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from the proximal half of the sides of adjacent metatarsal bones. The two heads of the muscle form a central tendon, which passes deep to the transverse metatarsal ligament. The first tendon is inserted into the medial side of the second toe; the other three are inserted into the lateral sides of the second, third, and fourth toes. HOW AND WHY INTEROSSEOUS MUSCLES GET INJURED No unusual activity is needed to strain the interosseous muscles. Strains of these small, but important muscles are fairly common and can be caused by being on your feet for longer periods of time than the body can sustain. Such strains are frequently noticed when you first step out of bed in the morning and are walking barefoot. A sharp pain is felt with each step. This may follow a day of heavy exertion, but not necessarily. The pain is lessened, or even eliminated, by wearing shoes because the shoe stabilizes the front of the foot. However, in severe cases, the pain may persist during walking, with or without shoes. This knife-like pain is usually felt between the bones of the second, third, and fourth toes on the dorsal surface of the foot, and in some cases, on the plantar surface as well. In mild cases, the pain may last for a few weeks then disappear for a short while, only to return once again with increased activity. In the acute phase of the injury, the pain can be so severe that many people will have difficulty even bearing their full weight on the injured foot. In this injury, multiple small muscle tears occur as a result of frequent fatigue in the leg. The muscles of the leg tire and the brunt of the body's weight falls on these very weak and small muscles between the toes. They often tear in several places at once, more commonly on the dorsal foot, as mentioned earlier. When they heal, matted scarring usually develops. This scar tissue can then re-tear under prolonged exertion. Additional symptoms of interosseous muscle strains are swelling, tenderness, and bruising on the dorsal and/or sometimes the plantar aspect of the foot. Slight pressure on the muscle is often painful. All of these symptoms may limit the range of motion of the injured foot. There are various scenarios and causes for this kind of injury: a crush injury that often results from dropping a heavy object directly onto the foot, which causes immediate severe soft- tissue damage and pain; an injury due to a fall from a great height, or even a fall off a curb which causes a twisting of the foot; and a slow onset of an interosseous strain injury from excessive standing, especially when on a hard surface like concrete, or from participating in continuous running sports that have few breaks. These activities bring on fatigue of the muscles of the legs and feet and may lead to this type of injury. Those who wear shoes that are excessively tight or wear very high heels that place unnatural pressure on the forefoot "plant the seeds" of an interosseous muscle injury. Foot injuries are fairly common among athletes. It is important to remember that some seeming interosseous muscle injuries could actually be fractures of one of the For access to free videos and articles and the latest news on upcoming trainings, join Ben Benjamin on Facebook at Facebook.com/benjamininstitute. Sobotta: Atlas der Anatomie des Menschen @ Elsevier GmbH, Urban & Fischer Verlag Munich. Dorsal interossei Celebrate ABMP's 25th anniversary and you may win a refund on your membership. ABMP.com. 109