Table of ContentsView AllTable of ContentsTypes of TendonitisTendonitis SymptomsCausesDiagnosisTreatmentPreventionFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Types of Tendonitis
Tendonitis Symptoms
Causes
Diagnosis
Treatment
Prevention
Frequently Asked Questions
Tendonitis occurs when thesetendons become inflamedas a result of injury or overuse. It causes pain with activity that usually goes away with rest, only to return when you move it again.
Learn more about what causes tendonitis, how to prevent it, and when to see a healthcare professional.
Tendonitis can affect different parts of the foot and ankle.
These different areas include:
Rest and at-home care will usually heal these injuries within a few weeks. The following are common types of tendonitis of the foot and ankle.
Verywell / Brianna Gilmartin
Achilles Tendonitis (Back of Ankle)
TheAchilles tendonis the large tendon that attaches the calf muscles to the back of the heel. With Achilles tendonitis, pain is located two to six centimeters (about one to three inches) above the area where the tendon attaches to the calcaneus (heel bone) or at the insertion site of the tendon to the heel bone. The area may be swollen and warm and it may be difficult to stand on your toes.
Achilles tendonitisis a commonsports injury. It can happen if your activity level has recently increased, you’ve started playing a new sport, or you’ve started wearing new shoes. In addition, tight calf muscles can add to the problem.
There are plenty of conservative therapies you can try, and Achilles tendonitis rarely needs surgical intervention.
Overview of Achilles Tendonitis
Posterior Tibial Tendonitis (Inner Side of Ankle)
The tendon of thetibialis posteriormuscle (the deepest muscle in the back of the lower leg) wraps around the inside (big toe side) of the ankle and instep of the foot. With this type of tendonitis, pain is typically felt on the inner side of the foot and ankle. Swelling may also be present. For some people, this can cause problems with walking.
Posterior tibial tendonitis is usually associated withflat feet. Flat feet can show the “too-many-toes” sign—where you can see four toes when looking from behind the heel.As the condition gets worse, the foot becomes flatter, and the toes fan further outward.
Physical therapy can be beneficial. You may need a short leg cast or walking boot if you have this type of tendonitis. This allows the tendon swelling to go down. After that, you may need to wear a brace ororthotics(shoe inserts that hold your foot in a better position).
A brace used for this condition should be Ankle Foot Orthotic (AFO), a custom brace that holds the ankle in a certain position to allow the tendon to relax and heal, This is usually worn for over 6 months, with a typical maximum of up to a year, and surgery can be a final solution for some people.
Overview of Posterior Tibial Tendonitis
Peroneal Tendonitis (Outer Side of Ankle)
The tendons of theperoneal muscleswrap around the outside (little toe side) of the ankle. Symptoms ofperoneal tendonitisinclude pain and possibly swelling around the outer ankle and just below and above it.
Or it will be painful at the styloid process of the 5th metatarsal, along the pinky toe side between the toe and the ankle where the tendon inserts into the bone.
If you have high-arched feet and a history of ankle sprains, you may be at risk for this type of tendonitis.
Peroneal Tendon Tears
Flexor Tendonitis (Inner Back of Ankle)
If you strain your flexor hallucis longus (FHL) tendon, it can result in flexor tendonitis. This causes pain deep in the back of the ankle, on the big toe side. Other common symptoms include:
This type of tendonitis usually affects dancers or people who do activities that require a lot of toe balancing.
Extensor Tendonitis (Top of Foot)
Less frequently, health conditions that cause general swelling, likerheumatoid arthritis, can cause it.
High-arched feetare more likely to cause shoe friction that leads to this type of tendonitis.
Persons with extensor tendonitis may have pain and swelling on the top of the foot. This pain may worsen when running both uphill and downhill.
With tendonitis, you will notice pain at the site of the injured tendon, especially when you first start an activity, like getting up and walking. The pain may go away for a little while but then return as you keep walking or doing other activities.
The main symptoms of tendonitis include:
Rest usually makes the pain go away, although the affected tendon may still be painful to touch. Swelling is not usually an immediate symptom, though it may occur later. Often, your foot and ankle will become stiff when you have tendonitis.
Several things may cause tendonitis. You have more control over some of the causes than others. For example, you can be careful to stretch and not overuse your muscles. However, you can’t control your foot structure or whether you develop certain health conditions.
Common causes of tendonitis include:
Your healthcare provider will take your medical history and may order X-rays or a magnetic resonance imaging (MRI) scan. These tests will help your healthcare provider see whether you have a broken bone, calcification (a build-up of calcium in the tendon), or if your tendon has torn.
Knowing the source of the pain will help guide treatment. For example, a torn tendon must be kept very still with a cast or boot and may even require surgery.
If you often experience tendonitis symptoms, you may benefit from seeing apodiatrist(a healthcare professional who specializes in feet and ankles). They can help identify foot abnormalities that may be causing your problem.
