Abductor Hallucis Strain

Abductor Hallucis Strain: Its Causes And Treatments

Abductor Hallucis Strain

Abductor hallucis strain can be encountered in sedentary people, in weekend warriors that impose a sudden increase in physical activities to atrophic and weakened muscles or in athletes that overload the abductor hallucis by repetitive motions or by a sudden impact causing a partial or complete muscle tear.


The abductor hallucis muscle and its distal tendon runs from the inside of the heel bone down to the inside of the proximal phalanx of the big toe. It is located at the medial (inner) aspect of the foot and arch while the plantar ligament is found at the plantar aspect of the foot and arch.


As the abductor hallucis muscle may sometimes spread the big toe sideways, its main function is to help in pushing the body forward during gait and to help in stabilizing the foot.

The foot’s complex structure contains over a hundred of tendons, ligaments, and muscles that stabilize or move over thirty joints in between the twenty-six bones providing structure to support the body weight. Bones are designed to primarily support our body weight while only a small portion of the body support is to be provided by the surrounding and stabilizing soft tissue structures, among them the plantar ligament, the posterior tibialis muscle-tendon complex and the abductor hallucis muscle and tendon.

Muscle Strain Definition

Muscle or tendon strain or tear refers to microdamage to a muscle or its tendon. Muscle damage can be in the form of tearing (part or all) of the muscle and tendon fibers. The tearing of the muscle can also damage small blood vessels, causing local bleeding, hematoma, bruising, and pain caused by irritation of the nerve endings in the area.

Root Causes and Aggravating Factors

In many cases, abductor hallucis muscle strain is caused by long-standing repetitive microtraumas imposed on the affected structure(s) during the course of normal daily activities especially when one is affected by increased or excessive pronation; as the foot collapses during function due to repetitive inward, downward and forward subluxation (displacement) of the ankle bone upon weight bearing, excessive forces are shifted away from the skeletal structures up to the point one or more soft tissue structures will get overloaded, microteared, inflamed, swollen and tender.

Sometimes the condition may be induced by overuse as a sudden heavy lifting, as a sudden increase in sport activities, or while performing usual or unusual work tasks. In some cases, this condition may result from footwear that does not properly work with the foot’s alignment or throws off the body’s natural weight balance.

Abductor Hallucis Strain

Abductor Hallucis Muscle Strain Symptoms

Symptoms of this muscle strain may include pain, swelling (edema), redness (erythema), and bruising (hematoma) along the medial aspect of the foot’s longitudinal arch. Pain is  present at rest and is made worse whenever the specific muscle or the joint in relation to that muscle is used. Some weakness within the strained muscle or tendon is often noticed.

When to Seek Emergency Podiatric Medical Care

If you have a significant foot pain that does not subside within 24 hours, call a Doctor of Podiatric Medicine and Foot Specialist for an emergency appointment (often the same day or week). If you hear a “popping” sound with the injury, cannot walk, or there is significant swelling, pain, you should be examined the same day.

Comprehensive Foot Exam First

The Doctor of Podiatric Medicine will take a medical history and perform a physical and radiological exam. During the exam, it’s important to establish whether the muscle is partially or completely torn, which can involve a much longer healing process, possible surgery, and a more complicated recovery. It is also very important to examine all of the foot structures, since it is not unusual to identify one or two co-existing foot conditions  (plantar fasciitis, plantar ligament tear, posterior tibialis tendonitis, Achilles tendonitis, tarsal tunnel syndrome, neuritis of the calcaneal branch of the tibial nerve) that need to be taken into account in the conception of the treatment plan.

Professional Treatment of Abductor Hallucis Muscle Strain

Professional Treatment of Abductor Hallucis Muscle Strain

This condition is highly responsive to 3 laser treatment sessions (using 2 to 3 different wavelengths in a synergistic mode) in order to reduce swelling and pain and to promote faster healing and stronger tissue repair. Increased to excessive pronation (moderate to severe flat foot) should be controlled with the full-time wear of custom-made orthotics to be dispensed as promptly as possible.

In the meantime, as a temporary measure to prevent further deterioration, longitudinal and transversal taping the plantar aspect heel, arch and ball of the foot can help reduce the stress on the injured muscle allowing the foot to rest and heal more easily and faster.

Your Homework

Rest is crucial. Continuing to train on an injured foot will only make the injury worse and dramatically delay the healing process and the strength of the repair. For a mild strain, one may only need a few days of rest or a few changes in the  training routine, for example substituting running for cycling or swimming until the pain subsides. Apply ice as soon as possible. Ice can be applied for 10 minutes every hour initially for the first few hours reducing frequency as pain and swelling go down to 2 or 3 times per day. Once the pain subsides, a progressive rehabilitation program using stretching and strengthening exercises is important. Stretches for the plantar ligament and the Achilles’ tendon can be done under the threshold of pain.