Tendonitis Foot Pain: Causes, Symptoms and Solutions

Pain in your foot could be due to any number of tendonitis issues: find out the locations of the main tendons in your foot, the common causes of tendon inflammation, and how best to treat these injuries.

Tendonitis, or tendinitis, of the foot can occur in several areas of your foot, heel, and ankle. Tendonitis foot pain can severely hamper your daily activities, starting first thing in the morning (when it’s at its most painful), and then clear into the evening. Not only does tendonitis foot pain turn every step you make into a chore, it can also lead to decreased physical activity, and even back and neck problems if you develop a limp to ease the pain. This article has information on the causes, symptoms, and treatment options for different types of foot tendonitis so you can hopefully address the condition before it becomes chronic.

What Is Tendonitis?

The “-itis” in tendonitis refers to inflammation, and it can afflict just about any tendon in your body, from those in your shoulders, your elbows (familiar with tennis elbow?), your wrists, your knees (how about jumper’s knee?), and, of course, your feet. Tendonitis of the foot can be tricky to deal with because many of us need to be on our feet for hours each day. Plus, our feet are as complex as our hands are when it comes to the vast number of small bones and moving parts.

Each of our feet have 33 joints, 26 different bones, and over 100 tendons, ligaments, and muscles. Just one connector out of sync and it’s like a rope has snapped in the rigging of a massive sailing ship: it could be an easy fix or it could be the first domino to fall in a series of ever-greater catastrophes. Tendons are the cords that attach muscle to bone, and while they are encased in lubricating sheaths to help protect them from friction and injury, one misstep or ankle injury could cause compounding pain and inflammation unless it’s treated quickly and correctly.

Read on to discover the common causes and symptoms of tendon injury to help identify the problem as soon as possible.

Tendonitis foot pain: causes, symptoms, and solutions.

What’s Causing Tendonitis Foot Pain?

Our tendons are built tough, especially the ones in our feet. While the tendons in our wrists and hands can be injured easily due to the delicate fine motor skills they’re meant to conduct, our feet bear the full weight of our bodies every day: walking, running, extending, climbing, and jumping when needed. However, even these strong bands have limits as to how far they can stretch.

When a tendon is repeatedly stressed or injured, small tears develop along its length, causing the body to respond at first with healthy inflammation, which may then lead to painful, chronic inflammation. Common causes of tendonitis of the foot include overuse, having high arches or flat feet, and sports-related or accidental injuries, but determining which tendon has been afflicted is the first step in discovering the cause and the solution.

Let’s highlight the main tendons in the foot, so you can better determine the location of your tendonitis foot pain as well as the causes, symptoms, and suggested treatments.

Ankle and Achilles Pain

The Achilles tendon is the thick band that attaches the back of the heels to the calf muscles.

Causes

Achilles tendonitis is often due to an injury from sports like soccer, but can also be caused by:

  • Tight calf muscles
  • Heel spurs or plantar fasciitis (a condition affecting the ligament in the foot’s arch)
  • Sporting or accidental injury
  • Overuse without enough recovery time

Symptoms

Symptoms of Achilles tendonitis may include:

  • Achilles pain
  • Stiffness of motion
  • Swelling at the heel bone or ankle
  • Difficulty walking in the morning or after long periods of rest

Treatment for a one-time injury may require no more than rest, ice, and over-the-counter anti-inflammatory drugs like acetaminophen (Tylenol) or ibuprofen (Advil). However, for athletes or those suffering serious injuries, it’s recommended that you consult a health care professional to determine whether physical therapy or orthotic shoe support is appropriate. For those with an underlying anatomy problem like flat feet (overpronation), orthotic support will help remove strain from the area and may help drastically prevent future injury.

Inner Ankle Pain

Your posterior tibial tendon is on the inside of your leg near your inner ankle bone, and it attaches your calf muscle to the inside of your foot, holding up the arch as you walk.

Causes

Causes of injury to this tendon often come from:

  • High-impact sports movements (jumping and landing in basketball, soccer, tennis, etc.)
  • Obesity or being overweight
  • Wear and tear due to aging
  • Overpronated or flat feet

Symptoms

Pain in this tendon will have symptoms like:

  • Swelling of the inner side of the foot
  • Pain on the inner side of the foot
  • Radiating pain throughout the foot if the foot collapses

Once more, the standard treatment is rest, ice, and possibly anti-inflammatory medications, but if this is a chronic problem due to the shape of your foot, your gait, or a sporting activity you regularly take part in, consult a doctor or physical therapist for advice on orthotic support or perhaps cortisone steroid injections to the area.

Outer Foot and Ankle Pain

There are two peroneal tendons in each foot. One runs from the lower leg bone (the fibula, next to the shin bone) and wraps around the outer ankle bone to where it attaches to the little toe. The other runs underneath the foot, attaching to the inside arch. They help stabilize our ankles and our arches while walking.

