Tendinopathy in the feet

What’s the difference between tendinopathy and tendinitis?

Pain in your feet can be caused by many things. One of these is tendinopathy which is a result of inflammation of your tendons. This painful condition is quite common and we help lots of people with treatment and management strategies.

If tendinopathy is getting you down, make an appointment with our friendly, competent podiatrists today, so we can diagnose your condition, and put a treatment program together.

Below, you’ll find more information about tendinopathy in the feet, and the best way to manage it.

Anatomy of the foot

The foot is made up of many different structures that enable us to stand and perform activities such as walking, running, jumping and dancing. Each foot is made up of 26 bones and 30 joints. Over 100 muscles, tendons and ligaments help facilitate the complex movements needed for motion and balance.

Tendons are bands of strong connective tissues that attach the muscles to the bones. The main tendon in the foot is the Achilles tendon. This runs from the heel all the way up to the calf muscle. This tendon makes running, jumping, walking up stairs and standing on your toes possible.

tendinopathy vs tendonitis?

It’s quite common for the terms ‘tendinopathy’ and ‘tendinitis’ to be used interchangeably. However, while both conditions have almost identical symptoms, they are different conditions.

Tendinitis is simply inflammation of the tendon as a result of microtears in the tendon

Tendinopathy occurs when the collagen in the tendon degenerates due to chronic over use.

Types of tendinopathy

There are a few types of foot tendinopathy. They are:

Achilles tendinitis (back of the ankle)
Posterior tibial tendinitis (inner side of the ankle)
Peroneal tendinosis (outer side of ankle)
Flexor tendonitis (inner back of ankle)
Extensor tendinopathy (top of the foot)

symptoms of foot tendinopathy

Typical symptoms of foot tendinopathy include:

pain
swelling and inflammation
redness or warmth in the skin over the affected area
reduced movement or stiffness at the affected joint
increasing discomfort or pain with activity
muscle weakness
pain relieved by rest, although tendon may be painful to the touch.

What causes tendinopathy in the feet?

There are a number of things that can cause tendinopathy in the foot and ankle. The most common cause of foot tendinopathy is overuse

Overuse — This is the most common cause of tendinopathy which occurs when repeating certain movements over and over.
Trauma — Trauma either through sudden injuries, or chronic rubbing against a shoe can also cause tendinopathy pain.
Abnormal foot structure — Flat feet or high arches can create muscular imbalances that can lead to tendinopathy.
Some medical conditions — Inflammatory conditions like rheumatoid arthritis, gout and spondyloarthropathy can also cause tendinopathy.

Who is at risk of developing tendinopathy?

Anyone can develop tendinopathy but there is usually a higher risk in people who:

How is foot tendinopathy diagnosed?

Diagnosing tendinopathy is usually done by taking a medical history and performing a physical examination. In some cases, it may be necessary to use imaging such as x-rays, ultrasound or MRI to confirm the diagnosis.

Treatment for tendinopathy of the feet

The good news is that tendinopathy usually improves with a combination of home and podiatry treatments.

home treatment

The first line of treatment is to rest the affected area so it can heal. This can take anywhere from a few weeks to a couple of months.

Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can also help reduce pain and inflammation.

RICE protocol which can be effective for tendon injuries.

Podiatry treatment

If you have tendinopathy or tendinitis it’s important that you involve a podiatrist in your recovery. Our friendly podiatrists are highly experienced in this area and can develop a tailor-made program just for you. There are many treatment options for tendinopathy and treatment can included the following:

exercises

Exercises can be used to treat tendinopathy with eccentric exercises being the most effective for treatment. Eccentric exercises reduce pain and in improve function of the affected tendon.

However eccentric exercises are usually used in a combination with stretching and isometric exercises. Your Podiatrist will tailor an exercise program for your to do at home.

custom made orthotic

Custom orthotics can be used to treat foot conditions like tendinopathy. Orthotics are never standalone treatment and are used to complement your treatment plan.

The goal of a custom-made orthotics for tendinopathy would to reduce internal and external forces acting on the tendon and thus reduce repetitive chronic injury to the tendon.

shockwave therapy

Shockwave therapy is a non-invasive approach to treating chronic and complex musculoskeletal conditions. Acoustic waves generated by the Shockwave trigger biological effects, leading to faster, long-term healing and tissue regeneration.

It is the ideal treatment method for numerous troublesome and complex musculoskeletal conditions like tendinopathy.

How to prevent foot tendinopathy

It may not always be possible to prevent tendinopathy, but there are some things you can do to reduce your risk. You should:

Ensure your warm up and cool down properly before and after exercise
Include stretching as part of your exercise routine
Avoid over-exercising and ensure you allow yourself enough time to recover
Participate in a wide variety of sports and activities to reduce the likelihood of overuse
Wear appropriate footwear for your sport or activity
Lose weight if necessary, as this will reduce strain on your tendons

Like many foot conditions, the earlier you seek advice for pain the better the outcome. If you notice pain anywhere in your foot that is not normal for you, please make an appointment to see one of our podiatrists.

frequently asked questions

Which cream eases bursitis in the foot?

Rubbing an anti-inflammatory cream like Voltaren may help ease your foot bursitis.

Is walking good for foot bursitis?

You can walk when you have foot bursitis to maintain your general health. However try limit the amount of prolonged weightbearing activities especially if you have severe symptoms.

When walking make sure to wear supportive footwear and avoid walking on uneven surfaces for prolong periods of times. If you have retrocalcaneal bursitis surfaces with sharp inclines may exacerbate the area.

Is acupuncture effective for foot bursitis?

There are some people who reported benefits from acupuncture for foot bursitis.