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Extensor hallucis longusMusculus extensor hallucis longus

Thin muscle on the front of the lower leg, partly hidden by its neighbours, that lifts the big toe and helps lift the foot.

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LatinMusculus extensor hallucis longus
Origin
  • Middle half of the anterior surface of the fibula
  • Adjoining interosseous membrane
Insertion
  • Base of the distal phalanx of the big toe (dorsal surface)
  • Usually also a slip to the base of the proximal phalanx of the big toe
Action
  • Extends the big toe (lifts it)
  • Assists dorsiflexion of the ankle (lifting the foot)
NerveDeep fibular (peroneal) nerve (L4–S1 (mainly L5))
NameLatin: the 'long straightener of the big toe (hallux)'.

Palpation

  1. Client supine with the leg straight and the heel resting on the table.
  2. Place your fingers on the front of the ankle, just outside (lateral to) the thick tibialis anterior tendon.
  3. Ask the client to lift only the big toe against light resistance from your finger on the toe.
  4. Feel the tendon stand out on the front of the ankle and along the top of the foot to the big toe; follow it up into the lower leg, where the belly lies deep between tibialis anterior and extensor digitorum longus.

Landmarks: Medial malleolus · Lateral malleolus

Extensor hallucis longus is mostly hidden under Tibialis anterior and Extensor digitorum longus in the upper leg. It appears between them lower down, and its tendon is easy to see on the front of the ankle when the big toe is lifted. In massage you mostly meet it while working its neighbours; specific work on it belongs to remedial training.

It is the only long muscle that lifts the big toe, so it is useful for telling apart the tendons on the front of the ankle. From the big-toe side outwards they are: tibialis anterior (the thickest), extensor hallucis longus, then extensor digitorum longus.

It works against Flexor hallucis longus, which bends the big toe down. It has no part in the Achilles (calcaneal) tendon, which belongs to the calf muscles at the back of the leg.

Source notes. Wikipedia describes it as “also a weak evertor/invertor” and says it assists both eversion and inversion; Gray’s Anatomy (1918) lists only toe extension and dorsiflexion. This note leaves eversion and inversion out. Nerve roots: Wikipedia gives L5 (range L4–S1); Gray gives L4, L5 and S1.

Techniques

  • Compression — Pressing straight down into a muscle with the palm, fist or forearm, holding briefly, then releasing and moving on.
  • Stripping — A slow, deep, narrow glide along the length of a single muscle with the thumb, knuckle or elbow, pausing over tight bands on the way.

Works with

  • Tibialis anterior — Long muscle beside the shin bone that lifts the foot up (dorsiflexion) and turns the sole inwards (inversion).
  • Extensor digitorum longus — Feather-shaped muscle on the outer front of the lower leg that lifts the four small toes and helps lift the foot.

Opposes

  • Flexor hallucis longus — Deep muscle on the outer back of the leg that bends the big toe and gives the push-off in walking, running and rising onto the toes.

Sources

  1. Wikipedia: Extensor hallucis longus muscle
  2. Wikipedia: Deep fibular nerve
  3. Gray's Anatomy of the Human Body (1918), Myology 8c: The Muscles and Fasciae of the Leg (archived Bartleby page) (Public domain. Gray gives roots L4, L5 and S1; Wikipedia gives L5 (L4–S1). Gray does not list eversion or inversion.)