The Center for Podiatric Care and Sports Medicine

Having Lateral Heel Pain? It Could Be Your Abductor Digiti Minimi

Posted by on Friday, January 15th, 2016


It was the last few weeks of my second pregnancy when I noticed a slight ache and a strange twitching on the outside of my left heel, along the bottom edge. What part of my anatomy was acting up? The structure residing in this location is called the abductor digiti minimi. During a pregnancy, muscles, ligaments, and tendons alike tend to become more lax and stretch out. One has to be careful not to overdo it. Shortly after my first pregnancy, I strained my Achilles tendon pretty badly running around with my dogs in the yard. I asked NYC podiatrists at The Center for Podiatric Care and Sports Medicine to shed some light on my lateral heel pain — before it’s too late and I injure myself!

lateral heel pain
If you have pain or twitching on the outer part of the heel or ankle, you could have an injury to your abductor digiti minimi. Image source: Flickr CC user Tony Alter

What Is the Abductor Digiti Minimi?

This muscle starts at the back part of the heel and connects with the plantar aponeurosis tissue along the sole of the foot. It shares space with lateral plantar nerves and vessels, which explains the electrical “twitch” sensation that had me worried I might be straining my foot schlepping a toddler and laundry baskets all over the house in slippers all day. The function of the abductor digiti minimi is to allow movement and flexion in the little toe.1

Causes and Symptoms of Abductor Digiti Minimi Strain

Pain on the outer heel or ankle during rest or movement is evidence of a strained abductor digiti minimi. Injuries to this area are often seen with patients who have plantar fasciitis, bunions, calluses, ankle sprains, diabetic neuropathy, and dislocated fifth metatarsals.

Common causes for abductor digiti minimi injuries include:

  • Running or walking on uneven surfaces
  • Wearing high heels, flats, or improperly fitting shoes
  • Congenitally weak ankles

What Can Happen If Lateral Heel Pain Is Left Untreated?

One woman who had been training for a marathon reported that she was originally diagnosed with Peroneal Brevis tendinitis.2 She was treated with a cortisone injection and walking boot, but an MRI revealed a tear in her abductor digiti minimi muscle as well. “The pain gets so bad that I can barely put pressure on the foot at all,” the woman reported. “Sometimes the pain feels like it is radiating up my calf and down to my toe.” It can take up to three months for soft tissue injuries of the feet to heal.

Treatments for Strained Abductor Digiti Minimi of the Foot

Dr. Josef J. Geldwert and the NYC podiatrists told me that rest and footwear modification are the two most important ways to prevent worsening of my condition. I wear custom orthoses normally and those should be worn at all times — inside the house, as well as outside the house. It may not seem like I’m walking a lot during the day, but it’s been said the average housewife walks about 10 miles a day just doing her chores around the house.

I tried putting my custom orthoses into my slippers, but I still felt like my feet were shifting around. With a floor-bound toddler, we try to keep stray dirt out of the house, so that means I’d have to invest in a pair of “house sneakers.”

I wondered, “Are there any stretches I should be doing for this part of my foot?” But the doctors warned me that attempting to stretch out an already-taxed muscle could do more harm than good. It’s best that I take it easy and put a cold gel pack on the aching area instead. I should apply the cold therapy along the heel, arch, and outside of the foot from the little toe to the ankle. A foot support or wrap could help remove some of the load and reduce strain to the region as well. Over-the-counter Biofreeze pain reliever can also be used in the short term for pain treatment, but it’s important to remember that pain is a signal that something is wrong and should be evaluated by a doctor.

Diagnosing Foot Pain in NYC

As tempting as it is to self-diagnose, it’s always a good idea to go in for diagnostic testing to be sure you don’t have a more serious issue causing foot pain. To be evaluated by a professional foot doctor in NYC, contact The Center for Podiatric Care and Sports Medicine.




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If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.