Massage & Bodywork

July/August 2013

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education clAssrooM to client | PAthology PersPectives | BoDy AWAreness | FUnCTIonaL anaToMy | soMAtic reseArch flexor hallucis longus By Christy Cael the flexor hallucis longus lies deep to the gastrocnemius and soleus and lateral to the tibialis posterior. The muscle belly anchors to the posterior surface of the fibula before joining the tibialis posterior and flexor digitorum longus distally, just behind the medial malleolus. These muscles all traverse the tarsal tunnel, a channel formed between a depression in the medial calcaneus and the fibrous flexor retinaculum. This structure is similar in architecture and function to the carpal tunnel of the hand. The tarsal tunnel also contains the tibial artery and nerve. It is helpful to use "tom, Dick, and Harry" to remember the tibialis posterior, flexor Digitorum longus, tibial artery and nerve, and flexor Hallucis longus. The flexor hallucis longus, flexor digitorum longus, and tibialis posterior all invert the foot and plantarflex the ankle. The flexor hallucis longus also flexes the big toe at the metatarsophalangeal and interphalangeal joints. This motion is critical for push off during gait and propulsion of the body. Center of gravity shifts from the heel, across the foot, and onto the big toe at the end of the stance phase of gait. Forces generated by the hip, thigh, knee, and lower leg move through the foot and big toe, propelling the body forward; the flexor hallucis longus plays a significant role in directing those forces. fleXor halluCiS longuS attachments • Origin: Distal posterior surface of the fibula and interosseous membrane • Insertion: Base of the first distal phalanx, plantar surface actions • Flexes the first metatarsophalangeal and interphalangeal joint • Plantarflexes the ankle • Inverts the foot innervation • Tibial nerve • S2–3 See what benefits await you. 51

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