The flexor digitorum brevis tendon splits into two slips at each lesser toe (like the FDS in the hand) to allow the FDL tendon to pass through to the distal phalanx. Its medial calcaneal tuberosity origin is at the same enthesis as the plantar fascia, making plantar heel pain in this region a combined fascia-FDB enthesopathy in many cases.
Lesser toe PIP joint plantarflexion; helps maintain longitudinal arch during push-off
FDB tendinopathy within the midplantar region of the foot produces plantar metatarsal pain distinct from plantar fasciitis (which is at the heel) or metatarsalgia (at the MTP joints). Ultrasound identifies FDB tendon pathology in the midfoot arch region. Progressive calf stretching and intrinsic foot muscle strengthening address the underlying functional contributors.
Flexor digitorum brevis tendon degeneration producing midfoot plantar pain managed with orthotic support and progressive loading.
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