I have identified Myomemory Transformation Advantage (M.A.T.) as the form of treatment I utilize at my clinic in treatment of your acute and chronic musculoskeletal pain. M.A.T. is an integrated, general systems, and functional approach to evaluating human posture and movement that I developed from my education and experiences as a physical therapist in over forty years of practice and my training and experiences in the winter sport of nordic ski jumping. I find it truly ironic that I am in a field that assesses the effects of gravity on the human structure and I participated in a sport that was in competition with gravity.
M.A.T. foremost identifies and addresses muscle imbalances affecting your posture and movement. Human movement is reciprocal in nature and opposing muscles, antagonists coordinate for optimal posture and movement. Muscle tone and length between these opposing muscle groups need to be in balance, in equilibrium for optimal function.
I assess muscle imbalances from both an integrated and isolated point of view. With the integrated view, the muscles on each side of your body should be symmetrical in tone and length at rest. When a muscle or muscles on one side of the body are larger, smaller, stronger, or weaker than the corresponding muscles on the other side, you have a muscle imbalance. This muscle imbalance at rest creates postural distortions or asymmetries that I assess during your postural evaluation. Again, when there are no muscle imbalances evident, your posture will achieve “ideal static alignment” where your center of gravity (COG) is ideally positioned between your base of support at and around S2.
I also assess the muscle imbalances at the isolated joints because each of the muscles that surround a joint ideally work together with opposing forces keeping the bones of a joint centered for optimum position and motion or optimum alignment. If an imbalance of tone and length exists, where one or more of the muscles becomes weaker, looser, or tighter than normal, you have a muscle imbalance that can limit joint motion. Also, the position, the alignment of a joint becomes compensated putting you at a higher risk of injury.
The two recognized causes of muscle imbalances are biomechanical and neuromuscular. Biomechanical imbalances are created by repetitive motions or sustained postures, simply your habits and behaviors. Neuromuscular imbalances are associated more with postural and movement patterns that evolve from birth and the predisposition of muscles to have increased tone or weakness.
Hand and leg dominance (laterality) contribute to muscle imbalances as well. In humans, the preference of using one side of the body for tasks is well recognized as a self-evident aspect of human motor control. This reflects bilateral asymmetry in motor control circuitry between the right and left hemispheres of the brain. People naturally use their dominant side more often. In my practice, I find most people are R hand dominant as well as R leg dominant. However, I do find people with R hand and L leg dominance. This is also the case with L hand dominant people.
Regardless, minor muscle differences from your right and left sides of the body are to be expected because of this dominance. But factors like overuse can turn these minor differences into significant imbalances such as with repetitive movements of sports. In addition, studies have found that this difference from one side of the body compared to the opposite side may be more pronounced in right hand dominate people. Right-handers had 10% more grip strength in their right hand than their left. But lefties didn’t have a significant difference between the two sides. Researchers in a different study believe this difference is due to lefties adapting to a right-handed centered environment, so they use both hands more.
We cannot neglect how lateral dominance of the brain can contribute to these imbalances. These patterns of lateral dominance greatly influence how a person’s brain internally processes sensory information. Therefore, everybody has a dominant brain hemisphere, eye, ear, and as already mentioned hands and feet which are used more frequently and adeptly during their functional activities of daily living against the vertical forces of gravity and GRF.
M.A.T. identifies these muscle imbalances within the framework of its neuromyofascial patterns which include the deep anterior/posterior linear, superficial anterior/posterior linear, side linear, diagonal, and spiral patterns. The side linear neuromyofascial pattern which provides lateral stability to your structure was the first pattern I discussed in my newsletter.
The side linear neuromyofascial pattern works in the frontal or coronal plane and runs predominately down the sides of your structure from the temporal bone of cranium down to lateral aspect of the thigh with the IT band to the posterior lower leg and calf to the bottom of the foot. The muscles of the side linear pattern create positions and motions of your body that includes a tilt, side bend, lateral flexion, shift and abduction and adduction of the extremities in the frontal plane as well as flexion and extension in the sagittal plane. These position and motions identified are linear in nature as the name of the pattern indicates and occur in the body’s mediallateral axis and frontal and sagittal planes.
With the frontal plane, the dysfunctional postural pattern seen with the side linear pattern is in the shape of a parallelogram which is a four sided rectilinear figure with the opposite sides parallel. In such a configuration, the shoulders and pelvis on one side of the body are elevated and tilted on the opposite side. On the elevated side, the lower extremity chain is supinated while on the tilted side, the lower extremity chain is pronated.
