Extensor Hallucis Brevis

Description[edit | edit source]

Extensor hallucis brevis

Extensor hallucis brevis (EHB) is a thin, broad muscle on the top of the foot that assists in extending the first toe (hallux). It is essentially the medial part of the extensor digitorum brevis muscle.[1]

Origin[edit | edit source]

Distal part of superior and lateral surface of the calcaneus, lateral talocalcaneal ligament and apex of inferior extensor retinaculum.[1]

Insertion[edit | edit source]

Dorsal surface of the base of the proximal phalanx of the first toe.[1]

Nerve[edit | edit source]

Deep peroneal nerve (L5 or S1 or both).[1]

Artery[edit | edit source]

  • Perforating branch of the peroneal artery
  • Anterior lateral malleolar artery
  • Lateral tarsal arteries
  • Dorsalis pedis artery
  • Arcuate artery
  • First dorsal metatarsal artery
  • Dorsal digital arteries[1]

Function[edit | edit source]

Assists extensor hallucis longus with extension of the hallux at the metatarsophalangeal joint.[1]

Clinical Significance[edit | edit source]

Extensor hallucis brevis muscle


Pain right at the top of the foot and near the toes; difficulty in raising the foot upwards; feeling of numbness in the foot; big toe pain; deformities (claw toe or hammertoes).

  • Common cause: Frequent stubbing of the toes; repetitive kicking; repetitive cycling.
  • Dorsal foot pain
  • Entrapment neuropathy of the peroneal nerve caused by EHB[2]

[3]

Assessment[edit | edit source]

  • Palpation: The belly of the muscle is palpable on active extension of the big toe.
  • Muscle length testing
  • Muscle strength testing

[4]

Treatment[edit | edit source]

There is limited research on the treatment of strains of the EHB. Some strategies that are frequently used include;

  • PRICE in the acute stage
  • Cryotherapy
  • Heat therapy - after the acute phase
  • Rehabilitation programme to strengthen the extensor muscles
[5]
[6]
[7]
  • Ensuring appropriate footwear
  • Calf muscle brace and strain
  • Trigger point management - Specific soft tissue mobilisations, myofascial release, massage, dry needling

[8]

References[edit | edit source]

  1. 1.0 1.1 1.2 1.3 1.4 1.5 Moore KL, Dalley AF, Agur AMR. Clinial oriented anatomy. Philadelphia: Wolters Kluwer, 2010.
  2. Kanbe K, Kubota H, Shirakura K, Hasegawa A, Udagawa E. Entrapment neuropathy of the deep peroneal nerve associated with the extensor hallucis brevis. The Journal of foot and ankle surgery 1995;34(6):560-2.
  3. Trigger Points 3D. Great Toe Extension - Extensor Digitorum Longus and Brevis - Trigger Point of the Week.
  4. Advanced Massage Techniques School. Extensor Hallucis Longus and Brevis Muscle Test.
  5. Conservative Orthopedics. Great Toe Extension - Extensor Hallucis Brevis Exercise.
  6. Conservative Orthopedics. Extensor Hallucis Brevis - Band Exercise.
  7. Conservative Orthopedics. Great Toe Short Extensor - Lowering w/ Resistance in Partial Weight Bearing.
  8. Tim Trevail. Dry Needling: Extensor Hallucis & Digitorum Brevis.