Tendonitis of the foot: Causes, Symptoms, and Treatment

Tendonitis of the foot is an inflammation of the tendons that connect the bones of the foot with the associated muscles. A distinction must be made between inflammation of the tendons (tendonitis) and inflammation of the tendon sheath (tendovaginitis).

In contrast to tendosynovaginitis, tendonitis of the foot often occurs as part of degenerative diseases. However, accidents or permanent strain on the tendons can also lead to inflammation of the tendons.

Causes of tendonitis of the foot

Inflammation of the tendon often occurs as a symptom of systemic diseases. Rheumatic diseases are often the cause of tendonitis. Repeated strain on the tendon can also damage it in the long term. Extreme athletes (marathon runners, etc.) are particularly at risk of developing tendonitis.

Even if bone fractures or injuries to the tendons in the foot area are behind, tendonitis can occur as a result. Finally, a bacterial infection of the tendon should always be considered as a cause.

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Symptoms of tendonitis of the foot

The main symptom of tendonitis is severe pain. Usually, the pain is described as stings. The pain occurs above all when the muscles connected to the tendons are moved. There is usually a severe pain of pressure in the affected area. In very unusual cases, it can happen that specific foot movements cannot be managed by pure muscle power because the tendon is too strongly irritated.

In addition to the pain, other symptoms can also occur and provide clues as to the underlying cause of the tendon inflammation. If there is an infection of the tendon, symptoms such as fever, as well as severe swelling and redness on foot, can usually be detected. If an inflammation of the tendon is not treated, but ignored, a rupture of the tendon can occur. The tear of a tendon leads to sudden pain and a complete loss of function of a muscle part.

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Achilles Tendon Inflammation

The Achilles tendon inflammation is a typical runner’s disease since the Achilles tendon is mainly responsible for the function of the calf muscle. Especially running sports such as jogging and athletics, but also football, handball, basketball, rugby, i.e., running sports with rapid changes of direction, favor the development of Achilles tendonitis.

An Achilles tendon inflammation usually manifests itself through pain in the lower part of the calf. Also, the mobility in the ankle joint can be limited. The reason for this is usually an overloading of the Achilles tendon, but trauma or an infection with bacteria can also lead to such an inflammation.

The therapy of Achilles tendon inflammation consists primarily of sparing the affected leg. Sport should be stopped until the symptoms are gone. Painkillers and anti-inflammatory drugs can also be used. Also, cooling the affected leg often helps in acute cases.

In the course of healing, the calf muscles should be stretched regularly. Physiotherapy and stabilization exercises for the ankle are also helpful. It is essential to treat the Achilles tendon inflammation consistently and to take a sufficient break so that the disease does not become chronic.

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Peroneal Tendon Inflammation

The peroneal tendons belong to the long and short fibula muscle. These muscles are used with every step to control the position of the foot. Especially when running frequently, the tendons can become irritated and overloaded, which in the long run, leads to inflammation of the peroneal tendons.

The tendons run behind the outer ankle and have contact with the bone there, which is why signs of overloading usually appear there first. Typically, the inflammation makes itself felt through pain and swelling on the outer ankle. These symptoms are more pronounced under stress than at rest. Risk factors for the development of the inflammation are mainly lousy posture in the ankle, such as bending the foot outwards when walking. But overweight and a high walking load can also be triggering factors.

When diagnosing peroneal tendon inflammation, the anamnesis is the most critical factor. The doctor can ask about typical symptoms and triggers. Further diagnostics such as x-rays and MRI are performed to exclude other causes of the complaints. The best way to treat peroneal tendon inflammation is to take a break from exercise and undergo physiotherapy. Painkillers and anti-inflammatory drugs can also be taken over a specified period.

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Posterior Tibial Tendonitis

The posterior tibialis muscle (posterior tibial muscle) is a muscle that belongs to the deep flexor group in the lower leg. It pulls along the inner ankle and attaches to the sole. Its function mainly consists of the so-called flexion of the foot (lowering the tip of the foot) and lifting the inner edge. When walking, the M. tibialis posterior is also responsible for the correct position of the foot with every step.

