If you spend your weekends chasing mountain peaks, gliding through snowy trails, or pounding pavement in pursuit of a PR, your feet are doing a lot of work—especially your big toe. One of the unsung heroes of your lower body is a muscle called the flexor hallucis longus, or FHL for short. When it’s not functioning well, you’ll feel it. Let’s break down what FHL dysfunction is, who it affects most, and how physical therapy can get you back on the trail, track, or slopes.
What is the Flexor Hallucis Longus?
The FHL is a deep muscle that runs along the back of your lower leg, behind your ankle, and under your foot. Its main job? Flexing your big toe and stabilizing your foot during push-off—a critical phase of walking, running, skiing, or hiking. It’s also part of the reason you can rise onto your toes or control your descent when stepping downhill.
When the FHL gets overused, inflamed, or irritated, you might develop FHL dysfunction, a condition that can seriously mess with your stride.
Who’s Prone to FHL Dysfunction?
Anyone can experience FHL issues, but certain types of athletes are more likely to run into trouble, especially if their activities involve repetitive push-off motions or constant big toe flexion. These include:
- Runners (especially long-distance)
- Hikers and backpackers logging long miles or steep ascents
- Skiers and snowboarders, especially those in tight-fitting boots
- Dancers, particularly ballet dancers en pointe
- Soccer and court sport athletes who do a lot of quick starts and stops
If you live an active lifestyle in Alaska, you’re probably already putting your FHL to the test on the daily.
What Does It Feel Like?
Common signs of FHL dysfunction include:
- Pain or aching deep in the back of the ankle or calf
- Soreness along the arch or underside of the foot
- Pain when pushing off the big toe (like during running or hiking uphill)
- Stiffness in the big toe
- A sensation of tightness or clicking near the ankle
Left untreated, it can lead to compensations in your stride, further injuries, or chronic tendon irritation.
Home Exercises to Start Feeling Better
If you’re catching the symptoms early, a few home-based stretches and strengthening exercises can start the recovery process:
- Big Toe Pumps with Band: Loop a resistance band around your big toe, anchor the other end, and gently flex and extend your toe against the resistance. This isolates and strengthens the flexor hallucis longus, improving toe control and restoring power in your push-off phase.
- Heel Raise with Ball Squeeze: Place a small ball (like a tennis or lacrosse ball) between your heels, and slowly rise onto your toes while squeezing the ball.
This activates the deep stabilizers of your foot and ankle, including the FHL, while promoting proper alignment and reducing overuse of compensatory muscles. - Calf Release with Tennis Ball: Sit on the floor and place a tennis ball under your calf, then roll slowly to find tight spots, especially along the inner part of your lower leg. Releasing tightness in the calf improves mobility and reduces strain on the muscle and tendon as it moves through the ankle and foot.
Important note: If pain increases or doesn’t improve after a couple of weeks, it’s time to get assessed by a physical therapist.
Big Toe Strengthening with Resistance Band
Heel Raise with Ball Squeeze
Calf Release with Tennis Ball
How Physical Therapy Can Help
We work with runners, skiers, hikers, and outdoor athletes every day. Our team understands how FHL dysfunction can derail your training—or just your ability to enjoy the outdoors. Here’s how we help:
- Thorough Assessment- We start by pinpointing the source of pain and identifying contributing factors like biomechanics, training errors, or imbalances.
- Hands-On Techniques- Manual therapy can reduce tension in the calf and foot muscles, improve mobility, and decrease inflammation.
- Targeted Strengthening & Mobility Work- We tailor exercises to your specific needs—think barefoot balance drills, ankle mobility work, and dynamic strengthening.
- Dry Needling- This technique uses thin needles to release tight or overactive muscles (“trigger points”), especially in the deep calf where the FHL runs. Dry needling can be a game-changer in calming down pain and restoring function.
- Gait and Footwear Analysis- We’ll check how your walking or running pattern may be affecting your FHL and recommend changes in footwear or orthotics if needed.
Dry Needling
Running Gait Analysis
Don’t Let Toe Pain Sideline You
If you’re dealing with nagging foot or ankle pain that just won’t quit, don’t ignore it. Flexor hallucis longus dysfunction is treatable—and the sooner you catch it, the easier it is to resolve. At Runners’ Edge Alaska, we’re here to help you get back to what you love—pain-free and stronger than ever.
