Tendinitis in the Foot and Ankle

What is it?

There are a number of important tendons in the foot and ankle that are critical to daily function, walking, and athletics. These include the peroneal tendons (on the outside of the ankle/foot), the posterior tibialis tendon (on the inside of the ankle/foot), the tibialis anterior tendon (on the top of the ankle/foot), the extensor tendons (on the top of the foot), and the tendons on the bottom of the foot (the flexor tendons). Any one of these tendons can get inflamed (tendinitis) or worn out (tendinopathy) due to repetitive activity, causing pain.

How is it diagnosed?

Diagnosis is made by discussion with your physician and physical examination. Sometimes an X-ray is done to rule out other causes of foot or ankle pain. In severe cases, an MRI or ultrasound may be done to further evaluate severity or rule out tendon ruptures.

How is it treated?

Treatment depends on which tendon is affected and the severity of symptoms. Physical therapy is often key to strengthening and stretching the tendon and its surrounding structures to return balance to the foot. In severe cases, a period of immobilization may be necessary to calm down the pain and inflammation prior to initiating therapy. The aggravating activities must be reduced in order to allow it to heal. Anti-inflammatories are often part of the treatment as well. In severe cases, when ankle motion or biomechanics of the foot are impaired, or the pain is severe and not responding to these treatments, surgery may be an option.