY OF INJURIES OF THE TENDONS OF THE LONG AND SHORT MUSCLE THAT REDUCE THE THUMB

Have the client abduct the thumb to locate the tendon. It is located slightly anterior and posterior to the extensor pollicis brevis tendon. Have the client move their thumb from side to side so that you can separate the abductor pollicis longus tendon and the extensor pollicis brevis tendon. They are located very close, therefore, in order to find the tendon of the abductor muscle, a little effort should be applied. Once you have located the tendon, palpate it to pinpoint the damaged area or areas. The main symptom of damage is local pain. Once you have located the damaged areas, ask the client to relax the thumb and proceed with therapy.

DETERMINATION OF THE DAMAGED AREA AND THERAPY OF MUSCLE TENDON INJURIES,
ADDUCTIVE THUMB BRUSH

Place your thumb on the medial interphalangeal joint of the thumb, and ask the client to bring the finger to the other fingers. Use your thumb or other fingers of the other hand to palpate distally and proximal to the interphalangeal joint. Palpate the tendon fibers to locate areas of pain, then ask the client to relax the finger and get to work. As the client's condition improves, include strengthening exercises that the client can do at home. If these exercises cause pain or discomfort, then it is not time to move on to this phase of therapy. Wait at least another week. Start with simple isometric exercises like the ones I'll describe below.

EXERCISES FOR THE CLIENT

I will describe these exercises using only one hand as an example. Have the client place the pad of their index finger on the thumbnail and then try to straighten the thumb, holding it in tension for a few seconds. Then ask the client to place the top of the index finger under the ball of the thumb and then try to bend the thumb while holding it in tension for a few seconds. After that, the client should place the tip of the index finger on the medial part of the thumb between its tip and the first joint, and then try to bring the thumb to the other fingers. Then the client should place the tip of the index finger on the side of the thumb and try to move it to the side.

These exercises allow you to train your thumb in four planes without using any additional sports accessories. I recommend repeating these isometric exercises for 5 sets 4-5 times throughout the day. I believe that this is the most affordable and effective way to strengthen the muscles and tendons of the thumb.

Dr. Ben E. Benjamin

12137 0

We will not describe the metatarsophalangeal and interphalangeal joints here, because they are identical to the joints of the fingers of the hand, with the exception of some functional differences. So, in the metacarpophalangeal joints, the amplitude of flexion is greater than the extension, and in the metatarsophalangeal joints, on the contrary, the extension exceeds the flexion:

the amplitude of active extension in the metatarsophalangeal joints ranges from 50° to 60°, and flexion is only 30–40°;
the amplitude of passive extension (Fig. 72), which plays a significant role in the last phase of the step, reaches 90 ° and may even exceed this figure, while passive flexion remains within 45-50 °.

Lateral movements of the toesoccur in the metatarsophalangeal joints within much smaller limits than the corresponding movements of the fingers. The big toe of the human foot, in contrast to the big toe of the monkey, has lost the function of opposition as a result of the transition to locomotion on two legs.

Active toe extensionIt is provided by three muscles: two external ones - the long extensor of the thumb and the long extensor of the fingers - and one internal muscle of the foot - the short extensor of the fingers.

Short finger extensor(Fig. 73) is located completely on the back of the foot. It originates from the calcaneal floor of the tarsal sinus and from the trunk of the lower retinaculum of the extensor tendons, divides into four fleshy bellies, which are attached by tendons to the outer sides of the corresponding tendons of the long extensor of the fingers, with the exception of the tendon belonging to the first metatarsal bone, which is attached directly to dorsal surface of the first phalanx of the thumb; the fifth finger does not receive any tendon from this muscle at all. Thus, the short extensor of the toes is the extensor of the metatarsophalangeal joints of the first four fingers (Fig. 74).