Pronation is referring to what happens with lower extremity kinetic chain during the stance phase of your gait in reaction to GRF. In pronation, the lower leg, foot, and ankle rolls in allowing for the absorption of your body weight. Conversely in supination, the lower extremity chain rolls out.
In addition with this dysfunctional postural patten, I will find a shift of the head and pelvic girdle toward the supinated side and lateral flexion/side bend of cervical, thoracic, and lumbar spine toward the pronated side. With this, there is usually a functional leg length difference with the leg appearing longer on the pronated side.
Sometimes hidden in this dysfunctional postural pattern of the frontal plane, is an anterior tilt, knee flexion, and plantar flexion on the supinated side and a posterior tilt, knee hyperextension and dorsiflexion on the pronated side in the sagittal plane. It is sometime difficult to detect this dysfunctional pattern in the sagittal plane because of the strong interplay between these two planes in reaction to gravity and GRF.
The muscles of M.A.T.’S side linear neuromyofascial pattern on the pronated side include the temporalis, lateral pterygoid, middle scalene, lower/mid trapezius, QL iliotransverse portion, psoas major, middle gluteus medius, anterior tibialis, flexor hallucis brevis, and flexor hallucis longus while the muscles on the supinated side include the masseter, medial pterygoid, rectus capitis lateralis, upper trapezius, QL iliocostal portion, iliacus, adductor magnus, triceps surae (gastocnemius/soleus), extensor hallucis brevis, and extensor hallucis longus.
Because the tone of these muscles are set by the descending neuromuscular reflexes in reaction to gravity and GRF initiated at the otoliths of the vestibular system, I will begin my discussion of the muscles at the side of the head and work down toward the lower leg, foot, and ankle. I will begin my description of a muscle on the supinated side followed by a description of its antagonist on the pronated side to emphasize the importance of muscle balance between the tone of these muscles.
The first muscle is the masseter which is one of the four muscles of mastication (chewing). It is a powerful quadrangular muscle originating from the zygomatic arch and inserts along of the mandibular ramus. Its primary function is elevation and protraction with the mandible (jaw).
The temporalis muscle is also a muscle of mastication. It is the most powerful muscle of the temporomandibular joint (TMJ). The temporalis muscle arises from the temporal fossa on the lateral aspect of cranium and the deep part of the temporal fascia. This is a very broad area of attachment. It inserts onto the mandible causing elevation and retraction.
Two muscles that I have neglected in the past to include within M.A.T.’s side linear neuromyofascial pattern is the medial and lateral pterygoid muscles. The pterygoid muscles’ primary function is to produce movement of the mandible at the TMJ. The medial petrygoid has increased tone on the supinated side and the lateral pterygoid on the pronated side. The medial pterygoid functions to assist with elevation and protrusion with the mandible. Conversely, the lateral pterygoid is the sole muscle of mastication that depresses the mandible. This being the case, depression of the mandible is primarily the result of gravity. It also with the medial pterygoid causes protrusion and side to side movements of the jaw.
Next on the supinated side is the rectus capitis lateralis (RCL), a small muscle located on the anterior surface of the neck pictured below. Its origin is along the anterior surface of the transverse process of the atlas and inserts up on occipital bone of the cranium. Its function is stabilize the head on the neck especially involving a shift. If for instance the RCL is tight, it will shift the head toward that side. It also weakly assists with lateral flexion of the head.
The RCL is part of the “suboccipital muscles” at the base of the head and neck. These group of muscles are intrinsically connected to the eyes to such a degree, that if you palpate them while moving the eyes, you’ll feel the suboccipital muscles respond directly to your eyes’s movements. Research has found that the suboccipitals have a tremendously high muscle spindle cell density involving our proprioceptive sense.
It is clear that the suboccipitals have important functions in the body including stabilizing and symmetrically pulling the atlas-axis and atlas-occipital joints, intrinsic relations to our vision, balance, and posture. Asymmetrical atlas-axis and atlas-occiput articulation, vertigo, headaches, whiplash, etc. are all indicators of compensation by the suboccipital muscles.
The middle scalene is its antagonist in the side linear pattern causing lateral flexion or a side bend of the cervical spine. It is the largest and longest muscle of the scalene group of lateral neck muscles. It is deeply placed behind the sternocleidomastoid (SCM). It originates from the transverse processes of the posterior tubercles of C2 to C7. Some individuals, however, will have it originate from the atlas (C1). Its insertion is onto the superior border of the first rib. The middle scalene along with the anterior scalene elevate the first rib during breathing.
