Extensor Tendonitis In Foot: Causes and Treatment

Extensor Tendonitis is the inflammation of the tendons of the muscles that extend the foot. These muscles are found at the top of the foot.

The extensor muscles are very important in helping us walk and because of the work they do, they can become irritated and inflamed. They are also prone to injuries because they do not have enough protection.

What Causes It?

  • Calf tightness. The calf muscles are responsible for raising the heel off the floor and pointing the toes towards the ground. For us to walk, the calf lifts the heel off the floor and when the heel touches the floor, the extensors lift the toes off. When the calf muscles are tight and cannot lift the heel off the floor, there is a lot of work and strain on the extensor tendons which can lead to inflammation.
  • Standing for long periods of time.
  • Overtraining.
  • Wearing the wrong shoes.
  • Wearing tight shoes. A tight shoe rubs against the extensor muscles, causing friction and possible inflammation.
  • Foot deformities like a flat foot. A collapsed or high foot arch can overstretch the extensor muscles.
  • Foot trauma.

Symptoms

  • Pain at the top of the foot
  • Swelling
  • Bruising
  • Tenderness
  • Difficulty walking

How Is It Diagnosed?

The extensor tendons raise the top of your foot and make it possible to point your toes to the ceiling. If raising your toes and pointing them towards you causes pain at the top of your foot, you possibly have extensor tendonitis and should see your doctor.

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When you see a doctor, an X-ray, CT scan or MRI is usually advised to rule out other conditions that may mimic the signs of extensor tendonitis. A CT scan and MRI will show the severity of the injury while an X-ray will rule out fractures or dislocations that may have happened at the foot or ankle.

Treatment

Rest

Rest is recommended for this type of injury. Since the extensor tendons have a lot of work to do while we walk, you’ll need to rest your feet for as long as your doctor and physiotherapist suggest.

Crutches or a foot brace may be recommended to allow healing.

Ice

Ice can be applied on the foot to reduce swelling. This can be done by placing the affected foot in a bowl of ice and water or place an ice pack on the top of the foot for 15 minutes. Ice can be applied every four hours.

Compression

Compression can help reduce swelling by wrapping an elastic bandage around the foot.

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Elevation

This reduces swelling. It is normally advised that the affected foot should be elevated and raised above the heart level. So when sitting, your foot can be placed on a stool or chair and when lying, pillows can be used to prop up the swollen foot.

Medication

Non-steroidal anti-inflammatory drugs are prescribed for this type of injury to relieve pain and reduce swelling. Some of these medications are ibuprofen, diclofenac, and naproxen. Ointments with the same components are usually applied directly on the injured foot to help relieve pain.

Physiotherapy

Physiotherapy is the major part of rehabilitation and the goal is to get your foot to how it was before the injury happened and to make sure the injury does not happen again.

A physiotherapist will assess your foot and then discuss the goals you will like and point you to other parts of the body like a tight calf that may contribute to a re-injury in the future. Some of these goals will be to:

  • Relieve pain by using electrical or thermal modalities
  • Reduce swelling through the use of ice, exercises or positioning
  • Stretch out any tight muscles
  • Strengthen weak muscles
  • Ensure you are well educated on the proper shoes to wear
  • Retrain your walking pattern so that you do not walk funny after getting better

Follow up with the physiotherapist is highly necessary to ensure that healing is going well and to upgrade exercises if need be as the healing continues.

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Exercises

Exercises might be prescribed by the physiotherapist. Some of these include:

Calf stretches

Since a tight calf muscle is one of the causes, the calf needs to be stretched so that it does not affect the extensor tendons.

  • Stand facing a wall
  • Place the affected leg behind you and the unaffected one in front of you
  • Place your palms on the wall as if you want to push the wall
  • You will feel a stretch in the calf muscles of the leg placed behind you.

Foot Extensor Stretches

This exercise can also be called a toe curl

  • Bend your toes towards the back of your feet to stretch the extensor muscles
  • Hold for five to ten seconds and release

Foot Extensor Strengthening Exercises

  • Place your affected foot on a towel or cloth
  • Use your toes to pull the towel towards you
  • This can be repeated 5 times

Or

  • Use your toes to pick a pencil from the floor and move it from one point to another

Recovery Time

Depending on how early treatment commences and when the necessary footwear and lifestyle modification begins, extensor tendonitis may take at least three days to six weeks for the injury to heal completely.

Prevention

  • Wear the right shoes
  • Loosen out your laces when you tie them to do any form of sporting activity
  • Warm-up before doing any sporting activity to prepare your muscles for the work they are about to do
  • Do not forget to stretch especially after being in a position like standing for a long period of time
  • Listen to your body. Do not over train yourself because you are eager to get results. Take your time.
  • Strengthen the muscles in your legs
  • Get insoles that can provide support to the foot in your shoes
Latest posts by Adekanmi Lipede, M.Sc, MPH (see all)
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