Long extensor toes And extensor thumb longuslocated in the anterior case of the lower leg, their tendons end at the phalanges.

extensor toe longus tendon(Fig. 75) passes anterior to the ankle joint, deeper than the outer half of the upper retinaculum of the extensor tendons, then posterior to the trunk of the lower retinaculum, after which it is divided into four tendons going to the II-V fingers, passing under the lower plate of the anterior annular ligament. Therefore, the V finger is unbent only due to the action of the common long extensor. This muscle, as its name implies, is an extensor of the toes, but in addition, it serves, very importantly, as a flexor of the ankle joint. Its extensor action on the fingers is only seen in its purest form when its function as an ankle flexor is balanced by an antagonist extensor (mainly the triceps, shown as white arrow). The tendon of the long extensor of the first finger (Fig. 76) passes deeper than the upper retinaculum of the tendons of the extensor muscles and then penetrates both legs of the lower retinaculum. It is attached to the back surface of both phalanges of the thumb: along the edges of the rear of the first phalanx and to the back surface of the base of the distal phalanx. That's why given muscle is not only the extensor of the thumb, but also, no less important, the flexor of the ankle joint. As with the extensor digitorum longus, its thumb extension action only occurs after its function as an ankle flexor is balanced by its antagonist. Duchenne de Boulogne states that the extensor digitorum brevis is the only true extensor.

"lower limb. Functional Anatomy"
A.I. Kapanji

In terms of location, action and number, the muscles of the toes are almost similar to the muscles of the fingers of the hand, but, as already indicated, depending on the little developed activity of the toes, the muscles of the rear of the foot are more related to movement in the ankle joint, and the muscles of the plantar side are involved in strengthening the arch of the foot.

Extensors and flexors of the toes

Between the extensors of the fingers (dorsal flexors) and their flexors (plantar flexors) we find long and short extensors, as well as long and short flexors. The first are located on the front surface of the lower leg and on the back of the foot, the second - on rear surface shins and soles.

Among the extensors we have the extensor digitorum longus and the extensor hallucis longus, which have already been described above; it remains for us to disassemble only the short extensors of the fingers.

Short finger extensor(m. extensor digitorum brevis, Fig. 72-11) begins on the dorsum of the calcaneus; its innermost part stands out under the name of the short extensor of the thumb (m. extensor hallucis brevis, Fig. 72-22). At the level of the metatarsal bones, the muscle fibers pass into the tendons of the first four fingers. All of them obliquely fit (outside inwards) to the outer side of the tendons of the long extensor and merge with them at the base of the first phalanx, except for the tendons of the thumb. The tendon of the short extensor of the thumb is attached directly to the first phalanx.

The short extensor of the fingers mainly acts on the first phalanges. The oblique arrangement of its tendons allows the abduction of the fingers outward in the metatarsophalangeal joint. Acting simultaneously with the long extensor of the fingers, the short extensor produces pure extension of the fingers at the metatarsophalangeal joint. The tendon of the short extensor of the first finger, attaching directly to the first phalanx, produces its extension.

Innervation: deep peroneal nerve (n. peroneus profundus, L IV-V and S I).

Among the flexors of the fingers, there are: a long flexor of the thumb and a common long flexor of the fingers with an accessory head starting from the calcaneus, a square muscle of the sole and a short common flexor of the fingers. In addition, there is a short flexor for both the thumb and little finger.

flexor digitorum longus(m. flexor digitorum communis longus, Fig. 66-7) is located in the deepest layer of the lower leg. It starts from two-thirds of the back surface tibia, in addition, part of its fibers originates from tendon arch formed by the fascia of the tibialis muscle.

So start it muscle fibers reaches the fibula. The posterior tibial muscle, approaching the formed tendon of the long flexor, crosses it and is located directly near the inner ankle. The tendon of the long flexor of the fingers, going down, is located closer to the midline of the lower leg and passes to the sole. On the sole, it receives a tendon stalk from the long flexor of the thumb and, in addition, a short additional head is attached to it from the lower and inner surface of the calcaneus - square muscle of the sole(m. quadratus plantae, s. sago quadrata Sylvii, Fig. 66-23). Then, at the level of the base of the metatarsal bones, the common tendon of the long common flexor of the fingers splits into four bundles, which immediately give rise to the so-called vermiform muscles, which extend from the inner (from the side of the first finger) side of its tendons. Moving further forward, each tendon of the common long flexor lies in a canal formed by the bifurcation of the corresponding tendon of the short flexor, just as it was on the hand of the superficial and deep flexors of the fingers. Located together with the short common flexor "of the fingers in the bone-fibrous sheath of the fingers, the tendons of the long flexor end, attaching to the third (nail) phalanges of the fingers -

The long common flexor of the fingers flexes the third phalanges over the second and the second over the first; at the maximum of its contraction, it can somewhat bend the first phalanx over the metatarsal bone; in addition, it informs the IV and V fingers of some deviation inwards, which is especially evident in the position of their nail phalanges. This last action is explained by the oblique (inside outward) direction of the tendons of the IV and V fingers on the sole. If the action of its accessory head and the action of the short common finger flexor are added to the action of the general long flexor of the fingers, then this deviation is destroyed.

