What is Tendinitis?
Tendinitis is the inflammation of a tendon (the cord-like structure that connects muscle to bone). Tendinitis (also spelled tendonitis) can occur in the foot and ankle and can be caused by using the muscle too much or with excessive and repetitive exercise. Other factors that can cause tendinitis are injuries, prolonged inactivity, weight gain as well as foot deformities (e.g. flat feet or high-arched rigid feet).
Tendons under excessive strain will begin to cause the outer covering of the tendon to swell or develop small tears. Tendinitis can start out with episodic pain, but with continued use of the part, the tendon can be painful whenever it is used.
There are four major tendons in the foot and ankle that commonly are involved. Each will be discussed briefly.
This affects the large tendon that connects the calf muscles to the back of the heel. Pain will usually occur as you lift your heel off the ground while walking or when going up steps. This condition may be associated with bursitis (inflammation of the soft tissue in the back of the heel) or a “pump bump” (an enlargement of bone that rubs against the back of your shoe).
Posterior Tibial Tendinitis:
This affects the tendon that connects under the arch into the bone and helps support your foot. Pain under the arch will be felt when you push off to take a step. People with flatfeet are affected the most. Being overweight can make you more prone to this tendinitis as well. It is not uncommon for an injury to partially tear this tendon which easily becomes a chronic or long-standing painful problem.
Anterior Tibial Tendinitis:
This affects the main tendon on the front of the ankle that lifts your foot while walking. Pain is felt on the top of your foot near the ankle and may also include the ankle when going downstairs or downhill. This tendinitis is also associated with stop and start sports like tennis, basketball, and soccer.
This affects the tendon on the outer portion or small toe side of your ankle and foot. The pain will be felt with standing or when pushing off to take a step. Causes of this tendon problem are often seen with high-arched feet, poor-fitting shoes with improper support and excessive exercise. This condition may also be created by injury.
When talking to Dr. Cruz at either the Brandon or Zephyrhills office, he may ask you the type of footwear that you use, when your ankles and feet hurt and about your overall health. During the examination, the doctor may take x-rays to look for abnormalities in your foot structure and possible fractures or other abnormalities in the bones. Special cases might involve an MRI (magnetic resonance imaging) scan to find possible tears in the tendon or tenosynovitis (inflammation of the tendon sheath).
Treatment of tendinitis:
Tendinitis is readily treatable with rest or change of activity to a non-impact sport like swimming or bicycling. Ice should be used when symptoms begin. Heat may be used after a few days. Dr. Cruz may prescribe an anti-inflammatory medicine that should be taken exactly as prescribed. In some cases, he may inject the tendon sheath with medicine (cortisone) to reduce inflammation except in the case of Achilles tendonitis where injections are to be avoided. To help with overall healing, Dr. Cruz may send you for physical therapy. He also offers natural regenerative medicine treatments that can be discussed.
Dr. Cruz may prescribe a heel lift or orthotic insert to optimally position your foot to reduce tendon strain. Some severe cases of tendonitis will require immobilization with a walking boot or specialized ankle and foot supports for 2-4 weeks. Finally, as a last option, surgery may be performed to repair partial or complete tears in the tendon or to address severe tenosynovitis.
If you wish to schedule an appointment at the Brandon or Zephyrhills offices for the treatment of tendinitis, please call Dr. Cruz at his Brandon office (813) 502-5904 or in Zephyrhills (813) 782-3233.
Jairo Cruz Jr DPM, Podiatrist at Gentle Foot Care Clinic. Dr. Jairo Cruz is a board-certified podiatrist in the Tampa Bay area. He has many years of experience as a podiatrist. Dr. Cruz specializes in treating all foot and ankle pain, Bunions, Hammertoes, Plantar Fasciitis, and Heel spurs, Neuromas, Peripheral Neuropathy, Ingrown toenails, Non-healing wounds, corns, calluses, Warts, Cysts, Toenail fungus.