The general idea for treating foot and ankle tendonitis is to rest the injury so the body can heal. Depending on the extent and cause of your injury, tendonitis can take a few weeks to a few months to heal. It may require physical therapy or orthotics to fully heal. You may be able to manage your tendonitis with self-care until it heals, but if it doesn’t get better, you should see a healthcare provider.
Self-Care
When tendonitis symptoms occur, the first thing to do is treat it withR.I.C.E, which stands for rest, ice, compression, and elevation.
To treat with R.I.C.E., do the following:
Medical Care
If pain and swelling don’t improve with home care, get worse, or occur while you are resting, you need to seek medical attention as soon as possible.
In addition to rest, your healthcare provider may suggest:
When Plantar Fasciitis Is So Bad You Can’t Walk
You also should wear shoes that offer plenty of support and avoid worn-out sneakers. Finally, when you start a new activity or sport, increase your time and intensity gradually.
Exercises for Foot and Ankle Injury Recovery
Summary
Tendonitis causes pain and swelling in the tendons of your foot and ankle. There are several types of tendonitis, each affecting different parts of the ankle or foot.
If the pain continues despite rest, see your healthcare provider. They will help you find a treatment plan that works for you. Your healthcare provider may also suggest shoe inserts or other orthotics, anti-inflammatory medication, or physical therapy. While it may mean weeks away from your favorite activities, the goal is to prevent complications that can sideline you for even longer.
Stretching your muscles before exercise is a good way to prevent tendonitis. Using proper shoes with adequate support and increasing your activity level gradually can also help prevent tendonitis.
Yes, people with flat feet are more prone to posterior tibial tendonitis. The posterior tibial tendon attaches from the tibia/ interosseous membrane and fibula and inserts to multiple bones to the bottom of the feet. It runs along the inner side of the ankle and arch. Shoe orthotics are often used to prevent and treat posterior tibial tendonitis.
14 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Johns Hopkins Medicine.Tendonitis.Thomopoulos S, Parks WC, Rifkin DB, Derwin KA.Mechanisms of tendon injury and repair.J Orthop Res.2015;33(6):832-9. doi:10.1002/jor.22806MedlinePlus.Achilles tendonitis.American Academy of Orthopaedic Surgeons.Posterior tibial tendon dysfunction.Bubra PS, Keighley G, Rateesh S, Carmody D.Posterior tibial tendon dysfunction: an overlooked cause of foot deformity.J Family Med Prim Care. 2015;4(1):26-9. doi:10.4103/2249-4863.152245Davda K, Malhotra K, O’Donnell P, Singh D, Cullen N.Peroneal tendon disorders.EFORT Open Rev. 2017;2(6):281-292. doi:10.1302/2058-5241.2.160047Children’s Hospital of Philadelphia.Flexor hallucis longus (FHL) tendonitis in children and teens.American Medical Society for Sports Medicine.Extensor tendinopathy.Jena D.Extensor hallucis longus tendonitis: a rare cause of dorsal midfoot pain.IJMSR. 2021;3:64-66. doi:10.25259/IJMSR_60_2020Cleveland Clinic.Tendinitis.Penn Medicine.Foot and ankle injuries treatment.OrthoInfo.Sprains, strains and other soft-tissue injuries.Li HY, Hua YH.Achilles tendinopathy: Current concepts about the basic science and clinical treatments.Biomed Res Int. 2016;2016:6492597. doi:10.1155/2016/6492597University of Rochester Medical Center.The best ways to prevent, treat tendonitis.Additional ReadingAmerican Academy of Orthopaedic Surgeons.Achilles tendinitis.American Academy of Orthopaedic Surgeons.Progressive collapsing foot deformity (flatfoot).DeLee JC, et al. Tendon injuries of the foot and ankle. In:DeLee & Drez’s Orthopaedic Sports Medicine: Principles and Practice. 4th ed. Philadelphia, Pa.: Saunders Elsevier; 2015.
