Extensor Tendonitis

Written By: Chloe Wilson BSc(Hons) Physiotherapy
Reviewed By: FPE Medical Review Board

What Is Extensor Tendonitis?

Let's start by looking at how tendons work. Tendons are tough, fibrous tissues that connect muscles to bones. The extensor tendons join the muscles on the front of the lower leg to the toes. They pull the toes upwards away from the ground.

What Causes Extensor Tendinopathy?

There are a number of things that increase the risk of developing extensor tendonitis in the foot:

• Friction: Extensor tendinopathy most commonly occurs due to the foot rubbing against a tight shoe, either from the shoe being too small or being laced up too tightly
  
  
• Activity: It tends to affect people who spend long periods on their feet especially people who walk or run on uneven surfaces or up and down hills
  
  
• Calf Tightness: Tightness in the calf muscles places the extensor muscles under greater strain making tendonitis more likely to develop
  
  
• Abnormal Foot Arches: People with high foot arches are more likely to have pressure on the top of their foot, and people with flat feet find their extensor tendons under more strain, both of which increases the chance of developing tendonitis
  
  
• Injury: Extensor Tendonitis can also occur after an injury such as if you have dropped something heavy onto the top of your foot or kicked something awkwardly  

Symptoms of Extensor Tendinopathy

The symptoms of extensor tendinopathy tend to be confined to the top of the foot, occasionally spreading to the arch of the foot:

• Top of Foot Pain: Tends to be worse with activity and better with rest.  The top of the foot maybe tender to touch making it uncomfortable wearing shoes
  
  
• Swelling: There may be some visible swelling and/or bruising across the top of the foot
  
  
• Bruising: You may notice some mild bruising across the top of your foot

A simple test for extensor tendinopathy is to try and draw your toes up towards you while resisting the movement with your hand. If that recreates your pain on top of foot, you probably have the condition.

How Do You Treat Extensor Tendonitis?

Treatment for extensor tendonitis aims to reduce irritation, inflammation and pain in top of foot. There are a number of things that can help:

• Shoe Laces: The simplest way to treat and prevent extensor tendonitis is to change how you lace your shoes. Either tie your knot at the side or miss out one of the lacing holes over the most painful area. It sounds simple, but it really does make a big difference.
  

• Steroid Injections: If the pain fails to settle, a steroid injection can be given to help reduce the inflammation. Care must be taken as it does temporarily weaken the extensor tendon

What Else Can Help

One of the best ways to treat extensor tendonitis is with a programme of stretching and strengthening exercises. Find out more about how to stretch and strengthen the calf muscles in the calf exercises section to help prevent and treat extensor tendinopathy and other common causes of foot pain.

Tendonitis can occur in a number of locations around the foot and ankle. Find out more in the foot tendonitis section, including achilles tendonitis which is a common cause of heel pain.  

Extensor tendonitis is just one of the possible causes of pain on the top of the foot. If this isn't sounding quite like your problem, visit the Top Of Foot Pain section for help working out what else might be going on and how to treat it.

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