Another important aspect of the middle scalene is that it helps to create the “scalene triangle.” It is an anatomical triangle formed between the anterior scalene, middle scalene, and first rib. Important vascular and nerve structures such as the subclavian artery and brachial plexus pass through this anatomical triangle. Someone with abnormal anatomy or injury to this region can cause compression of these neurovascular structures leading to thoracic outlet syndrome (TOS). Poor posture can affect this anatomical triangle causing various symptoms into the upper extremity.
Another muscle that is included in the side linear pattern even though it is located along the posterior aspect of body, is the trapezius. It is the upper trapezius on the supinated side that causes the elevation of the shoulder girdle with side linear dysfunctional postural pattern. The trapezius is divided into a descending or superior part referred to as the upper trapezius and an ascending middle and inferior part know as the middle and lower trapezius. The trapezius muscle has an origin that is more extensive than that of any other muscle of the human body.
The primary function of the muscle is to “set” the shoulder girdle consisting of the shoulder blade, clavicle, and glenohumeral joint (shoulder) allowing for shoulder abduction and adduction. Setting it in the optimal position where the tone of the upper, middle, and lower trapezius are equal allows for optimal “scapulohumeral rhythm.” But as mentioned, usually there is a muscle imbalance between the three parts of the muscle with the upper trapezius having increased tone on the supinated side and the middle and lower trapezius having increased tone on the pronated side. The result of this muscle imbalance is compensation by the supraspinatus and middle deltoid affecting shoulder abduction.
As mentioned, shoulder abduction and adduction are the primary positions of the extremities involving the side linear pattern. Since the primary muscles of shoulder abduction are usually involved with a shoulder dysfunction, I will only discuss the middle deltoid and supraspinatus. The middle deltoid has increased tone on the supinated side or the side where the shoulder girdle is elevated. The deltoid muscle is the the large triangular-shaped muscle draped over the glenohumeral joint. It too has three distinct portions including the anterior or clavicular, middle or acromial, and posterior or spinal. The primary function of the deltoid is stabilizing the humeral head. That is especially the case with the middle deltoid.
All heads of the deltoid work together to produce abduction at the shoulder, but primarily the middle deltoid which is part of the side linear neuromyofascial pattern. It also helps to lift arm to the front and back as with the anterior and posterior deltoid. It is definitely involved with any overhead activities and compensates for the loss of strength in the rotator cuff. Its antagonist is the supraspinatus which is the superior part of the rotator cuff.
The supraspinatus is the smallest of the rotator cuff muscles that also includes the teres minor, infraspinatus, and subscapularis. It is the rotator cuff muscles that are like the “power steering” of a car. When they are functioning at their optimum, the motion of the shoulder joint is smooth and easy. The supraspinatus abducts the arm from 0 to 15º then assists the deltoid to produce abduction beyond this range up to 90º. It is a primary stabilizer of the shoulder joint by keeping the head of the humerus firmly pressed medially against the glenoid fossa of the scapula. As part of the rotator cuff, it helps to resist gravitational forces which act on the shoulder joint to pull from the weight of the upper limb downward.
As I mentioned during my description of the side linear pattern, it all starts with lateral stability in sitting and standing. Because you acquire the ability to sit in your neurodevelopment at about 7 months, the quadratus lumborum is a major stabilizer. Sitting involves the SITS bones on either side of the pelvic girdle and proprioceptive input coming from the sacrotuberous, sacrospinous, and iliolumbar ligaments. An uneven sitting posture down through the SITS bones over time creates a functional muscle imbalance causing increased tone of the iliocostal portion of the quadratus lumborum (QL) on the supinated or elevated side and the iliotransverse position on the pronated or tilted side.
This compensatory postural pattern while sitting will cause a functional muscle imbalance mentioned above in addition to “pelvic obliquity” and an iliosacral “upslip” because the position between the ilium and sacrum is no longer symmetrical. With a iliosacral upslip, basically, the tissues of this joint between the sacrum and ilium of the pelvic girdle experience upward shear forces on the elevated side resulting in distortion of the SI joint. Since these ilium-on-sacrum shear forces are more affected by gravity than other iliosacral dysfunctions, they have very little chance of self-correction and in most cases must be addressed not only with exercise, but with manual therapy.