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Johns Hopkins Medicine.Tendonitis.Thomopoulos S, Parks WC, Rifkin DB, Derwin KA.Mechanisms of tendon injury and repair.J Orthop Res.2015;33(6):832-9. doi:10.1002/jor.22806MedlinePlus.Achilles tendonitis.American Academy of Orthopaedic Surgeons.Posterior tibial tendon dysfunction.Bubra PS, Keighley G, Rateesh S, Carmody D.Posterior tibial tendon dysfunction: an overlooked cause of foot deformity.J Family Med Prim Care. 2015;4(1):26-9. doi:10.4103/2249-4863.152245Davda K, Malhotra K, O’Donnell P, Singh D, Cullen N.Peroneal tendon disorders.EFORT Open Rev. 2017;2(6):281-292. doi:10.1302/2058-5241.2.160047Children’s Hospital of Philadelphia.Flexor hallucis longus (FHL) tendonitis in children and teens.American Medical Society for Sports Medicine.Extensor tendinopathy.Jena D.Extensor hallucis longus tendonitis: a rare cause of dorsal midfoot pain.IJMSR. 2021;3:64-66. doi:10.25259/IJMSR_60_2020Cleveland Clinic.Tendinitis.Penn Medicine.Foot and ankle injuries treatment.OrthoInfo.Sprains, strains and other soft-tissue injuries.Li HY, Hua YH.Achilles tendinopathy: Current concepts about the basic science and clinical treatments.Biomed Res Int. 2016;2016:6492597. doi:10.1155/2016/6492597University of Rochester Medical Center.The best ways to prevent, treat tendonitis.Additional ReadingAmerican Academy of Orthopaedic Surgeons.Achilles tendinitis.American Academy of Orthopaedic Surgeons.Progressive collapsing foot deformity (flatfoot).DeLee JC, et al. Tendon injuries of the foot and ankle. In:DeLee & Drez’s Orthopaedic Sports Medicine: Principles and Practice. 4th ed. Philadelphia, Pa.: Saunders Elsevier; 2015.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Johns Hopkins Medicine.Tendonitis.Thomopoulos S, Parks WC, Rifkin DB, Derwin KA.Mechanisms of tendon injury and repair.J Orthop Res.2015;33(6):832-9. doi:10.1002/jor.22806MedlinePlus.Achilles tendonitis.American Academy of Orthopaedic Surgeons.Posterior tibial tendon dysfunction.Bubra PS, Keighley G, Rateesh S, Carmody D.Posterior tibial tendon dysfunction: an overlooked cause of foot deformity.J Family Med Prim Care. 2015;4(1):26-9. doi:10.4103/2249-4863.152245Davda K, Malhotra K, O’Donnell P, Singh D, Cullen N.Peroneal tendon disorders.EFORT Open Rev. 2017;2(6):281-292. doi:10.1302/2058-5241.2.160047Children’s Hospital of Philadelphia.Flexor hallucis longus (FHL) tendonitis in children and teens.American Medical Society for Sports Medicine.Extensor tendinopathy.Jena D.Extensor hallucis longus tendonitis: a rare cause of dorsal midfoot pain.IJMSR. 2021;3:64-66. doi:10.25259/IJMSR_60_2020Cleveland Clinic.Tendinitis.Penn Medicine.Foot and ankle injuries treatment.OrthoInfo.Sprains, strains and other soft-tissue injuries.Li HY, Hua YH.Achilles tendinopathy: Current concepts about the basic science and clinical treatments.Biomed Res Int. 2016;2016:6492597. doi:10.1155/2016/6492597University of Rochester Medical Center.The best ways to prevent, treat tendonitis.
Johns Hopkins Medicine.Tendonitis.
Thomopoulos S, Parks WC, Rifkin DB, Derwin KA.Mechanisms of tendon injury and repair.J Orthop Res.2015;33(6):832-9. doi:10.1002/jor.22806
MedlinePlus.Achilles tendonitis.
American Academy of Orthopaedic Surgeons.Posterior tibial tendon dysfunction.
Bubra PS, Keighley G, Rateesh S, Carmody D.Posterior tibial tendon dysfunction: an overlooked cause of foot deformity.J Family Med Prim Care. 2015;4(1):26-9. doi:10.4103/2249-4863.152245
Davda K, Malhotra K, O’Donnell P, Singh D, Cullen N.Peroneal tendon disorders.EFORT Open Rev. 2017;2(6):281-292. doi:10.1302/2058-5241.2.160047
Children’s Hospital of Philadelphia.Flexor hallucis longus (FHL) tendonitis in children and teens.
American Medical Society for Sports Medicine.Extensor tendinopathy.
Jena D.Extensor hallucis longus tendonitis: a rare cause of dorsal midfoot pain.IJMSR. 2021;3:64-66. doi:10.25259/IJMSR_60_2020
Cleveland Clinic.Tendinitis.
Penn Medicine.Foot and ankle injuries treatment.
OrthoInfo.Sprains, strains and other soft-tissue injuries.
Li HY, Hua YH.Achilles tendinopathy: Current concepts about the basic science and clinical treatments.Biomed Res Int. 2016;2016:6492597. doi:10.1155/2016/6492597
University of Rochester Medical Center.The best ways to prevent, treat tendonitis.
American Academy of Orthopaedic Surgeons.Achilles tendinitis.American Academy of Orthopaedic Surgeons.Progressive collapsing foot deformity (flatfoot).DeLee JC, et al. Tendon injuries of the foot and ankle. In:DeLee & Drez’s Orthopaedic Sports Medicine: Principles and Practice. 4th ed. Philadelphia, Pa.: Saunders Elsevier; 2015.
American Academy of Orthopaedic Surgeons.Achilles tendinitis.
American Academy of Orthopaedic Surgeons.Progressive collapsing foot deformity (flatfoot).
DeLee JC, et al. Tendon injuries of the foot and ankle. In:DeLee & Drez’s Orthopaedic Sports Medicine: Principles and Practice. 4th ed. Philadelphia, Pa.: Saunders Elsevier; 2015.
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