Duchenne and Poirier completely deny the action of the long general flexor of the fingers on ankle joint at the top support. Braus, on the other hand, believes that with the upper support, the common long flexor of the fingers can produce plantar flexion, supination (turning the sole inside) and abduction medially (from the midline of the foot), with supination being most pronounced, plantar flexion being the least, and abduction medially corresponding to the action posterior tibial muscle. When a person is in a standing position, the long flexor of the fingers strengthens the arches of the foot and can extend the lower leg (plantar flexion) when raising the torso on toes.

Innervation: tibial nerve (n. tibialis, L V and S I).

Short common finger flexor(m. flexor digitorum communis brevis, Fig. 74) starts from the lower surface of the calcaneal tubercle, from the posterior third of the upper surface of the plantar aponeurosis and from the intermuscular septa. At the level of the base of the metatarsal bones, it forms four tendons, which split longitudinally at the level of the first phalanges and, having passed the corresponding tendons of the long

the common flexor of the fingers, pass through the bone-fibrous sheath and are attached to the sides of the second phalanges, reaching their articulations with the third. Their attitude and construction are quite consistent with the attitude and construction of the superficial and deep flexor of the fingers, which were described above. The tendon of the flexor of the fifth finger is sometimes very thin and is not pierced by the tendon of the common long flexor of the fingers, sometimes it is completely absent.

The short common flexor of the fingers flexes the second (phalanges) and almost does not show 4 its action on either the first or third phalanges. With a lower support, its main action is to strengthen the longitudinal arch of the foot (Fig. 74) and plantar aponeurosis.

Innervation: plantar internal nerve (n. plan-taris medialis, L V and S I).

flexor thumb longus(m. flexor hallucis longus, Fig. 66-19, 15) is the most external muscle deep posterior muscle layer of the lower leg; it begins on the middle lower third of the posterior surface of the fibula; going down and inside, it passes into the tendon, located in the groove located on the posterior surface of the talus, fits under the internal process of the calcaneus (sustentaculum tali) and goes to the inner edge of the foot.

On this path, the tendon of the long flexor of the thumb crosses with the tendon of the long common flexor of the fingers, connects to it with a tendon bundle and then, passing between both parts of the short flexor of the thumb and both sesamoid bones of the metacarpophalangeal joint of the thumb, reaches its nail phalanx, where it attached (Fig. 74-4).

The long flexor thumb strongly flexes the second phalanx and has little effect on the metatarsophalangeal joint. Duchenne completely rejects its influence on the ankle joint. According to Braus, the flexor hallucis longus plays a large role in pushing the foot off the ground. It is also necessary to note its importance in relation to the movements of the entire foot. It is predominantly a plantar flexor, but at the same time, with the upper support, it abducts the foot inwards and supinates it. With lower support, the long flexor of the big toe strengthens the arch of the foot in the longitudinal direction and counteracts the formation of a flat sole (pes planum).

Innervation: tibial nerve (n. tibialis, L V and S I-II).

Flexor thumb short(m. flexor hallucis brevis, Fig. 74-2; 75-1) is divided into two parts. Both of its parts start from the sphenoid bones, from the ligamentous apparatus connecting the plantar surface of the calcaneus and metatarsal bones, and from the plantar aponeurosis. Heading towards the thumb along the metacarpal bone, the short flexor of the thumb is divided into two parts and attached to the tubercle of the first phalanx: one on the outside, the other on the inside. Both tendons have sesamoid ossicles.

Rice. 75. deep muscles feet. (Poirier.) 1 - short flexor of the thumb, 2 - transverse head of the adductor thumb muscle, 2 "- oblique head of the adductor thumb muscle, 3 - short flexor of the V finger, 4 - muscle opposing the V finger, 5 - tendon of the long peroneal muscle - its course along the plantar surface and attachment

The short flexor thumb flexes the thumb at the metatarsophalangeal joint, which is especially important when standing on toes. Acting with separate heads, the short flexor of the thumb can abduct the first phalanx to one side and the other (from the midline of the foot). Starting from the deep ligamentous apparatus of the foot and to the side of the plantar aponeurosis, it strengthens the internal longitudinal arch of the foot along with other muscles.

