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Dance Foot Injury: What is Trigger Toe?

What is ‘Trigger Toe’?
Why does my big toe ‘click’ or ‘lock’ when I dance?

trigger toe
Trigger toe muscle, FHL

If you look at the top of the foot and claw your toes, you will see the long ropey structures that work your toes move beneath the skin. The one that leads to the big toe is called the Flexor Hallucis Longus tendon.  If the FHL tendon can’t slide freely as it contracts and elongates, it can become move outside the groove that it is supposed to stay in.  It can then become caught or ‘locked’ outside the tendon canal.  It is usually worst when moving through demi and full pointe positions.  This condition is sometimes referred to as ‘Trigger Toe’ and is most painful with eccentric contraction.  This is the movement that occurs as you perform controlled lowering from a pointe or demi pointe position.

This poor pattern of movement of this tendon can cause inflammation to both the tendon and its protective sheath.  Long term inflammation may cause scarring further reducing the tendon’s ability to work smoothly.   Ice and gentle massage will reduce inflammation.  The dancer should take great care to stretch and ‘warm up’ the big toe and ball of the foot correctly before dancing.  In more serious cases, surgical release of the tendon may be necessary.

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