Written By: Chloe Wilson BSc(Hons) Physiotherapy
Reviewed By: FPE Medical Review Board
Extensor tendonitis is a common problem that causes pain across the top of the foot.
This form of foot tendonitis is caused by inflammation or irritation of the tendons that pull the toes up.
Typically, tendonitis of the extensor tendons develops due to repeated friction across the top of the foot or excessive pressure from a poorly-fitting shoe.
Here, we will look at the common causes, symptoms and treatment options for this common foot problem.
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.
The two main toe extensor tendons are:
Extensor Hallucis Longus: which lifts up the big toe
Extensor Digitorum: which lifts the other four toes
Both tendons run down across the front of the ankle, across the top of the foot and then fan out attaching to the tips of the toes.
The extensor tendons sit between the skin and the bones and there is little padding around them, making them prone to injury resulting in top of foot pain.
With extensor tendonitis, the tendons become inflamed and swollen, usually due to overuse or excessive pressure on the tendon. Over time, the tendon can weaken and cause scarring, which can lead to further weakening and reduced flexibility.
There are a number of things that increase the risk of developing extensor tendonitis in the foot:
The symptoms of extensor tendinopathy tend to be confined to the top of the foot, occasionally spreading to the arch of the 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. Extensor tendonitis is one of the most common causes of top of foot pain.
Treatment for extensor tendonitis aims to reduce irritation, inflammation and pain in top of foot. There are a number of things that can help:
It can take anything from a few weeks to a few months to recover from extensor tendonitis. The earlier you start treatment, the quicker you are likely to recover.
Factors that can affect recovery time include the severity of the condition, the type of treatment used, age, overall health, and lifestyle choices. Other factors, such as stress levels, nutrition, and sleep, can also play a role in the recovery process.
It is really important to try and avoid any activities that bring on your pain with extensor tendonitis, and to wear comfortable fitting shoes, to allow the tendon time to heal. Failure to do so will lead to continued irritation of the tendon and slow healing.
The good news is, in most cases, people make a full recovery with the right treatment plan.
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:
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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Page Last Updated: 03/02/23
Next Review Due: 03/02/25
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