FHB straddles the hallux MTP joint via its two heads with sesamoid insertions. The sesamoids form the anatomical pulley for FHL beneath the first MTP joint.
| Origin | Cuboid plantar surface and lateral cuneiform |
|---|---|
| Insertion | Both sides of the hallux proximal phalanx base via the medial and lateral sesamoids |
| Nerve Supply | Medial plantar nerve (S1, S2) |
| Blood Supply | Medial plantar artery |
| Actions | Flexes the hallux MTP joint; Stabilises the hallux during push-off via the sesamoid pulley system |
|---|
Sesamoiditis produces forefoot pain beneath the first MTP in dancers and runners. FHB is the primary push-off muscle whose weakness in turf toe significantly impairs athletic performance.
Palpated plantar to the first MTP as the thick cushioning muscle during resisted hallux MTP flexion.
Sesamoid bone inflammation or stress fracture within the FHB tendon, managed by offloading orthotics and immobilisation for fracture.
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