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 Tendonitis
 Tendonitis Photo What is Tendonitis?
When you use a set of muscles too much, you’re 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 tendon’s 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 doctor’s help, tendonitis can be controlled. Both your symptoms and your risk of future problems can be reduced.

Where Does Your Foot Hurt?
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.

The 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 Foot
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 Foot
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 Your Foot
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, you’ll 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.

Testing
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).

Treating Tendonitis
Your doctor’s 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 doctor’s 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 day.

Medications
Your doctor may tell you to take aspirin or other anti-inflammatory medications. These reduce pain and swelling. Take them as directed. Don’t wait until you feel pain. In more severe cases, cortisone may be injected to relieve pain.

Limiting Activities
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.

Staying Pain Free
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 shoe’s support and cushioning meet your needs. Also, choose shoes with good arch and heel support. Ankle support is helpful, too.
  • Vary or reverse your exercise route or routine. That way, one set of muscles is not always under extra stress.

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.
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