Causes

Peroneal tendonitis could be caused by:

  • Repeated ankle sprains
  • Unsupportive footwear
  • Overuse or overtraining injury
  • Having high arches
  • Having muscle imbalances

Symptoms

Common symptoms of injury include:

  • Pain when pushing off the foot
  • Pain when turning the foot in and/or out
  • Pain and/or swelling at the back of the ankle
  • Ankle instability
  • The area feels warm to the touch

Treatment is the same: rest, ice, elevation, anti-inflammatory drugs or natural supplements, orthotics, and certain stretches meant to help loosen and strengthen the calf muscles and ankle stability. Seek medical advice from a physical therapist or health professional to learn proper stretching techniques for your specific tendonitis foot pain.

Top of the Foot Pain

Extensor tendons are in both our hands and our feet. In our hands they’re the ones on top that help to move our fingers, wrists, and thumbs, and in our feet they connect between the muscles at the front of our legs to our toes. They’re very close to the surface of the skin (you can feel them shift if you wiggle your toes), and thus are all the more vulnerable to injury.

Causes

Extensor tendonitis can be caused by:

  • Too-tight footwear
  • Being on your feet for extended periods of time (fast food workers, nurses, warehouse workers, etc.)
  • Walking or running on uneven surfaces
  • Tight calf muscles

Symptoms

Symptoms of extensor tendonitis may include:

  • Pain on the top of the foot
  • Swelling, bruising, tenderness on the top of the foot
  • Pain that worsens with activity and feels better when at rest

Treatment can involve rest, ice, and pain meds, but it also could be as simple a solution as changing the way you lace your shoes: if too much compression on these tendons is causing your foot pain, lacing shoes loosely, knotting the laces to the side instead of on top, or choosing a new style of footwear could alleviate the pain.

Big Toe Foot Pain

The flexor tendon runs from the lower leg, travels along the inside of the ankle, and attaches to the big toe.

Causes

The causes of flexor tendonitis may be:

  • Overuse of the big toe
  • Injury of the big toe
  • Improper footwear
  • Proper ballet dancing or other flawed forms of dance or sport

Symptoms

Symptoms of this tendonitis may include:

  • Pain deep within the inside back of the ankle
  • Pain in the foot’s arch (distinct from plantar fasciitis)
  • Pain when bending the big toe or on the outer side of the big toe
  • Tenderness anywhere along the course of the tendon

Treatment includes rest, ice, possible pain medications, stretching or massage, physical therapy, and (for dancers especially) taping up the foot to help protect the form and stability of the arch.

Don’t Foot the Bill for Tendonitis

Tendonitis foot pain is well known in sports medicine due to the extra strain put on feet during rapid or prolonged physical activity, but it can affect anyone. Tendonitis symptoms should be well-heeded, as taking care of these twinges and inflammatory reactions early can mean saving yourself from months or years of chronic pain.

Long-term foot pain can derail your exercise regimen and limit your range of motion, so it’s important to seek medical advice or to get a physical exam as soon as possible to rule out underlying medical conditions. The sooner you get the support you need, the more likely you’ll be able to relieve your pain through simple, nonsurgical treatment.

Tendonitis: When Tennis Elbow Has You Down for the Game

A painful condition, tendonitis involves inflammation of the tendons—fibrous cords connecting muscles to bones. Commonly occurring in the knees, heels, shoulders, elbows, and wrists, tendonitis leads to swelling and discomfort when moving the affected body part.

A painful condition, tendonitis involves inflammation of the tendons—fibrous cords that connect muscles to bones. Commonly occurring in the knees, heels, shoulders, elbows, and wrists, tendonitis leads to swelling and discomfort when moving the affected body part.

You might know tendonitis by the following terms:

  • Jumper’s knee (patellar tendonitis)
  • Tennis elbow (lateral epicondylitis)
  • Golfer’s elbow (medial epicondylitis)
  • Pitcher’s shoulder or swimmer’s shoulder (rotator cuff tendonitis)

Tendonitis is also spelled tendinitis, so don’t let those variations confuse you. Whatever you call it, tendonitis causes pain and discomfort that can have a negative effect on quality of life. And while the condition usually improves on its own with rest, more severe cases may require physical therapy, medication, and even surgery to heal. Understanding the signs and symptoms of tendonitis is the first step in knowing when and if to seek medical attention.

Common Causes of Tendonitis

The most common causes of tendonitis are sudden injury and repetitive motions, such as from physical activities that put stress on the tendons. If proper technique isn’t followed, tendonitis or tendon rupture can occur.

Risk factors for tendonitis include age— it’s inevitable that as we age, our tendons become less pliable—occupation, and certain sports. Jobs that involve repetitive movements or forceful action, such as frequent overhead reaching, can cause irritation of a tendon. Sports injuries that cause tendinitis are common among tennis players, runners, golfers, swimmers, bowlers, baseball players, and basketball players.