Fifth finger flexor short(m. flexor digiti quinti, Fig. 75-3) starts from the fibrous sheath of the long peroneal muscle, from the crest of the lower surface of the cuboid bone, from the base of the metatarsal bone of the fifth finger and is attached to the base of the first phalanx of the fifth finger. It flexes the V finger at the metatarsophalangeal joint, and also strengthens the outer longitudinal arch of the foot through the plantar aponeurosis.

Innervation: external plantar nerve (n. plantaris lateralis, S I-II).

Muscles that abduct the toes to kick three and outward from the midline of the foot

Abduction, which is possible in the metatarsophalangeal joints, is performed in the same way as on the hand, by means of the interosseous and vermiform muscles, and in the thumb and small fingers, also by specially abducting muscles. Only the opposing muscle of the thumb is missing here; as for the same muscle of the fifth finger, it is sometimes observed. On the foot, as well as on the hand, in this group there should be 10 abductor and adductor muscles. Of these, the muscles that abduct and adduct the thumb, as well as the abductor of the thumb, are located on the sole, and the rest are between the metatarsal bones, which is why they, like the muscles of the hand, are called interosseous. The worm-like muscles, which were mentioned in the description of the long common flexor of the fingers, being located on the inside of its tendons, also take part in the abduction of the II finger and the adduction of the III, IV and V fingers.

On the foot, the middle line, towards which adduction (adductio) will be performed and away from which abduction (abductio) will be performed, coincides with the middle line of the second finger. Thus, only the second finger will have two interosseous muscles that abduct to both sides of the midline, while the remaining fingers will have interosseous muscles that abduct from the midline and lead to it.

At the thumb we have independent muscle abducting the thumb and independent adductor.

Abductor thumb muscle(m. abductor hallucis, Fig. 74-3) lies superficially under the fascia on the inner edge of the foot and forms an elevation of the thumb. The abductor muscle starts directly from the lower part of the inner surface of the calcaneal tubercle, as well as from the ligamentous apparatus of the foot and plantar aponeurosis; it is attached by a well-developed tendon to the inner edge of the first phalanx, fusing with the tendon of the inner head of the short flexor of the thumb. Sometimes the abductor thumb muscle sends a tendon extension to the extensor tendon of the thumb. It produces the abduction of the thumb from the midline of the foot, in which it is partly helped by the inner head of the short flexor of the thumb.

The muscle that abducts the thumb can be attributed to a static type: pinnate arrangement of fibers (powerful tendon). Its main value is to strengthen the inner arch of the foot. Abduction of the thumb is weakly expressed.

Innervation: internal plantar nerve (n. plantaris medialis, L V and S I).

adductor thumb muscle(m. adductor hallucis, Fig. 75-2, 2 ") consists of two heads. One of them, obliquely located, starts from the cuboid bone, from the third sphenoid, second and third metatarsal bones, and also from the fibrous sheath of the long peroneal muscle and goes obliquely from the middle of the foot to the first finger.The second head, transversely located, starts from the head of the metatarsal bone of the fourth finger and, on the way to the first finger, crosses the heads of all other metacarpal bones in the transverse direction, receiving separate muscle bundles from them and from the intermetatarsal ligaments.

The obliquely located head, approaching the first finger, fuses with the outer head of the short flexor of the thumb and together with it will bring the thumb to the midline of the foot. The transversely located head of the adductor thumb muscle is more independent than was observed on the hand, and some (Lebuk) even indicate that this muscle has an independent attachment on the first phalanx: on the one hand, it sends a continuation to the rear of the thumb to its extensor , on the other hand, part of the fibers, passing through the attachment of the oblique head of the adductor muscle of the thumb and its short flexor, ends at the bone-fibrous sheath of the thumb. The oblique head has the strongest adductor effect on the first phalanx of the big toe and, as Duchene points out, is an active ligament that does not allow the heads of the metatarsal bones to diverge, and thus strengthens the transverse arch of the foot.

Innervation: internal and external plantar nerves (n. n. plantares medialis et lateralis, S I-II).

Abductor fifth finger muscle(m. abductor digiti quinti, Fig. 74-5), like the muscle that removes the thumb, is located superficially, but only on the outside. The muscle abducting the V finger begins from the lower surface of the posterior external tubercle of the calcaneus, from the inwardly facing surface of the plantar aponeurosis and from the intermuscular septum that separates it from the short flexor of the fingers. Heading forward along the metacarpal bone of the fifth finger, it ends on the outer surface of the base of the first phalanx of the fifth finger and on the lower surface of the bursal ligament of the metatarsophalangeal joint.

