Tendinitis in the foot

Definition

Inflammation of tendons in the foot is an inflammation of the tendons that connect the bones of the foot with the associated muscles. A distinction must be made between inflammation of the tendons (tendinitis) and inflammation of the tendon sheath (tendovaginitis). In contrast to tendosynovaginitis, tendon inflammation in the foot is often caused by degenerative diseases. However, accidents or permanent strain on the tendons can also lead to inflammation of the tendons.

Causes of tendon inflammation in the foot

Inflammation of tendons is often a symptom of systemic diseases. Rheumatic diseases are often the cause of tendon inflammation. Repeated strain on the tendon can also damage it in the long term.

Extreme athletes (marathon runners etc.) are particularly at risk of developing tendonitis. Even if bone fractures or injuries to the tendons in the foot area are behind, tendonitis can occur as a result. Finally, a bacterial infection of the tendon should always be considered as a cause.

Symptoms of tendonitis in the foot

The main symptom of tendonitis is severe pain. Usually the pain is described as stings. The pain occurs above all when the muscles connected to the tendons are moved.

There is usually a strong pain of pressure in the affected area. In very pronounced cases, it can happen that certain foot movements cannot be managed by pure muscle power because the tendon is too strongly irritated. In addition to the pain, other symptoms can also occur and provide clues to the underlying cause of the tendon inflammation.

If the tendon is infected, symptoms such as fever, as well as severe swelling and redness of the foot can usually be detected. If an inflammation of the tendon is not treated, but ignored, a rupture of the tendon can occur. The tear of a tendon leads to sudden pain and a complete loss of function of a muscle part.

These are the most common tendon inflammations of the foot

Achilles tendon inflammation is a typical runner’s disease, since the Achilles tendon is largely responsible for the function of the calf muscle. Especially running sports such as jogging and athletics, but also soccer, handball, basketball, rugby, i.e. running sports with rapid changes of direction, favour the development of Achilles tendonitis. Achilles tendonitis usually manifests itself as pain in the lower part of the calf.

There often a hardening can be determined. Also the mobility in the ankle joint can be limited. The reason for this is usually an overloading of the Achilles tendon, but trauma or an infection with bacteria can also lead to such an inflammation.

The therapy of Achilles tendon inflammation consists primarily of sparing the affected leg. Sport should be stopped until the patient is free of symptoms. Painkillers and anti-inflammatory drugs can also be used.

In addition, cooling the affected leg often helps in acute cases. During the healing process, the calf muscles should be stretched regularly, and physiotherapy and stabilisation exercises for the ankle are also helpful. It is important to treat the Achilles tendon inflammation consistently and to take a sufficient break so that the disease does not become chronic.

The peroneal tendons belong to the musculus peroneus longus and brevis, the long and short fibula muscle. These muscles are used with every step to control the position of the foot. Especially when running frequently, the tendons can become irritated and overloaded, which in the long run leads to inflammation of the peroneal tendons.

The tendons run behind the outer ankle and have contact with the bone there, which is why signs of overloading usually appear there first. Typically, the inflammation makes itself felt through pain and swelling on the outer ankle. These symptoms are more pronounced under stress than at rest.

Risk factors for the development of the inflammation are mainly bad posture in the ankle, such as bending the foot outwards when walking. However, overweight and a high walking load can also be triggering factors. When diagnosing peroneal tendon inflammation, the anamnesis is the most important factor.

The doctor can ask about typical symptoms and triggers. Further diagnostics such as x-rays and MRI are performed to exclude other causes of the complaints. The best way to treat peroneal tendon inflammation is to take a break from exercise and undergo physiotherapy.Painkillers and anti-inflammatory drugs can also be taken over a period of time.

The posterior tibialis muscle is a muscle that belongs to the deep flexor group in the lower leg. It pulls along the inner ankle and attaches to the sole of the foot. Its function essentially consists of the so-called flexion of the foot (lowering the tip of the foot) and lifting the inner edge.

When walking, the M. tibialis posterior is also responsible for the correct position of the foot with every step. Repeated overloading can cause the tendon to become inflamed, usually at an advanced age. Overweight and high blood pressure are also often responsible for the development of the disease.

Women are affected significantly more often than men. The diagnosis of tendon inflammation is made on the basis of the patient’s medical history and physical examination as well as with imaging procedures. In particular, the tendon can be assessed using MRI and ultrasound, so that degenerative (stress-related) changes can be easily detected.

As with many other tendon inflammations, the therapy consists of stress reduction. In addition, the healing process should be specifically controlled, for example, through physiotherapy. Painkillers and anti-inflammatory medications can also be effective at times for pain and other complaints.

Depending on the phase of the inflammation (acute or chronic), a cold or heat application is more helpful. The plantar tendon is located under the sole of the foot and runs from the heel bone to the toes. It thus causes the toes to bend and plays an essential role in keeping the foot securely in place with every step.

Often affected are athletes who are particularly keen on running sports. This leads to overloading of the plantar tendon, which can cause inflammation. In rare cases, traumas with bleeding or bacterial infections can also trigger the plantar tendon inflammation.

Since the complaints mainly occur in the form of load-dependent pain, a sports break is essential for treatment. In most cases, one must expect a break of several months. In addition, cold applications as well as anti-inflammatory and analgesic agents can be used in the first phase of the inflammation.

In this way, the complaints decrease and the inflammation is fought at the same time. After a few weeks, a cautious build-up training can be started. However, a full load is only possible again after a few months.

In order to avoid a chronification of the plantar tendon inflammation, this compulsory break should be observed at all costs. Other therapeutic options such as laser and shock wave therapy are usually only used if the inflammation does not disappear after weeks or months with conventional treatment. The muscle tibialis anterior (front shin muscle) belongs to the so-called toe lifters.

Its tendon extends to the big toe. Through its control over the big toe, the muscle plays an important role in the rolling movement and the controlled landing of the foot with every step. In most cases, the cause of the inflammation is an overloading of the muscle and the tendon. In this case, a sports break and immobilization of the foot will help. Painkillers can also be taken.