When you use a set of muscles too much, youre likely to strain
the tendons (soft tissues) that connect those muscles to your bones.
At first, pain or swelling may come and go quickly. But if you do
too much too soon, your muscles may over-tire again. The strain
may cause a tendons outer covering to swell or small fibers
in a tendon to pull apart. If you keep pushing your muscles, damage
to the tendons adds up and tendonitis develops. Over time, pain
and swelling may limit your activities. But with your doctors
help, tendonitis can be controlled. Both your symptoms and your
risk of future problems can be reduced.
Where Does Your
Depending on what causes the stress or overuse, tendons in the back,
sides, or front of your foot may hurt. At first you may feel pain
only during or after a workout, such as running or an aerobics class.
As tendon damage adds up, however, your foot may hurt when you walk
or even when you stand still.
Back of Your Foot
The Achilles tendon connects
the calf muscle to the heel bone. If tendonitis occurs here, you
may feel pain when your foot touches down or when your heel lifts
off the ground.
The Front of Your
The anterior tibial tendon
helps control the front of your foot when it meets the ground. If
this tendon is strained, you may feel pain when you go down stairs
or walk or run on hills.
The Inside of Your
The posterior tibial tendon
runs along the inside of the ankle and foot. If this tendon is strained,
your foot may hurt when it moves forward to push off the ground.
Or you may feel pain when your heel shifts from side to side.
The Outside of
The peroneal tendon wraps across
the bottom of your foot, from the outside to the inside. Tendonitis
here may cause pain when you stand or push off the ground.
Your Physical Exam
During the exam, youll probably be asked to describe your
symptoms, your overall health, and your usual activities. The doctor
will check your foot and ankle for areas of redness, swelling, and
warmth. The range of motion in your foot and ankle may also be tested.
X-rays may be taken to rule out a broken bone. To identify damage
to a tendon, your doctor may order an MRI
(magnetic resonance image).
Your doctors first concern is to reduce your symptoms. Using
ice and heat, taking medications, and limiting activity help control
pain and swelling. Follow all of your doctors instructions.
Returning to activity too soon may cause your symptoms to come back.
Ice and Heat
Ice helps prevent swelling and reduce pain. Place ice on the painful
area for 10 minutes. Repeat the icing several times a day. If you
already have swelling, using heat may help. Apply a heating pad
or hot towels to the tendon for 30 minutes two or three times a
Your doctor may tell you to take aspirin or other anti-inflammatory
medications. These reduce pain and swelling. Take them as directed.
Dont wait until you feel pain. In more severe cases, cortisone
may be injected to relieve pain.
Rest allows the tissues in your foot to heal. Stay off your feet
for a few days, then slowly work back into activity. If you do high-impact
activities, such as running or aerobics, try other activities that
place less strain on your foot. Cycling and swimming are good choices.
Avoiding overuse is the best way to protect your feet and stay pain-free.
If your doctor prescribes an ankle brace or custom-made shoe inserts
(orthoses), wear them as directed. Also stretch your feet and ankles
before and after exercise.
Protect Your Feet
Limit the amount of stress created when your foot hits the ground.
The tips below can help.
- Wear the right shoe for the activity, so
the shoes support and cushioning meet your needs. Also,
choose shoes with good arch and heel support. Ankle support is
- Vary or reverse your exercise route
or routine. That way, one set of muscles is not always under extra
Consultant: Brad L.Z. Naylor, DPM, MS With contributions
by: G. Howard Bathon, MD, ORS & Thomas T. Pignetti, DPM
This information is not intended as a substitute
for professional health care.
©1996, 1999 The StayWell Company