The FDL tendon passes through the tarsal tunnel and crosses the plantar foot to divide into four slips for the lateral four toes after the quadratus plantae modifies its direction. At the knot of Henry in the midfoot, the FDL crosses the FHL tendon — a site of intersection tenosynovitis in runners. Its contribution to toe flexion grip against the ground is the primary plantar-side contribution to push-off propulsion.
Distal phalanx flexion of lesser toes; push-off propulsion; medial arch support
FDL tenosynovitis in the tarsal tunnel contributes to tarsal tunnel syndrome symptomatology, and the tendon sheaths can be decompressed during tarsal tunnel release. The knot of Henry intersection of FDL and FHL occasionally produces midfoot pain from tenosynovitis at the crossing point, reproduced by resisted toe flexion of both the great and lesser toes simultaneously.
Tendon sheath inflammation in the tarsal tunnel or at the knot of Henry producing medial and plantar foot pain managed with orthotics and injection.
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