Abductor Hallucis Tendinopathy

Abductor Hallucis Tendinopathy

If you’re getting pain at the bottom of your heel that’s worst first thing in the morning and on standing after rest, a lot of sources will tell you that you’re likely to have plantar fasciitis.

But there’s another muscle that has the same insertion in the heel and spans the arch to your big toe - it’s called your abductor hallucis muscle - and it could be true cause of your heel pain and the reason you’re not getting better as fast as you’d expected.

Where is your abductor hallucis and what does it do?

Your abductor hallucis (from hallux, meaning ‘big toe’) is a muscle that spans your arch, beginning at the inner aspect of your heel and attaching to the inner side of your big toe. It helps to move the big toe sideways (like when you splay your feet to grip onto the ground), supports your arch and foot with every step you take, and supports a massive amount of weight (among more technical functions that help).

Because the plantar fascia and the abductor hallucis start and finish in similar areas (though the plantar fascia attaches to ALL the toes like a fan whereas the abductor hallucis only attaches to the great toe), pain in this area is often mistaken for plantar fasciitis.

What causes abductor hallucis tendinopathy?

The abductor hallucis can be stressed and strained in the same way as the fascia - through pronating (feet rolling inwards/flat feet) and other actions that strain the arch, such as a sudden increase in physical activity that strained the fascia, poor footwear, foot type, trauma and more.


Unlike plantar fasciitis, you may experience some numbness beneath your big toe or a deep muscle ache when you’re resting.

What should you do?

If you’re worried or your pain isn’t settling, come in and have your feet checked by our expert team. While many treatment options for abductor hallucis tendinopathy overlap with treatment for plantar fasciitis, a large difference is that as a muscle (whereas the fascia is a tissue), rehabilitation needs to have a greater focus on strengthening the muscle back to its solid, strong state.

Arch support through orthotics is good for relieving tension off the abductor hallucis while it heals and recovers from the damage, but if the muscle has become weakened then there it can be likely that your symptoms may come back when the muscle is placed under excess strain again. Hence, intrinsic strengthening can be key to give the muscle back the strength it needs to adequately support the foot and fulfil its functions without incurring damage in the process.

On top of that, our team are trained in various aspects of manual therapy such as acupuncture and trigger point therapy that can be used on the abductor hallucis muscle.

Two weeks with Calcaneal Spur and finally got to see Doc. He sent me to Kevin @ Eleven and with One Appointment, he had me walking without Crutches. Yes! It still hurt. Did the Stretching, Rolling my Foot on a Spikey ball and Iced it occasionally. Return visit, after he had his Holiday, and I' am walking fine. They do NOT want to see me again, unless it deteriorates. Which it has not :-)
- Ivan CooKe