Generality
Foot tendonitis is the inflammation of one or more tendons of the foot.
The appearance of this tendon inflammation can be the result of: a traumatic event affecting the foot, a functional overload of the foot or a form of arthritis (eg, rheumatoid arthritis).
The typical symptomatology of a tendonitis in the foot includes: pain, swelling and joint stiffness.
In general, an accurate physical examination and a careful medical history are sufficient to make a correct diagnosis.
The classic treatment of the most common cases of tendonitis in the foot includes: rest from any activity that causes pain, application of ice, elevation of the painful lower limb and the use of anti-inflammatories.
If the therapies are late or inadequate, the symptoms can become chronic or, worse still, the inflamed tendon suffers an injury which, in certain situations, makes surgery indispensable.
Basics of anatomy: the foot and its tendons
The foot is the equal anatomical component of the human body, which resides at the distal end of the lower limb.
Including 26 bones, 33 joints, a hundred muscles and a large number of tendons and ligaments, the foot begins at the important ankle joint and ends with the last phalanges of the fingers .
Its functions are mainly three:
- Ensure stability when standing,
- Absorb most of your body weight
- Allow locomotion, thanks to dorsiflexion, plantarflexion, eversion and ankle inversion movements.
| Table: movements of dorsiflexion, plantarflexion, eversion and inversion of the foot. | |
 | Dorsiflexion : it is the movement that allows you to lift your foot and walk on your heels. |
 | Plantarflexion : it is the movement that allows you to point your foot towards the floor. The human being performs a plantarflexion movement when he tries to walk on his toes. |
 | Eversion : means raising the side edge (ie the outer edge) of the foot, keeping the medial edge (ie the inner edge) on the floor. |
 | Inversion : it means raising the medial edge of the foot, keeping the side edge on the floor. |
TENDINI OF THE FOOT
A tendon is an extremely flexible band of fibrous connective tissue, which combines a skeletal muscle with a bone.
The foot includes many tendons, as there are many muscles that, with one of their two ends, find insertion in the bones of the foot.
Among the tendons of the foot that deserve a mention, are:
- The 6 so-called ankle tendons . Specifically, these are: the Achilles tendon, the anterior tibial tendon, the posterior tibial tendon and the three peroneal tendons;
- The tendon of the extensor muscle of the toes and the tendon of the extensor short muscle of the big toe . The muscles to which these tendons belong reside on the back of the foot;
- The tendons of the numerous plantar muscles of the foot .
What is a tendonitis in the foot?
Foot tendonitis is an inflammatory condition that affects one or more tendons located in the foot and ankle.
MAIN TYPES OF FOOT BEANS
There are as many types of tendonitis in the foot as there are tendons located between the foot and ankle.
The most widespread and important types of tendonitis in the foot are: the yarrow tendinitis (ie the tendonitis of the Achilles tendon), the anterior tibial tendinitis (or tendinitis of the anterior tibial tendon), the posterior tibial tendinitis (ie tendon tendonitis). tibialis posterior), the tendonitis peronea (ie the tendonitis of one of the peroneal tendons) and the tendinitis of the extensor tendons of the toes .
The first four aforementioned types of tendonitis in the foot are four different forms of ankle tendonitis .
Causes
The main causes of tendonitis in the foot include traumatic foot injuries, functional foot overload and some forms of arthritis .
TENDINITIS SUCCESSIVE TO TRAUMATIC INJURIES TO FOOT
A trauma to the foot can cause damage to several of its anatomical components, including tendons.
Foot trauma means both acute and direct phenomena - such as the so-called ankle sprains - and chronic and repetitive phenomena, such as continuous compression and repeated rubbing of a shoe that is too narrow.
In most cases, episodes of tendonitis in the foot are the result of acute trauma and, in particular, of the aforementioned ankle sprains.
The individuals most prone to the development of a traumatic foot tendinitis are the subjects who practice sports such as running, football, volleyball, basketball, volleyball, rugby or tennis.
FUNCTIONAL OVERLOAD FOOT TENDINET
The functional overload pathologies are conditions that appear following the exaggerated and continuous repetition, over time, of particular gestures / movements.
Foot tendonitis due to functional overload is the result of a certain movement of the foot, repeated many times during the day, which affects the health of one or more tendons.
Since the movements of the foot depend to a large extent on the ankle, episodes of tendonitis of the foot due to functional overload almost always involve the ankle tendons.
The subjects most at risk of tendonitis of the foot due to functional overload are the medium / high level athletes, who, for performance reasons, train many hours every day and for long periods of time.
FOOT tendonitis from arthritis
In medicine, the term arthritis refers to any inflammatory process involving one or more joints.
There are many forms of arthritis; Among the various forms of existing arthritis, those with the greatest tendency to cause tendinitis in the foot are: rheumatoid arthritis, ankylosing spondylitis, gout and reactive arthritis .
RISK FACTORS
Doctors believe that the most important risk factors for tendonitis in the foot are:
- Practice at high levels of sports such as football, running, basketball, volleyball, rugby, American football and tennis;
- The practice of work activities, which put stress on the feet and in general the lower limbs;
- The habit of wearing particularly narrow shoes, especially at the ankle level;
- The presence of rheumatoid arthritis, reactive arthritis or gout.
Symptoms, signs and complications
The characteristic symptoms and signs of tendonitis in the foot are: foot pain, foot swelling and joint stiffness .
The precise location and severity of the aforementioned symptoms depend, respectively, on the location of tendon inflammation (hence the inflamed tendon) and the severity of the inflammatory process.
ACHE
First by appearance, pain is the most classic symptom of tendonitis in the foot.
Generally, it tends to be a sharp and burning sensation, which, in the absence of adequate treatments, spreads from a specific point (where the inflamed tendon is) to several parts of the foot.
