Your feet are much more complex than you might think. Each foot consists of 26 bones, 33 joints, and more than 100 muscles, ligaments, and tendons. This complexity is necessary for range of motion and mobility required in daily life.
This means that pain and other problems can develop in many parts of the foot. Foot tendinitis - sometimes spelled tendonitis - is a common cause of foot pain that occurs when a tendon becomes irritated or inflamed.
Tendinitis can affect any tendon in the foot, and since there are so many of them, it may be difficult to tell what you have if you’re in pain. Fortunately, there are some straightforward ways to identify your foot tendinitis and determine the best treatment based on the location of your symptoms.
How Does Foot Tendinitis Develop?
A tendon is a strong, cord-like band of tissue that connects muscle to bone. These structures can withstand a great deal of force, but they have limits. When a tendon works too hard, for too long, or in the wrong way, tiny tears will start to develop. To cure these tendon injuries, the body’s healing response creates inflammation, and the result is tendinitis.
Although each type of tendinitis affects a different part of the foot, they all share similarities and usually develop for similar reasons. Overuse is generally a key component of all forms of foot tendinitis. Athletes who push themselves too hard or people who spend lots of time on their feet both have a higher chance of damaging their tendons and getting tendinitis. Injuring the foot or ankle, as well as having flat feet or high arches can also increase this risk. But the type of tendinitis that develops has to do with several factors.
Exploring the Different Types of Foot Tendinitis
- Symptoms – Pain, stiffness, and possibly swelling will be noticed either right at the bottom of the heel or slightly above the ankle, depending on which part of the tendon gets inflamed. The pain is usually worse after taking the first few steps of the day or after long periods of rest.
- Causes – The Achilles tendon is a large tendon that connects the calf muscles to the back of the heel. A common sports injury, Achilles tendinitis tends to develop when active individuals increase the intensity of their training too aggressively without enough time to recover. Having tight calf muscles or a heel spur will also add to this risk.
- Treatment – Rest, ice, pain-relieving medications, and physical therapy are always recommended as the first line of treatment. Wearing one of our orthotic insoles is also a good way to address Achilles tendinitis, especially if a foot deformity like flat feet is contributing to the problem. Doing so will take some of the strain off the Achilles tendon and reduce damage to the tendon.
Posterior Tibial Tendinitis
- Symptoms – Pain and possibly swelling will be centered on the inner side of the foot, which often arises when pushing off the foot. Pain may also occur on the outside of the ankle if the foot collapses.
- Causes – The posterior tibial tendon attaches the calf muscles to the bones on the inside of the foot. It holds up the arch and supports the foot when walking. High-impact sports like basketball, tennis, and soccer, being overweight and old age can all lead to posterior tibial tendinitis. Individuals with flat feet are also at a higher risk.
- Treatment – As with Achilles tendinitis, rest, ice, pain medications, physical therapy, and orthotics are most appropriate for managing posterior tibial tendinitis. Using a semi-custom foot orthotic will help correct flat feet and other types of foot problems. Cortisone injections may be needed if other treatments fail.
- Symptoms – Peroneal tendinitis results in pain around the back and outer side of the ankle and foot, especially when standing or pushing off the foot. The ankle might also feel unstable during activities.
- Causes – Two peroneal tendons wrap around the outside of the ankle. One connects to the little toe and the other to the big toe. Inflammation of these tendons usually comes from a history of ankle sprains, training too hard, wearing unsupportive footwear, or having muscle imbalances. High arches are also considered a risk factor.
- Treatment – Rest, apply ice, use pain medications, and elevate the ankle above the heart when resting to manage the pain. Stretching and strengthening exercises for all the muscles of the calf will also reduce tension and speed up the healing process. Orthotics may be helpful, but for this type of tendinitis it’s best to seek medical advice to determine if they are best for your foot type.
- Symptoms – Extensor tendinitis symptoms involve pain directly on the top of the foot, which gets worse with activity and better with rest. There may be some swelling, tenderness, or bruising in this area as well.
- Causes – The extensor tendons run from the front of the ankle, across the top of the foot, and attaches to the tips of the toes. This type of tendinitis typically occurs in people who lace their shoes too tightly, walk or run on uneven surfaces regularly or spend lots of time on their feet. Tight calf muscles can also contribute to the problem.
- Treatment – In addition to rest, ice, pain medications, and physical therapy, one of the best ways to address extensor tendinitis is to change the way you lace your shoes. Try tying the knot on the side or skip lacing the holes over the most painful area. Orthotics may also help to support your feet, but speak with a doctor before doing so.
- Symptoms – Pain is felt in the deep back of the ankle, on the side of the big toe, or in the arch of the foot, when the big toe is being bent.
- Causes – The flexor tendon runs from the lower leg, along the inside of the ankle, and connects to the big toe. Inflammation of this tendon results from bending the big toe too much. Ballet dancers are most likely to develop flexor tendinitis, while athletes with flawed technique or the wrong shoes are also at risk.
- Treatment – Rest, ice, pain medications, physical therapy, stretching, and gently massaging the painful toe are all recommended. Taping the foot to protect the arch may also help.
Anterior Tibial Tendinitis
- Symptoms – Pain and possibly swelling develops in the front of the foot when walking or running on sloped surfaces.
- Causes – The anterior tibial tendon lies on the inner front part of the ankle and helps to lift the foot and ankle upwards and inwards. It is one of the least common types of tendinitis, and inflammation occurs more frequently in older adults than athletes.
- Treatment – Rest, ice, pain medications, physical therapy, and calf stretching are all appropriate. A brace or walker boot may also be needed to stabilize the ankle or limit its movement.
Walk Better. Feel Better. Live Better.
As you can see, foot tendinitis can strike many places in the foot, but there is always a solution. The best treatment will usually consist of taking a rest from your activities, icing the painful area and using pain medications. Stretching out the connecting muscles and making adjustments to your shoes may also help. Our semi-custom orthotic insoles are ideal for addressing Achilles tendinitis and posterior tibial tendinitis, and may be appropriate for other types of tendinitis as well. Be sure to check with a podiatrist or sports medicine professional if you’re uncertain whether insoles are right for you.
Foot tendinitis can certainly impact your exercise routine and daily life. Realize that it’s usually a minor problem that you have the power to fix. Listen to your body, take time off when you need it, and make changes to your exercise habits as necessary. Your feet-and the rest of your body-will thank you.