With constant and repetitive unbalanced loading caused by this muscle imbalance of the QL in sitting and resultant asymmetry of the pelvic girdle in the frontal plane, it can gradually deform the SI joint ligaments causing an iliosacral upslip and down slip. In addition, it can cause a “functional leg length” difference creating a dysfunctional unleveling of the pelvic girdle and sacral base when in standing which is one of the most important contributing factors of chronic musculoskeletal pain. Although leg-length discrepancies are quite common and have various causes, any measurement of over 1/2” or more is significant. “Anatomical short legs,” on the other hand, can only be accurately documented with a measurement using a x-ray image and are usually attributed to fractures, polio, limb overgrowth, and of course someones genetic make up causing a defect.
The functional muscle imbalance of a hypertonic iliocostal QL on one side and the QL iliotransverse on the other side in sitting not only causes asymmetry of the pelvic girdle, but binds down the lumbar vertebrae and tends to flatten the lumbar curve on the tilted side. In addition, there is more compression forces on the L hip from the tilting of the pelvic girdle. It is the QL and other lower back muscles that comprise what is referred to as the “multifidus angle” and should be considered when treating a functional muscle imbalance of the iliocostal and iliotransverse QL.
The multifidus angle includes the facet joints, erector spinae muscles, and lumbar fascia. The functional mobility of the lumbar spine affects the coupled motion of the spine, pelvic girdle, and lower extremities in all three planes and is significantly affected by this tilt and elevation of the pelvis in the frontal plane.
During the dynamics of the vertical, upright human gait, an important kinetic chain link identified is the side bending/lateral flexion and rotation of the cervical, thoracic, and lumbosacral spine encouraging the cross-patterned gait, the pinnacle of all human movement. The central element permitting the development of a vertical upright human gait is this coupled motion of the spine that is significantly affected by the compensation in M.A.T.’s side linear pattern. As you trace the path of energy from heel strike in reaction to GRF during walking, you can see how the spine conserves this energy it has been given from the ground. It seems reasonable to suggest that this pulse of energy from GRF and the lower extremity chain entering the body at the L5/SI interface is distributed to all levels of the spine until none remains at the atlas/axis junction of the neck.
The coupled motion of the spine just described is a fundamental feature of human movement and is used in training programs by various sports disciplines. Therefore, it can be argued that coaching any athletic skill should essentially be teaching the proper use of the spinal coupled motion to maximize the power required for performance of an athletic skill. From my life experiences in training and competing for twenty-three years in the sport of nordic ski jumping, I would agree with that statement.
As already mentioned, M.A.T.’s side linear pattern has an effect on the coupled motion of the spine during walking. A compensatory pattern often seen with the side linear pattern is a lateral shift of the pelvic girdle on the supinated side occurring along with a lateral shift of the shoulder girdle toward the opposite side.
During the stance phase of your gait, you normally shift your body weight over the supporting leg and in order to do this, you must transfer your COG by shifting the pelvis over the standing leg. Try walking without the shifting of your pelvic girdle laterally and you will soon learn the importance of this side-to-side shift or translation of the pelvic girdle during gait.
When the shoulder girdle shifts, your upper body instead laterally shifts over the standing leg allowing the swinging leg to be lifted. In this way, the pelvic girdle does not have to lateral shift as much during gait. The compensatory gait pattern often demonstrated in the frontal plane is asymmetry for the shoulder and pelvic girdles with a greater shift of the pelvic girdle on one side, the supinated side and a greater shift of the shoulder girdle on the opposite side, the pronated side.
Again, this asymmetrical shifting of the pelvic and shoulder girdles walking is a direct result from compensation in sitting. Pay closer attention to the gait of people today especially after this pandemic where people have a tendency to sit way too much causing this compensatory shift during their gait. You will notice more of this asymmetrical shifting between the pelvic and shoulder girdles and the loss of the inherent cross-patterned walking between the torso and hips while limiting the lift coming from the lower extremity kinetic chain in reaction to GRF.
In addition, the side linear pattern includes the lateral spring system (LSS) seen during gait which is one of the most unappreciated of all the body’s antigravity structures. Driven by the hip abductors, this myofascial gait force “sets” the pelvic girdle on the aastance leg just prior to push-off and side bends the rotating pelvis on the opposite side so the leg can swing through.
Everything works as it should if the gluteus medius and minimis on the stance leg are properly toned and firing in the correct sequence. During a normal gait, the QL should be relatively silent. When the QL becomes tight from sitting unequally into the SITS bones, the ideal abduction firing-order pattern from stance to through toe-off is disrupted. It should ideally be: gluteus medius/minimis, co-contraction of the hip adductors on the same side, tensor fascia latae (TFL), piriformis (synergistic stabilizer of M.A.T.’s diagonal pattern) and QL. When the QL is dominate on one side and hip hikes the pelvis as the swing leg comes though during gait, dysfunctional forces occur. These people walk like a block with a labored gait and is easy to see.