Repeated overloading can cause the tendon to become inflamed, usually at an advanced age. Obesity and high blood pressure are also often responsible for the development of the disease. Women are affected significantly more often than men.

The diagnosis of tendon inflammation is made based on the patient’s medical history and physical examination as well as using imaging procedures. In particular, the tendon can be assessed using MRI and ultrasound, so that degenerative (stress-related) changes can be easily detected.

As with many other tendon inflammations, the therapy consists of stress reduction. Also, the healing process should be individually controlled, for example, by physiotherapy. Painkillers and anti-inflammatory medications can also be effective at times for pain and other complaints. Depending on the phase of the inflammation (acute or chronic), a cold or heat application is more helpful.

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Plantar Fasciitis

The plantar tendon lies under the sole and runs from the heel bone to the toes. It thus causes the toes to bend and plays an essential role in keeping the foot securely in place with every step. Often affected are athletes who are particularly keen on running sports. This leads to overloading of the plantar tendon, which can cause inflammation. In rare cases, traumas with bleeding or bacterial infections can also trigger the plantar tendon inflammation.

Since the complaints mainly occur in the form of load-dependent pain, a sports break is essential for treatment. In most cases, one must expect a break of several months. Also, cold applications, as well as anti-inflammatory and analgesic agents, can be used in the first phase of the inflammation. In this way, the complaints are reduced, and the inflammation is fought at the same time. After a few weeks, a cautious build-up training can be started. However, a full load is only possible again after a few months.

Other therapeutic options such as laser and shock wave therapy are usually only used if the inflammation does not disappear after weeks or months with conventional treatment.

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Anterior Tibialis Tendonitis

The muscle tibialis anterior (front tibial muscle) belongs to the so-called toe lifters. Its tendon extends to the big toe. Through its control over the big toe, the muscle plays a vital role in the rolling and controlled landing of the foot with every step. The cause of the inflammation is an overloading of the muscle and the tendon.

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Therapy of tendonitis

The therapy of tendonitis depends on the underlying cause. Since inflammation can always reoccur if the cause is not found, this is essential in the preparation of a therapy plan. For example, a heel spur can be removed surgically, while rheumatic diseases are treated with medication.

If no underlying disease is found, it is likely that the tendon was overstressed, which led to the inflammation. Consistent protection and the use of anti-inflammatory painkillers can usually treat the inflammation adequately. Physiotherapeutic measures can be supportive. With specific foot shapes, insoles can help to reduce the strain on individual tendons.

Before a more extended period of strain on the foot, the tendons should be stretched sufficiently after the disease has healed. Additionally, there is the possibility of using alternative healing methods.

If there are signs of tendon inflammation, a doctor should be consulted to initiate an adequate therapy as soon as possible.

Ointment for tendonitis of the foot

There are several different ointments that can help with tendonitis. Cooling ointments can alleviate the symptoms of tendonitis somewhat. Ointments containing anti-inflammatory and pain-reducing substances are also frequently used to treat tendonitis.

Other ointments containing alternative substances and plant extracts have not been proven to be effective against tendonitis. As with all ointments, special care should be taken to ensure that no allergic reactions to the active ingredients contained therein occur.

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Plaster for tendonitis of the foot

The application of a plaster cast is usually necessary when the affected area needs to be immobilized for complete healing. This is usually the case with bone fractures. In individual cases, however, a plaster cast can also be used for tendonitis. This becomes necessary when immobilization by the usual therapy attempts is not sufficient.

Home remedies for tendonitis

In the case of tendonitis, it is primarily essential not to put more weight on the affected foot than necessary. Besides, the foot should be cooled so that the inflammation is contained. Cooling can be done with the help of a simple cold pack or an ice pack. The cold pack should always be wrapped in a towel and not be placed directly on the skin.

Cabbage or curd wraps can also be used for cooling. For a quark wrap, a conventional food quark can be put on a kitchen towel. This is placed on the painful and inflamed area. Ideally, the quark should come directly from the refrigerator. This is the best way for it to develop its cooling effect.

