Your tendons are flexible connective tissue structures that connect your muscles to your bones.
When there is misuse, overexertion, or injury to the foot, the tendons can be affected. Tendonitis in your feet and lower extremities can significantly impair your ability to perform the activities of daily living.
There are three main types of tendonitis that are related to the foot and ankle:
1) Posterior Tibial Tendonitis: Your posterior tibial tendon begins in your calf and runs down your lower leg to the inside of your foot arch. People who struggle with this type of tendonitis often have problems with flat foot. The stress associated with arch collapse can cause small tears in the posterior tibial tendon, resulting in pain and inflammation.
2) Achilles Tendonitis: The most common form of tendonitis occurs where your Achilles tendon attaches to your heel bone. Pain in the back of your heel is commonly accompanied by a palpable lump in your Achilles tendon. We often see this type of tendonitis among athletes, runners and people who are on their feet for long periods of time. People who carry heavy objects or have rapid shifts in the way they stand are also prone to Achilles tendonitis.
3) Peroneal Tendonitis: The tendons on the lateral side of your foot keep your foot and ankle in alignment. When there is excessive stress on those tendons from a foot injury, you may alter the way you walk or stand, which changes your weight distribution on the foot and ankle. When these tendons become inflamed, it can lead to pain and swelling on the outside of your foot and ankle.
CAUSES
Numerous factors may contribute to or cause tendonitis in your feet and ankles, including:
• Strain, degeneration, or rupture of the involved tendon
• Foot abnormalities, such as flat feet
• Tight tendons, or tendon contracture
• Excessive hill walking or running
• Runners increasing their mileage too quickly
DIAGNOSIS
Sometimes tendonitis is quite easy to diagnose. When there is substantial swelling of the tendon that is localized to a specific area, we can usually tell with great certainty by visual inspection. Sometimes other tests may be ordered to look at the tissue in greater detail and to rule out other potential problems.
SYMPTOMS
The localized response of inflammation within and around your affected tendon is associated with several noticeable physical symptoms, including pain, swelling, redness at the tendon site, and a hot sensation. Patients may also notice a deformity of the area that is affected.
TREATMENT
Most tendonitis responds well to conservative, non-invasive exercise and anti-inflammatory medications.
• Rest (especially avoiding activities that exacerbate your condition)
• Icing the affected area or using contrast (hot/cold) therapy
• Appropriate lower extremity stretches
• Shoe therapy (i.e. appropriate footwear changes or modifications)
When problems are more advanced or if they do not respond to non-invasive treatment, we may want to perform an outpatient procedure that requires the patient to be under general anesthesia and/or a regional nerve block. After the surgery, you’ll typically be given pain medication, bandaged (often a splint or cast is applied depending on the situation), and will be able to return home the same day.
Because tendon repair usually involves incisions to cartilage, ligaments, and tendons in the body, the patient generally has to undergo a recuperation process involving follow-up care and physical therapy that may last anywhere from several weeks to several months, depending on the individual situation and what the surgeon views as best.