The gluteus medius is one of the muscles that is on the side of the hip. It resides under the gluteus maximus, and works with the gluteus minimis. The latter two muscles will be discussed in more detail with other M.A.T. patterns. It is all but covered by the gluteus maximus except for its anterio-superior third which is uncovered and a safe area for injections.
The gluteus medius is divided into three positions much like the deltoid of the shoulder. Fibers of the posterior portion pass forward and downwards, fibers of the middle portion pass downwards, and fibers of the anterior portion backwards and downward. With the side linear pattern we will focus more on the middle portion whereas the anterior and posterior portions will be discussed with M.A.T.’S diagonal pattern.
The middle gluteus medius is the prime mover of abduction at the hip joint, but is vital in maintaining frontal plane, lateral stability of the pelvis during gait. It is an important muscle in walking, running, and single-leg weight-bearing. When a limb is taken off the ground and swinging through like during your gait, the pelvis on that side will tend to drop due to a loss of GRF. The gluteus medius on the stance leg works to maintain a level pelvis allowing the leg to swing through.
There is a relationship between a weak and dysfunctional gluteus medius causing many lower extremity injuries an problems such as a Trendelenburg gait, ilii-tibial band syndrome, patellofemoral pain syndrome, anterior cruciate and other knee ligament injuries, and ankle injuries. The Trendelenburg sign is when the pelvis will drop on the opposite side of the weakness causing compensation with the trunk in lateral flexion. As already mentioned, a shift will also occur.
Before going onto the other muscles of M.A.T.’s side linear pattern, I felt it important to mention the iliotibial band (IT Band). Even though the IT band is not a muscle, I feel it needs to be addressed. The IT band runs along the lateral thigh on both sides of the body from the just above the hip to just below the knee and is made up of fascia, the elastic connective tissue found throughout the body. For many people, it is the source of nagging and painful musculoskeletal pain especially for runners and bikers. Fascia is made up of the proteins collagen and elastin and it was felt by me that it was predominately collagen providing stability for your structure.
Therefore, it has been the belief for years that the IT band’s main function was providing lateral stability to the human, skeletal structure and again why I felt it needed to be mentioned with the side linear pattern. However in recent studies, it is now felt that the IT band stores and releases elastic energy to make walking and running more efficient. Evidently, it has been found that the IT band has the capacity to store elastic energy. Again, this notion that the IT band acts as a spring to aid in the human gait runs counter to the decades old belief that its primary function is to stabilize the hip during walking.
Evidently, it has been found that one part of the IT band stretches as the limb swings backward during gait storing elastic energy. That stored energy is then released as the leg swings forward during a stride, potentially resulting in energy savings. It should be noted that the gluteus maximus and tensor fascia latae muscles both of which attach into the IT band are part of M.A.T.’s spiral neuromyofascial pattern which is primarily responsible for the human reciprocal gait pattern.
Two very anonymous muscles of the side linear pattern are the vastus intermedius and biceps femoris brevis. The vastus intermedius is the deepest of the quadriceps lying under the rectus femoris. Its main function is extension of the knee which I find to be tight on the pronated side during the stance phase of gait.
The biceps femoris brevis, on the other hand, is part of your hamstrings. The biceps femoris has two heads including the longus attaching to the head of the fibula and will be discussed in M.A.T.’s spiral pattern. However, it should be noted that the brevis is the only hamstring muscle that doesn’t attach to the “ischial tuberosity” of the pelvic girdle. It is very active during the stance phase of gait in flexing the knee of the opposite swing through limb. Therefore, it is more active on the supinated side.
That brings us to the end of the lower extremity kinetic chain involving the lower leg, heel, ankle, and foot. It includes the gastrocnemius and soleus, anterior tibialis, adductor hallucis, abductor hallucis and abductor digiti minimi, flexor hallucis brevis/longus, and extensor hallucis brevis/longus.
The gastrocnemius and soleus, often times referred to as part of the “triceps surae” is involved with plantar flexion of the foot at the ankle joint allowing the heel to elevate against gravity resulting in a propulsion force against GRF. The plantaris muscle is also included in the triceps surae, but is only found in between 7-20% of all humans.