The tendonitis pain in the foot is stronger in the morning, immediately after waking up, and when the movements are resumed, after long periods of immobility (eg: a trip by car for many hours).
The following bulleted list shows where the pain is located, in the most common types of tendonitis in the foot:
- Tendonitis of the Achilles tendon: causes pain in the heel and, sometimes, also in the calf. The painful sensation increases with the practice of activities such as walking and, above all, running;
- Tendonitis of the anterior tibial tendon: it causes pain on the inner side of the foot. This pain tends to increase when you stand up or push the affected foot outward;
- Tendonitis of the posterior tibial tendon: causes pain on the front of the foot. As a rule, this painful sensation tends to increase by going down the stairs or walking / running on a downhill surface.
- Artificial tendonitis: induces pain on the back side and on the external side of the ankle and foot in general. Typically, the painful sensation increases when you stand up.
- Tendonitis affecting the extensor tendon of the toes: it causes pain on the back of the foot, which tends to become more acute during a brisk walk or a run.
SWELLING
In the presence of tendonitis in the foot, swelling is a clinical sign that appears, as a rule, gradually. At the beginning of the inflammation, in fact, it is hardly mentioned; after a few weeks, on the other hand, it takes on dimensions that clearly show it.
To the touch, the area presenting the swelling appears soft.
RIGIDITY
In episodes of tendonitis in the foot, joint stiffness makes movement of the affected foot difficult.
Like pain, stiffness is more pronounced after long periods of immobility, therefore upon awakening from sleep at night, after a long stay on a chair, etc.
Generally, it tends to fade with movement.
COMPLICATIONS
Failure to treat certain types of tendonitis in the foot, associated with the perpetuation of activities that are harmful to already inflamed tendons, can lead to chronic symptoms or, even worse, tendon injury .
A well-known tendon lesion that is of some importance in the medical-clinical field is the lesion of the Achilles tendon . Better known as Achilles tendon rupture, the Achilles tendon lesion severely limits the subject's motor skills and requires surgery.
Diagnosis
In most cases, doctors diagnose tendonitis in the foot and identify the triggering causes thanks to a thorough physical examination and a thorough medical history .
If they resort to more in-depth tests, such as nuclear magnetic resonance, it is because they have some doubts or want to clarify the exact state of health of the anatomical components of the foot.
IMPORTANCE OF ACCURATE DIAGNOSIS OF CAUSES
In the context of a tendinitis in the foot, the precise knowledge of the triggering causes is necessary for doctors to plan the most appropriate therapy.
Important information on the causal factors comes from the anamnesis, which clarifies whether the patient suffers from some form of arthritis, practices sports activities or work at risk etc.
Therapy
The canonical treatment of the most common episodes of tendonitis in the foot involves an anti-pain and anti-inflammation therapy, and a preventive therapy against all possible aggravating factors or that can, in some way, prejudice the healing process.
In patients with complications, the aforementioned treatment plan changes; in these cases, before a chronic symptomatology, physiotherapy is added to the above therapies; in the presence of a tendon lesion, however, surgery is required, followed by proper physiotherapy rehabilitation .
CLASSIC TREATMENT
The classic treatment of uncomplicated tendinitis in the foot consists of:
- Rest and abstinence from all physical / motor activities that induce pain in the foot . The rest of the tendon that causes pain is essential for the resolution of the inflammatory state;
- Application of ice on the painful and swollen area . The use of ice has a remarkable anti-inflammatory power, which many people ignore or underestimate.
Normally, in the presence of inflammatory conditions, doctors recommend applying ice 4-5 times a day, for at least 15-20 minutes;
- Elevation of the painful lower limb . It is a remedy that relieves the foot of the body's load, accelerating the recovery time from inflammation;
- Using crutches, to avoid "giving weight" to the sore foot. Crutches are indicated for patients with very severe tendinitis;
- Administration of Non-Steroidal Anti-inflammatory Drugs ( NSAIDs ). As can be guessed from their name, these medicines act against inflammation, reducing it. The most prescribed NSAIDs in the presence of tendonitis in the foot are ketoprofen and naproxen sodium.
Prognosis
If the therapies are timely and appropriate, the prognosis of a tendonitis in the foot is, almost always, positive. In these situations, healing times are reasonable and depend mainly on the duration of the inflammation: for less severe tendinitis, a few days of rest, ice, anti-inflammatories, etc are sufficient; for the more severe tendinitis, on the other hand, it takes several weeks of careful treatment.
HOW CHANGE PROGNOSIS IN THE PRESENCE OF COMPLICATIONS
In the presence of complications, the prognosis becomes more uncertain and the path leading to recovery becomes longer and full of obstacles:
- In the case of chronic symptoms, classic therapy and physiotherapy could last for a long time (several months) and, at the end, be only partially effective;
- In the event of a tendon lesion requiring the intervention of the surgeon, the operation must be followed by several months of rest and physiotherapy treatment, to allow the correct welding of the tendon tissues undergoing repair.
Prevention
Do not overdo sports activities at risk, avoid the continuous repetition of wrong movements with the foot, wear comfortable shoes, observe breaks during work activities that require continuous use of the lower limbs and feet in particular, wear special braces ( clearly when it is possible or allowed) and, lastly, to perform exercises for the muscle lengthening of the foot, are the main preventive measures against tendinitis in the foot.
HOW TO AVOID THE SEWING OF A FOOT TENDITYE
Refrain from activities that cause pain and avoid the use of painkillers if you have not consulted a doctor beforehand (as the aforementioned drugs cancel the pain, deluding the patient of having solved the problem), are the main advice given by the doctors, to prevent aggravation of tendonitis in the foot.