In most cases, the muscle that abducts the V finger is only a flexor of the first phalanx, and only in children can it still be abducted. Being located on the outside from the heel to the main phalanx of the fifth finger, it, of course, has a great influence on strengthening the outer arch.

Innervation: external plantar nerve (b. plantaris lateralis, S I-II).

The abduction and adduction of the remaining fingers is performed with the help of the interosseous muscles; they are located like the interosseous muscles of the hand, on the one hand, in the deepest layer on the sole (interosseous internal muscles), on the other hand, on the back of the foot (interosseous external muscles). As on the hand, there are three internal interosseous muscles on the foot, four on the outside; the inner ones will lead to the midline of the foot, the outer ones will lead away from the midline; you just need to remember that the midline of the foot passes through the second toe and therefore two abductors will be at the second toe, and not at the third, as we saw on the hand.

Adductor internal interosseous muscles(m. m. interossei interni, Fig. 76) start from the posterior third of the lower edge of each of the last three metacarpal bones (V, IV and III) and from the lower surface of their base. They lie more superficial than the interosseous spaces themselves, so that they completely cover the lower surface of the metacarpal bones. They end in a completely different way than the internal interosseous muscles of the hand: in most cases, they are attached only to the lateral internal (on the side of the thumb) part of the first phalanx and to the bursal ligament of its joint; they do not continue to the extensor tendon of the fingers.

According to their location and attachment, the internal interosseous muscles are the muscles leading to the midline of the foot III, IV and V fingers; the second finger has no adductor muscle, since it lies on the midline of the foot, and the big one has its own adductor, described above (Fig. 75-2).

Innervation: deep branches external plantar nerve (rami profundi n. plantaris lateralis, S I-II).

Abductor external interosseous muscles(m. m. interossei externi, Fig. 77) are located on the back of the foot, fulfilling all the gaps between the metacarpal bones. They are biceps and start from the lateral parts of the metacarpal bones facing each other, from the lower surface of their bases and the dorsal interosseous fascia. Starting from two opposite sides, they form pennate muscles, the tendons of which are attached to the base of the first phalanges and to the bursal ligament of the joint on the outside of the III and IV fingers and on both sides of the II finger. They do not continue to the extensor tendon of the fingers; rather, you can find continuations to the cartilaginous thickenings of the bag of the metatarsophalangeal joint.

The interosseous muscles of the IV, III and II fingers are abducting from the midline of the foot. These movements in the foot are very limited, as they are constantly constrained by shoes, and are most marked in children or people who do not wear shoes. Approaching the first phalanx from both sides, more from the plantar surface, and combining its action with the action of the internal interosseous muscles, the external interosseous muscles of the IV, III and II fingers bend the first phalanx; the same movement is produced by the abductor V finger in combination with the internal interosseous V finger.

Innervation: deep branches of the external plantar nerve (n. plantaris lateralis, S I-II).

vermiform muscles(m. m. lumbricales,) mentioned above when describing the long common flexor of the fingers, from the tendons of which they begin, also take part in the abduction of the fingers. Located on inside of each tendon of the II, III, IV and V fingers, they are attached to the inside of the first phalanges of the same fingers, and, therefore, will contribute to the work of the interosseous muscles that produce abduction in their direction. In the second finger, they will produce abduction from the midline, and in the remaining (III, IV and V) fingers, they will lead to the midline.

The vermiform muscles, to a certain extent, can participate in the flexion of the first phalanges.

Innervation: internal plantar nerve (n. plantaris medialis); external plantar nerve (n. plantaris lateralis to the first, third and fourth, L V and S I-II).

To the muscles of the foot, one must also add a non-permanent muscle that opposes the fifth finger.

Opposite V finger muscle(m. opponens digiti quinti, Fig. 75-4). Man does not have an opposing muscle of the thumb, since the thumb, being one of the main points of support, has lost all significance for grasping. The opposing muscle of the fifth finger is important for adapting the sole to uneven ground. Even when it exists, it is poorly developed and not completely separable from the flexor brevis and abductor digit V. It differs from the muscles mentioned only in that it is attached not to the first, but to the metacarpal bone of the fifth finger. During its contraction, the muscle opposing the V finger pulls the metacarpal bone somewhat inward (towards the midline of the foot) downwards.

