What is Tendonitis?

Foot tendonitis is inflammation or irritation of a tendon in your foot. Tendons are strong bands of tissue that connect muscles to bones. Overuse usually causes foot tendonitis, but it can also be the result of an injury. Tendonitis is a common foot condition that occurs due to tendon injuries. There are different types of tendonitis and they are identifiable by which part of your feet they affect.

Types of Tendonitis

The types of foot tendonitis that can cause intense pain and distress include Achilles, Extensor, Peroneal, Posterior tibial tendonitis, and Plantar fasciitis.

1. Achilles Tendonitis - The Achilles tendon is a large tendon that attaches the calf muscles to the back of the heel. Achilles tendonitis affects the back of the ankle and is a common sports injury that occurs when an activity level is suddenly increased, or a new activity is started.
2. Posterior Tibial Tendonitis - This affects the inner side of the ankle and causes strain on the tendon of the tibialis posterior muscle which is at the back of the lower leg. Posterior tibial tendonitis usually occurs due to flat feet. 
3. Peroneal Tendonitis - In peroneal tendonitis, the tendons of the peroneal muscles which are on the outer side of the ankle cause pain and possibly swelling. High-arched feet and a history of ankle sprains could put you at risk for this type of tendonitis.
4. Flexor Tendonitis - The flexor tendon on tendonitis foot extends from the calf muscle to the toes of the feet through the side of the ankle. This tendon is key in ensuring you can easily bend your toes. Overuse of this tendon can cause pain and inflammation. 
5. Extensor Tendonitis - The Extensor tendon runs along the top of your foot and connects the toes to the bones at the front of your leg. Extensor tendonitis is relatively rare and prevents you from being able to lift your toes, and causes intense pain during physical activities.
6. Plantar fasciitis - Pain at the underside of your heel and within the arch of your foot. While this is technically not a tendon but a ligament, it can produce the same type of painful conditions that present like tendonitis with similar treatment approaches.

Why do people get tendonitis?

No one is immune from developing tendonitis. However, some risk factors increase your chances of developing the condition. Age is one important risk factor because as you get older, the flexibility of your soft tissues and tendons decreases. This makes you more susceptible to injuries like tendonitis. 

Other risk factors for developing tendonitis include:

1. Occupations with repetitive motions, strong vibrations, and frequent heavy exertion (examples: construction, jackhammering, landscaping)
2. Sports with involve repetitive motions (examples: tennis, running, golf, swimming, baseball)
3. Poor posture and improper technique when performing repetitive motions (examples: shoveling, scrubbing, raking, gardening)
4. Physical conditions that put stress on your tendons (examples: arthritis, gout, psoriatic arthritis)
5. Overdoing new/infrequent activities or overusing your tendon without the proper conditioning (examples: jogging five miles after being sedentary)

While you can develop tendonitis wherever a tendon connects your bone and muscle, certain body parts are more likely to be affected by the condition: your elbow, shoulder, hip, knee, thumb, and Achilles tendon. 

What causes foot tendonitis?

Foot tendonitis is usually chronic, meaning it develops over time when you put repeated stress on the tendons in your foot. But tendonitis can also happen suddenly if you overstretch the tendon, over-rotate your ankle or use improper technique when running, jumping or playing sports.

What are the symptoms of foot tendonitis?

Symptoms vary depending on which tendon you injure, but may include:

1. Bone spurs (small formations of extra bone near the tendon).
2. Pain along the length of the tendon or where the tendon attaches to the bone.
3. Pain that gets worse with physical activity.
4. Stiffness in the tendon after periods of inactivity, such as first thing in the morning.
5. Swelling, redness or warmth around the tendon.
6. Thickening of the tendon.

Treatments for Tendonitis 

1. Over-the-Counter and Prescription Medications 

Experts usually prescribe safe over-the-counter medications such as painkillers and non-steroidal anti-inflammatory drugs to help relieve tendonitis pain. 

2. Rest, ice, compression, and elevation (RICE) 

The combination of rest, ice applied on the affected area, compression (wrap the affected area), and elevation (raising the affected area to the level of your heart) has shown to be an effective method to reduce the adverse effects of foot tendonitis. 

3. Physical Therapy 

Physical therapy is a reliable way through which one can achieve relief from peroneal tendonitis and other forms of the condition. A physiotherapist provides the best advice on the balance between rest, methods, and exercise based on your requirements. 

4. Orthotics or other supportive devices 

Since poor footwear causes foot tendonitis, expert physiotherapists often recommend using orthotics - special medical devices that help you recover gradually and other supportive devices, including special footwear. 

5. Home Remedies

While resting and avoiding strain on your feet and ankles will go a long way in recovery, other methods such as ice, compression, and changes to diet to include more vitamins and minerals can help you recover smoothly. 

6. Surgery 

When left untreated for an extended period or depending on the severity of the injury to the tendon, physiotherapists may advise considering surgery options, including Gastrocnemius recession, Tenosynovectomy, Tendon transfer, or Ultrasound-Guided Hydrodissection (TenJet).

Prevention of Tendonitis 

1. Warm-up and Stretching

Before undertaking any continual physical activity such as exercise, running, or jumping, warming up your muscles by stretching them will ensure that your muscles are prepared for exercise, avoiding inflammation and injury. 

2. Proper Footwear 

Unruly, unsupported, worn-out footwear can have serious consequences on your foot, leading to foot and ankle tendonitis. Therefore, if you feel uncomfortable with your current footwear, switching to supportive footwear is best. 

3. Cross-Training 

Cross-training refers to mixing additional cardio-vascular exercises with your recovery exercises. This means that along with stretching and exercises to recover from ailments like peroneal tendonitis, you can add activities like swimming, cycling, aqua-jogging, etc., to your routine. 

4. Maintain a Healthy Weight

Unhealthy weight can impact your posture, and being heavy on your feet can cause pain and inflammation. Take measures to stay at an optimal height, including following a healthy diet, exercising, and more. 

5. Seek Professional Help

Seeking professional help is necessary if foot tendonitis causes severe pain and discomfort. When left unattended, tendonitis pain can cause further complications, which can be avoided with the guidance of an expert physiotherapist.

When should I contact my doctor?

Contact your doctor if you are unable to walk or bear weight on your foot, can’t bend or flex your toes or ankle, feel or hear a snapping or popping sensation or sound in your foot or ankle, have severe pain in your foot, ankle or calf and notice swelling in your foot, ankle or calf.

If you need a consultation with our best podiatrist, you can contact us today or set an appointment online. You may reach us in Bethesda Maryland to schedule an appointment.