Foot tendonitis: causes, symptoms and treatment

As explained by Dr. Giovanni Bonaspetti, Head of Orthopedics and Traumatology section II of the St. Anna Clinical Institute, there are different types of tendinopathies:

• Achilles Tendinopathy, one of the most frequent;
• Anterior Tibialis Tendonitis, that of the flexor and extensor tendons of the fingers;
• Posterior Tibial Tendinopathy.

Posterior tibial tendinopathy

“Posterior tibial tendinopathy is a tendinopathy closely linked to foot dysmorphism (permanent anatomical modifications). If neglected, in fact, it can lead to rupture of the posterior tibialis, which is not rare, and to a collapse of the plantar vault. The foot becomes flat and tends to pronation, a physiological rotation of the foot inwards. A dramatic event from a mechanical point of view that also forces to abandon any physical activity,” explains orthopedic surgeon.

Dr. Bonaspetti continues: “The origin of tendinopathies most often can be traced back to:

• functional overload of the tendon due to a physiological process of wear;
• excessive repeated stress (as occurs among sportsmen);
• some deformities in the structure of the foot that can undermine the mechanics of one or more tendons.

Less frequent, although possible, cases of foot tendinopathies originating from:

• trauma or microtrauma;
• metabolic diseases (for example, diabetes which causes an alteration of the microcirculation that affects the tendon vascularity, putting the health of the tendons at risk);
• systemic pathologies;
• calcific tendonitis which seriously undermines the elasticity of the tendons.”

Common symptoms of various types of foot tendinopathies that differ mainly due to the different localization are pain and swelling.

“These are diseases that can manifest themselves at rest and get worse during activation of the inflamed tendon. The differential diagnosis, which identifies among the diseases that have a partially common symptomatic complex the signs that are specific to a certain pathology, must not be made between one tendon and another, but between a tendon and non-tendon pathology,” clarifies the specialist.

The best solutions to keep an inflammation at control are:

• apply ice;
• rest;
• take anti-inflammatories.

“In the most frequent cases, once a possible tendon injury for which surgery is often necessary has been ruled out, physiotherapy sessions are recommended to take advantage of both benefits of instrumental therapies and the usefulness of some specific exercises aimed at restore a balance to the joint biomechanics,” adds Dr. Bonaspetti.

To prevent foot tendonitis, it is very useful to:

• carefully choose the footwear;
• limit repeated and tiring movements;
• practice a good warm-up before starting any physical activity.

In addition, a balanced diet and the possible intake of targeted supplements help to prevent any relapses and preserve the health of tendons. A tendinopathy that is not adequately treated or neglected over time can evolve into a more serious disorder, tendinosis, a chronic degenerative disease of tendon tissue.

Anterior tibial tendinopathy is a form of tendonitis that affects even the youngest. Dr. Bonaspetti warns:

“Fastening the laces of their shoes too tightly can promote inflammation of the anterior tibial tendon which, failing to flow freely, can compress to the point of inflammation and pain.”