However more importantly, the gastrocnemius-soleus eccentrically affects the heel or calcaneus and talus in reaction to GRF. The talus is the bone of your structure that sits on top of the calcaneus and is the only bone that doesn’t have a muscle attached to it. It reacts to what the heel does in reaction to GRF much like how a saddle reacts to the movement of a horse. The talus sits up between the tibia and fibula, the lower leg bones forming the ankle. The joint created by the heel and talus is referred to as the “subtalar joint.”
Dr. Phillip Greenman states, “the subtalar joint is the body’s steering wheel and the most important joint you didn’t know you had.” This joint located just below the ankle, does only two things. It rolls in or pronates reacting to GRF and rolls out or supinates to push off the ground. Both pronation and supination are normal movements of the lower extremity kinetic chain and naturally occur during the human gait cycle.
But upon heel strike, 80% of your body weight should be directly over your calcaneus producing a vertical force that is transmitted up through the lower extremity chain into the body at the L5/S1 interface. The lower leg, foot, and ankle pronate (roll in) during the stance phase of your gait allowing for the absorption of your body weight in reaction to GRF. The weight is distributed between the calcaneus and metatarsals causing the subtalar joint to dorsiflex and adduct causing eversion of the heel. In response to the internal and medial shearing forces, the lower leg internally rotates to complete the articulation with the calanceus. This rotation of the talus and calcaneus is known as the “torque converter” of the lower leg.
In supination (roll out), the extrinsic muscles in the lower leg function from toe-strike to push-off allowing for external rotation as the contralateral limb swings forward. This external rotation of the lower leg causes lateral shearing forces within the foot and ankle causing the midtarsal joint to lock while the subtalar joint goes through plantar flexion, abduction, and inversion of the heel. It should also be noted that dorsiflexion of the first metatarsalphalangeal joint occurs increasing the tension of the plantar aponeurosis assisting the subtalar joint in supination, a mechanism referred to as the “windlass effect.”
Its antagonist is the anterior tibialis on the pronated side situated on the anterior and lateral side of the tibia. It is the primary dorsiflexor of the ankle and works with the extensor hallucis longus, extensor digitorum longus, and peroneal tertius. It contributes to maintaining the medial arch of the foot.
A fundamental feature of the foot often overlooked during your gait is your big toe mobility corresponding with the windlass effect mentioned above. Specifically the metatarsophalangeal (MTP) joint. The first MTP should be able to extend as much as 65º, but many people lack this. Limited MTP or hallux rigidus will cause the your nervous system to compensate leading to hip or knee pain.
According to research, hallux rigidus affects one of every 45 middle aged people and 35-60% of the population over 65 years of age. If your brain perceives a threat, the joint may become painful in attempt to offload gravitational and GRF stresses. This is often the case with hallux valgus toe, where a bunion forms as the long metatarsal bones shift toward the inside of the foot and the phalanx bones angle toward the second toe.
This is where the intrinsic and extrinsic muscles of the foot come into play. The extensor hallcuis brevis and longus is active during the supination and push off from the ground. The brevis is on top of the foot and assists in extending the MTP and is essentially the medial part of the extensor digitorum brevis muscle. The extensor hallucis longus too extends the MTP, but also the interphalangeal joints of the big toe and assists in dorsiflexion.
The flexor hallucis brevis (FHB) active during pronation is along the bottom of your foot having two heads. The medial head forms a common tendon with the abductor hallucis and inserts on a point at the base of the proximal phalanx of the big toe. Within this tendon sits the tibial sesamoid bone. The lateral head of the FHB forms a common tendon with the adductor hallucis and within this tendon sits the fibular sesamoid bone. The FHB along with the flexor hallucis longus causes flexion of MTP at the big toe which is important during pronation of the lower extremity kinetic chain.
The adductor hallucis has two heads called the transverse and oblique. It adducts and flexes the MTP joint of the big toe and supports the transverse arch. It is more active during the push off and supination of the gait cycle. It contributes to as mentioned to hallux valgus deformities.
The abductor hallucis is also along the plantar surface of your foot alongside the flexor digitorum brevis and abductor digiti minimi. All of these muscles help to stabilize the foot in reaction to GRF. The abductor hallucis also abducts the big toe as its name implies.
Well, there you have it. A complete picture of all the muscles involved with M.A.T.’S side linear neuromyofascial pattern providing the lateral stability for your structure against the vertical forces of gravity and GRF. Next will be the muscles of the diagonal pattern that have a strong interplay with the side linear pattern during your functional activities of daily living. Until then, be well.
Terry