You can also easily compress the affected foot yourself. A gauze bandage wrapped tightly around the foot is sufficient for this. In this way, swelling of the foot can be prevented. It is essential that the gauze bandage is only wrapped tightly enough so that the foot can still be supplied with sufficient blood.

If the toes become white and cold or the feeling in the toes disappears, the compression is too tight and should be reapplied.

Finally, the affected foot should be put up. Ideally, it should be placed high enough to be above the heart. In this way, gravity additionally counteracts swelling of the foot.

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Zinc glue against tendonitis

A zinc paste bandage fulfills several important therapeutic components in the case of tendonitis of the foot. On the one hand, it can be wrapped in such a way that a certain amount of compression is created on the affected foot, thereby counteracting the swelling of the foot.

Also, the zinc paste is still moist when the bandage is applied, so it has a cooling effect. As soon as the bandage dries, it becomes firm and can thus stabilize the foot, which relieves the inflamed tendon.

Homeopathy for tendonitis

The use of homeopathic remedies is also becoming increasingly popular for tendonitis. Arnica, in particular, is a popular ingredient in the products recommended for tendonitis. As no proof of the efficacy of the remedies has been provided to date, the use of homeopathic remedies and globules cannot be recommended in every case.

The most important thing is to immobilize the affected foot. The possibility of taking homeopathic products to support the foot can be obtained from many doctors.

How long should the sports break last in case of tendonitis?

In the case of tendonitis of the foot, a sports break of several months should be expected.

First, the tendon must recover from the inflammation so that there is no longer any acute pain. However, even if there are no more complaints at rest and everyday stress is already possible again, sport should still be avoided.

Depending on how quickly the initial complaints subside, a light build-up training can be started again after usually one to two months. Overloading with renewed irritation of the tendon should be avoided at all costs.

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Tendonitis inside the foot

Inflammation of tendons on the inside of the foot can affect different tendons, depending on their exact location. Frequently, an inflammation of the tendons on the inner underside of the foot is standard. This tendon area, known as the longitudinal arch, is subject to heavy strain and is easily inflamed. Especially with specific foot shapes, tendon inflammation can quickly occur. People with a flat foot, hollow foot, or overweight are particularly at risk of developing tendonitis in the area of the foot.

Unsuitable footwear and a general overloading of the tendons through specific physical activities should also be considered as a cause for internal foot pain.

Diagnosis of tendonitis

The diagnosis of tendonitis begins with a detailed anamnesis and an inspection and physical examination of the foot. Important events such as constant strain on the foot, injuries to the foot, and an accurate description of the quality of the pain can help to make a suspected diagnosis of tendonitis.

During the physical examination, the movements during which the pain occurs are discussed. It is also discussed whether there is swelling and redness at the painful site. The presence of other diseases can also provide an indication of a connection.

The use of imaging diagnostics may also be necessary. If a bone fracture or heel spur is suspected, an X-ray is usually taken. Ultrasound examinations and an MRI scan of the foot can also be useful examination methods.

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How long does an tendonitis in the foot last?

The duration of tendonitis depends on several factors. Above all, the underlying disease and the extent of the inflammation are essential parameters that can significantly influence the duration of the disease. Overall, however, tendonitis is a relatively long-lasting disease.

While mild courses can be symptom-free within two weeks, tendonitis can last up to 3 months. If no improvement can be achieved after a few months, a renewed search for underlying diseases should be conducted, and surgical treatment of the tendon considered. In general, the duration of the inflammation can usually be shortened considerably using a quickly initiated therapy, consistent protection, and the correct intake of medication.

How long is the duration of a tendonitis on sick leave?

The length of time on sick leave in the case of tendonitis is highly dependent on the physical strain at work. If you sit at your desk all day, you only need to be on sick leave for as long as pain in your foot prevents you from working. A week’s sick leave is usually sufficient for this.

If, on the other hand, you work physically, walk a lot or drive a car, you should expect a more extended sick leave.

Only when the foot is fit for the respective job can work be resumed. Depending on the persistence of the tendon inflammation, this can take weeks or months.

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