Gravity only works one way. To lift something up, you have to have a force actively acting against it. Machines have cables with motors. Feet have muscles and tendons. The structures that straighten or lift your toes and flex your feet are called your extensor tendons. As many active people are aware, however, those connective tissues are not injury proof. Top of the foot pain
can stop many athletes in their tracks if not properly cared for. Fortunately, this condition—extensor tendonitis—is easy to treat. Extensor tendonitis, also called extensor tendinopathy, is a painful overuse injury that makes it difficult for you to lift or flex your foot. Many runners are unfortunately familiar with this condition. The tendons that
pull your toes and whole foot up and backwards end up inflamed and irritated. As a result, the top of your foot aches and burns whenever you try to flex your toes or lift your foot when you run. Sometimes the top of the foot swells as well. Usually the discomfort develops slowly and gets worse the longer you have it. Generally you develop this injury when the tendons on the top of your foot are overworked or overstressed. Sometimes this means you are pushing
your feet harder in your running or other sports than they are conditioned to handle. A sudden change in training, like running more hills or switching to a treadmill, can aggravate these tendons. Lacing your shoes incorrectly or wearing poorly-fitted footwear can lead to the problem as well. Shoes that are laced too tight or don’t fit can pinch the tendons and nerves on the top of the foot, leading to irritation and swelling in the connective tissues. This is a type of overuse injury, so it doesn’t get better without treatment. Dr. Sanjay Patel will carefully examine your lower limbs and your biomechanics to identify the problem. Out staff may need a few tests to rule out other potential causes of your discomfort, but once we’ve identified extensor tendonitis as the culprit, we can help you begin treating it. The good news is that this condition doesn’t have to be serious and usually only needs conservative care. The most important step is to rest—as much as runners and other athletes dislike hearing that. Put your training on hold until the pain has disappeared. Running or playing sports on the injury risks turning your top of the foot pain into a chronic problem and causing the tendons to degenerate. Ice your foot to decrease swelling and irritation there. Stretch and strengthen both your extensor muscles and your calves, since they need each other to function well and avoid injuries. Most importantly, check to make sure your shoes fit correctly. If they do, consider finding a new way to lace your sports shoes so they don’t put too much pressure on the top of your foot. Top of the foot pain from extensor tendonitis shouldn’t have to sideline you for long. A little treatment and a few footwear changes should get you back to doing what you love. Our team at Family Foot Care & Surgery, L.L.C. is happy to help you get back to living without painful feet. Contact our two Connecticut offices for an appointment. You can call us—203-876-7736 for the Milford location, or 203-288-4055 for the Hamden office—or fill out our contact form to reach us. The extensor tendons run along the top of your foot and give you the ability to pull it upward and straighten your toes. When these tendons become inflamed, they can cause top of the foot pain when running—or what is referred to as extensor tendonitis. Though rare, you can also get extensor tendonitis in the hand. In both cases, the tendons are vulnerable because they aren't protected by bones, muscle, or fatty tissue. Here is what you need to know about extensor tendonitis, which is often responsible for top of the foot pain when running. Extensor Tendonitis: Top of the Foot Pain When Running Experiencing top of the foot pain when running is a common complaint among walkers, runners, and other exercisers. Top of foot pain is usually felt right under your shoelaces and has various causes. The most common cause is inflammation of the extensor tendons, resulting in a condition called foot extensor tendinopathy or "tendonitis." It can
be due to overuse injuries or shoes that are too tight. Symptoms of Extensor TendonitisIf you’re dealing with extensor tendonitis, you’ll feel pain on the top of your foot as you’re running or walking. You may see swelling on the top of your foot and notice a large bump somewhere along the tendon. A simple test to determine if the pain on the top of your foot is a result of extensor tendonitis requires you to have a friend assist you. First, flex your foot down and push down on your toes. Now, provide resistance by having someone press on your toes. Then, try to pull your toes up against the resistance. If you're feeling pain across the top of your foot or along the extensor tendon, extensor tendonitis is likely the cause. Causes of Extensor TendonitisFiguring out what is causing your foot pain is the first step to finding ways to treat it. Some common factors that may lead to extensor tendonitis are:
Treating Top of Foot PainIf you are experiencing pain on the top of your foot, you have two basic options. You can try to treat it yourself or you can see a doctor. Self-TreatmentExtensor tendonitis often clears up after a few days of rest, especially if you catch it early. For mild cases, also try stretching your calf muscle. You can do this by using a towel to pull your big toe toward you or by trying to spread your toes as far apart as you can. Self-massage using a foam roller helps too, and ice and anti-inflammatory medications can be used to reduce inflammation, swelling, and pain. Compressions and braces may be used to support the foot or ankle, providing greater stability to the pained area. Also try loosening your laces and lace your shoes across the shoe tongue in a ladder pattern, rather than in a typical crisscross pattern, to relieve pressure on the top of the foot. It's usually safe to exercise through foot extensor tendonitis if the pain is mild and it’s not affecting your gait. If you do find running to be too painful, take a couple of days off before you attempt it again. Once the extensor tendon is no longer inflamed, you’ll be able to walk or run relatively pain-free. When to See Your DoctorIf your pain doesn’t go away after trying the above treatments, you may be dealing with a different injury or condition. Other conditions with similar symptoms include metatarsal stress fractures, atypical gout, and degenerative arthritis. Consult your podiatrist or another healthcare professional to determine the exact diagnosis and next steps. In some more extreme cases, a podiatrist may recommend custom-made orthotics or another treatment, especially if you're dealing with fallen arches. Prevention of Top of Foot PainBy taking a few simple actions, you can help reduce your chances of having extensor tendonitis, or of it reoccurring if you've been diagnosed with this condition in the past. Preventing foot extensor tendonitis begins with not overly stressing the foot with too much training or by placing too much pressure on the feet at one given time. Instead, work to build up the strength and resilience of the soft tissues around your feet slowly over time. Wearing good fitting shoes is important too. If your shoes fit correctly, the tops of your feet are less likely to become irritated or inflamed. This involves, in part, choosing shoes that are meant for the exercise you do, whether walking, running, or other gym exercise.
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Christine Luff, ACE-CPT Thanks for your feedback! How do you treat tendonitis on the top of your foot?Rest: Avoid the activity that irritated your tendons. Don't overuse your hand or foot while it heals. Ice: Apply a cold compress to your hand or foot for 15 minutes at a time, four times a day. Compression: You can wrap the painful area in an elastic bandage to help reduce swelling.
How long does it take for extensor tendonitis to heal?Most people with Extensor tendinopathy symptoms improve within 3 months of following the recommended advice, however, symptoms can take up to 1 year to improve in some people. It is also normal to have periods of increased pain or flare-ups during your recovery.
How do I know if I have tendonitis on the top of my foot?The main symptom of extensor tendonitis in the foot is pain on the top of the foot. It is often right where your shoelaces are. You may feel this pain while you are running or walking. Sometimes, there is visible swelling or a bump on the extensor tendon that is injured or inflamed.
Does extensor tendonitis go away?Extensor tendonitis often clears up after a few days of rest, especially if you catch it early.
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Tendon on top of foot hurts when walking
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