=Tendinitis is inflammation or irritation of a tendon—the strong band of tissue connecting a muscle to a bone. In the foot and ankle, tendinitis can make walking, exercising, climbing stairs, or simply standing for extended periods uncomfortable. Pain may begin suddenly after an injury or develop gradually from repetitive stress and overuse. At The Schottenstein Center, we diagnose and treat foot and ankle tendinitis at our Miami and Hallandale Beach locations. Our goal is to identify the affected tendon, determine what is causing the irritation, and develop a treatment plan that promotes healing while helping prevent the problem from returning.
Common Types of Foot and Ankle Tendinitis
Numerous tendons help support and move the foot and ankle. Tendinitis symptoms and treatment needs can differ depending on which tendon is affected.
Achilles Tendinitis
The Achilles tendon connects the calf muscles to the heel bone and plays an essential role in walking, running, and jumping. Achilles tendon problems commonly cause pain, stiffness, or swelling above the back of the heel. Symptoms may be particularly noticeable during the first steps in the morning or after physical activity.
Posterior Tibial Tendinitis
The posterior tibial tendon helps support the arch of the foot. Inflammation or weakening of this tendon can cause pain and swelling along the inside of the ankle and arch. If the condition progresses, the arch may gradually flatten and affect the alignment of the foot and ankle.
Peroneal Tendinitis
The peroneal tendons run along the outside of the ankle and help stabilize the foot. Peroneal tendinitis may cause pain behind or below the outer ankle bone. It is frequently associated with repetitive activity, ankle instability, high arches, or a sudden increase in exercise.
Extensor Tendinitis
The extensor tendons run across the top of the foot and help lift the toes. Irritation can cause pain or swelling on top of the foot, particularly while walking or wearing shoes. Tight footwear, repetitive exercise, and changes in training intensity may contribute to this condition.
Flexor Tendinitis
The flexor tendons travel along the inside of the ankle and bottom of the foot. Tendinitis affecting these structures can produce pain during toe movement, walking, or pushing off the ground.
What Causes Tendinitis?
Foot and ankle tendinitis often develops when a tendon is repeatedly stressed without enough time to recover. Athletes and physically active individuals may be more susceptible, but tendinitis can affect anyone. Common causes and contributing factors include:
- Repetitive movements or overuse
- A sudden increase in running, walking, or exercise
- Improper training techniques
- Unsupportive or poorly fitting footwear
- Abnormal foot structure or walking mechanics
- Flat feet or unusually high arches
- Tight calf muscles
- An acute foot or ankle injury
- Age-related changes within a tendon
- Medical conditions such as diabetes or inflammatory arthritis
Athletes may benefit from a comprehensive sports medicine evaluation to identify training patterns, repetitive stress, and other factors contributing to the injury. Determining why the tendon became irritated is an important part of developing an effective treatment plan.
Symptoms of Foot and Ankle Tendinitis
Symptoms may appear gradually or begin after a particular activity or injury. Common signs of tendinitis include:
- Pain near the affected tendon
- Tenderness when the area is touched
- Swelling around the foot or ankle
- Stiffness after resting or upon waking
- Pain that increases with activity
- Weakness or difficulty pushing off the foot
- Reduced ankle or foot movement
- A thickened or enlarged tendon
Continuing to place excessive stress on an injured tendon can cause symptoms to worsen. Without appropriate care, chronic inflammation may progress to tendinosis, which involves degeneration and damage within the tendon itself. A severely weakened tendon may eventually develop a partial or complete rupture that could require surgery.
How Is Tendinitis Diagnosed?
A proper diagnosis is important because fractures, arthritis, ligament injuries, nerve problems, and other conditions can produce symptoms similar to tendinitis. During your examination, Dr. Schottenstein will discuss when the pain began, the activities that aggravate it, and any previous injuries or treatments. The foot and ankle will be evaluated for tenderness, swelling, strength, flexibility, alignment, and range of motion.
A biomechanical and gait analysis may also help identify abnormal movement patterns that place excessive pressure on the affected tendon. When necessary, digital X-rays may be used to evaluate the surrounding bones and look for calcification or other abnormalities. An MRI or CT scan may be recommended when more detailed imaging is needed to evaluate tendon damage or rule out another injury.
Nonsurgical Tendinitis Treatments
Most cases of foot and ankle tendinitis can be treated without surgery, especially when care begins early. Treatment depends on the tendon involved, the severity and duration of the condition, the patient’s activity level, and any underlying structural or medical factors.
A conservative treatment plan may include:
- Rest and temporary modification of aggravating activities
- Ice and elevation to help manage discomfort and swelling
- Supportive footwear
- Bracing or immobilization
- Stretching and strengthening exercises
- Physical therapy
- Medication when medically appropriate
- A gradual return to exercise and physical activity
Custom molded orthotics may be recommended when flat feet, high arches, poor alignment, or abnormal gait mechanics place repeated stress on a tendon. Supporting the foot and addressing these underlying biomechanical factors may promote recovery and reduce the risk of recurring tendinitis.
Extracorporeal Shock Wave Therapy for Persistent Tendinitis
When tendinitis becomes chronic or calcium deposits are present within the affected tendon, Extracorporeal Shock Wave Therapy (ESWT) may be recommended. This noninvasive treatment delivers targeted acoustic pressure waves to the injured area to help stimulate circulation and the body’s natural healing response. For appropriately selected patients, ESWT may help reduce tendon pain, promote tissue repair, and break down calcium deposits without surgical removal. It is often considered when rest, activity modification, supportive footwear, physical therapy, orthotics, and other conservative treatments have not provided sufficient relief.
The appropriate treatment will depend on the affected tendon, the extent of the damage, the presence of calcification, the duration of symptoms, and the treatments previously attempted. No single treatment is appropriate for every patient, and results can vary.
When Is Surgery Needed for Tendinitis?
Surgery is generally reserved for severe tendon damage, a partial or complete tendon rupture, or symptoms that do not improve after an appropriate course of nonsurgical care. If surgery is necessary, the recommended procedure will depend on the affected tendon and the type and extent of the injury.
When Should You See a Foot and Ankle Specialist?
Schedule an evaluation if foot or ankle pain persists, repeatedly returns, interferes with normal activity, or is accompanied by swelling or weakness. Sudden severe pain, a popping sensation, difficulty bearing weight, or an inability to push off the foot may indicate a tendon rupture or another significant injury and should be evaluated promptly. Early treatment can help prevent a minor tendon problem from developing into chronic pain, tendon degeneration, or more extensive structural damage.
Schedule a Tendinitis Evaluation in Miami or Hallandale Beach
If tendon pain is making it difficult to walk, exercise, work, or enjoy your normal activities, The Schottenstein Center can help. Dr. Schottenstein provides comprehensive diagnosis and treatment for foot and ankle tendinitis in Miami and Hallandale Beach. Contact The Schottenstein Center today to schedule an appointment and learn which tendinitis treatment options may be appropriate for your condition.