Tennis Elbow and Tendonitis Symptoms

Wondering if you’re suffering from tennis elbow or just a mild cause of overexertion? Here are some of the primary signs and symptoms of tendinitis:

  • Pain that worsens with movement
  • A cracking or grating feeling around the bone
  • Swelling
  • A lump near the affected tendon

Despite the name, tennis elbow often occurs in people who have never picked up a racket. In fact, the condition may occur in anyone whose work or hobbies involve repetitive motions of the wrist and arm. To that end, tennis elbow is common in painters, plumbers, and carpenters as well. Older people are more likely to get tennis elbow, as tendons become less flexible with age.

If you’re suffering from persistent pain around your elbow that spreads into the forearm and wrist, or if you’ve noticed a bony bump on the outside of your elbow, don’t hesitate to seek medical attention. Left untreated, tendonitis can cause a more serious condition called tendon rupture, which often requires surgery to repair.

Tendonitis Diagnosis

Your health care provider will determine if you have tendonitis or a related condition by taking a medical history and conducting a physical examination that assesses range of motion and discomfort in the affected area. Be upfront with your work and physical activities, including any new sports you’re trying out, so the doctor can consider contributing risk factors.

Your physician may also order X-rays to rule out arthritis or a fracture and blood tests to rule out conditions such as rheumatoid arthritis. Your doctor may even go a step further and order an MRI scan (magnetic resonance imaging) to see changes in the tissue around the tendon.

The type of test used is greatly determined by the area affected. For instance, the Finkelstein test helps diagnose wrist tendonitis. Your doctor will bend your thumb, fingers, and wrist in a specific manner to see if the pain that results is tied to wrist tendonitis or another type of wrist injury.

Tendonitis Treatments

There’s no one cure for tendonitis. The goal of treatment is to reduce pain and inflammation while giving the body time to heal. Some of the most effective home remedies for the condition include:

  • Resting and avoiding activities that led to the injury
  • Applying an ice pack to the affected area for 20 minutes every couple hours
  • Using a compress or bandage on the affected area
  • Elevating the limb or injured body part
  • Taking over-the-counter medication, such as ibuprofen

It’s important to note that tendonitis can take 4 to 6 weeks to heal. However, more serious or long-lasting cases of tendonitis may require additional treatment. If rest and medication are doing little to alleviate your discomfort, you might want to see a doctor and/or physical therapist to discuss the following treatment options:

  • Steroid injections to reduce inflammation and pain
  • Shockwave therapy
  • Platelet rich plasma injections to encourage healing
  • Surgery to repair tendon ruptures and remove damaged tissue

Note that it could take 6 months for a tendon to heal completely after surgery.

A painful condition, tendonitis involves inflammation of the tendons

Achilles Tendonitis Treatment

Athletes and other people who spend a lot of time on their feet are at risk for a type of tendonitis affecting the Achilles tendon. With Achilles tendonitis, the large tendon that runs down the back of the leg becomes inflamed. As a result, patients may suffer stiffness, swelling, and pain that worsens with activity. Treatments for Achilles tendonitis vary based on the severity of the condition and may include:

  • Rest and avoiding repetitive motions
  • Stretching and muscle-strengthening exercises
  • Icing the area
  • Elevating the affected foot
  • Physical therapy
  • Taking anti-inflammatories
  • Wearing special shoes to take tension off the tendon

In severe cases, patients may require steroid injections or surgery to treat their Achilles tendonitis.

What Is the Difference Between Tendonitis and Tendinosis?

Tendonitis involves inflammation. When tendonitis is at play, you’ll see hallmark inflammatory signs such as warmth, swelling, redness, and pain. Take wrist tendonitis, for example. Wrist tendonitis involves inflammation of the wrist tendons and is caused by either a sudden injury or repetitive motions that cause the wrist tendons to rub against the bone. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen can help the pain as the tendonitis subsides over the course of several weeks.

Tendinosis, on the other hand, is chronic, which means continuous or recurring. It’s caused by a repetitive trauma or overuse injuries, and can take several months to heal. The main difference between tendonitis and tendinosis is that tendinosis is the the non-inflammatory degeneration of a tendon.

Amino Acids as a Tendonitis Cure

An increasing amount of research suggests that amino acids can boost musculoskeletal health and even help repair damage. When people engage in exercise, their muscles break down more rapidly, and additional protein is required to prevent minor injuries from becoming serious ones.

According to a 2018 article titled “Nutritional Research May Be Useful in Treating Tendon Injuries,” evidence suggests that certain amino acids, including leucine, arginine, and glutamine, can aid in tendon growth and healing. However, it’s always best to consume a balanced mixture of essential amino acids to ensure optimal health and wellness.

The article goes on to reveal that tendon surgery isn’t always successful, and many patients experience chronic pain even after treatment. More research is needed to determine if amino acids could be used in therapeutic approaches to tendon injuries and other problems.

Additionally, people can protect their long-term tendon health by avoiding exercises and activities that put undue stress on tendons. It’s also smart to mix up workout routines, take time to stretch and warm up, and use ergonomic equipment in the workplace.