The long extensor of the thumb (lat. Musculus extensor hallucis longus) is the muscle of the lower leg of the anterior group.
Lies between the anterior tibial muscle (lat. M. tibialis anterior) and the long extensor of the fingers (lat. M. extensor digitorum). The upper two-thirds of the long extensor of the finger is covered by these muscles.
The muscle originates from the medial surface of the middle and lower thirds of the fibula and the interosseous membrane of the lower leg and, heading down, passes into a narrow long tendon, which passes under the lat along the middle canal. retinaculum mm. extensorum inferius to the big toe. It attaches to the distal phalanx. Part of its bundles fuses with the base of the proximal phalanx.

Related concepts

References in literature

long extensor thumb brushes. Along the radial edge of the forearm it reaches the ulnar fold, then rising to the outer-posterior surface of the shoulder to the acromial process of the scapula and further to the seventh cervical vertebra. From this point, the meridian goes to the supraclavicular region, from where one of its branches goes deep into the body to the large intestine, and the second - along the neck, crossing the lower jaw in front of its angle. There he makes a turn, moving to the opposite side. In the nasolabial groove, it intersects with an identical meridian running along the other side of the body. There are 20 points along the meridian.

2. Meridian of the large intestine. Pair meridian. Refers to the Yang system. It starts from the nail bed of the index finger, runs along its radial edge, then goes between the first and second metacarpal bones and between the tendons of the short and long extensor thumb brushes. Along the radial edge of the forearm, it reaches the ulnar fold, then rising to the outer-posterior surface of the shoulder to the acromial process of the scapula and further to the seventh cervical vertebra. From this point, the meridian goes to the supraclavicular region, from where one of its branches goes deep into the body to the large intestine, and the second - along the neck, crossing the lower jaw in front of its angle. There he makes a turn, moving to the opposite side. In the nasolabial groove, it intersects with an identical meridian running along the other side of the body. There are 20 points along the meridian.

Related concepts (continued)

The pectoralis major muscle (Latin musculus pectoralis major) is a large superficial fan-shaped muscle located on the anterior surface of the chest. Under it is a triangular small pectoral muscle.

Round pronator (lat. Musculus pronator teres) - the thickest and most short muscle surface layer. Two heads are distinguished in it: a large humeral head (Latin caput humerale), which starts from the medial epicondyle humerus, the medial intermuscular septum of the shoulder and the fascia of the forearm, and the smaller ulnar head (lat. caput ulnare), lying under it and originating from the medial edge of the tuberosity of the ulna. Both heads form an abdomen somewhat flattened from front to back, which ...

The quadriceps femoris muscle (lat. Musculus quadriceps femoris) - occupies the entire front and partly the lateral surface of the thigh. Consists of four heads.

The muscles of the upper limbs provide freedom and a wide variety of arm movements. The muscles of the upper limb are usually divided into the following groups: 1) muscles shoulder girdle; 2) muscles of the free upper limb - shoulder, forearm and hand.

The sartorius muscle (Latin musculus sartorius) is the muscle of the anterior thigh group. It is the most long muscle human body.

The latissimus dorsi muscle (Latin musculus latissimus dorsi) is a superficial muscle that occupies the entire lower back, the upper bundles in the initial part are covered by the trapezius muscle.

The small round muscle (lat. Musculus teres minor) is an oblong, somewhat rounded cord, the muscle bundles of which are parallel to each other.

The triceps muscle of the shoulder (triceps; lat. musculus triceps brachii) - extensor muscle rear group shoulder, occupies the entire back side of the shoulder, consists of three heads - long (caput longum), lateral (caput laterale) and medial (caput mediale).

The large round muscle (lat. Musculus teres major) is flat and elongated in shape. All over in the back section is covered latissimus dorsi back, in the outer section - the long head of the triceps muscle of the shoulder, deltoid muscle, and in the middle section - a thin fascia.

The biceps muscle of the shoulder (biceps, lat. musculus biceps brachii) - big muscle shoulder, clearly visible under the skin, due to which it is widely known even among people who are new to anatomy.

The coracobrachialis muscle (lat. Musculus coracobrachialis) is flat, covered throughout by the head of the biceps brachii. The muscle starts from the top of the coracoid process of the scapula and is attached below the middle of the medial surface of the humerus along the crest of the lesser tubercle.

The gluteus maximus muscle (lat. Gluteus maximus) is the largest muscle of the three gluteal muscles, which is closest to the surface. It makes up the bulk of the form and appearance buttocks.