What Is Tendonitis?

Tendons are the special connective tissues that anchor your muscles to your bones, transmitting the force of muscle contractions into movement. When tendons are overloaded through repetitive activity or sudden trauma, microscopic tears can develop within the tendon fibers. The body responds with inflammation in an attempt to repair this damage — and it is this inflammatory response that produces the pain, swelling, and stiffness characteristic of tendonitis.

While tendonitis can affect tendons throughout the body, it is particularly common in the foot and ankle due to the repetitive nature of walking, running, and standing.

Who Is Most at Risk for Tendonitis?

Tendonitis most commonly affects adults over the age of 40, as tendons naturally become less flexible and more prone to injury with age. However, it is also frequently seen in athletes and physically active individuals of any age. Key risk factors include:

• Participating in activities that involve repetitive foot and ankle movements, such as running, cycling, tennis, golf, or basketball
• Rapidly increasing the intensity or duration of exercise without adequate conditioning
• Occupations or hobbies that require prolonged standing, walking, or use of repetitive motion (gardening, painting, hair styling)
• Wearing footwear that does not provide adequate support for your foot type
• Having biomechanical irregularities such as flat feet or high arches that place excess strain on specific tendons
• Prior tendon injury or incomplete rehabilitation from a previous episode

Common Types of Tendonitis in the Foot & Ankle

• Achilles tendonitis — affecting the tendon that connects the calf muscles to the heel bone, causing pain at the back of the heel and lower leg
• Posterior tibial tendonitis — affecting the tendon that supports the arch, often associated with flat feet and causing inner ankle pain
• Peroneal tendonitis — affecting the tendons along the outer ankle, often resulting from ankle instability or repeated sprains
• Extensor tendonitis — affecting the tendons on the top of the foot, causing pain with walking or during activity
• Flexor tendonitis — affecting the tendons on the bottom of the foot or toes, producing pain and limited toe movement

Symptoms of Tendonitis

Tendonitis typically presents as:

• Localized pain at or near the affected tendon, often worsening with activity
• Stiffness and reduced range of motion, particularly noticeable in the morning or after periods of rest
• Swelling, warmth, or tenderness along the length of the tendon
• A gradual onset that worsens over time if left untreated
• In some cases, a sudden sharp pain if a partial or complete tendon tear occurs

How Is Tendonitis Treated?

At New Canaan Podiatry, Dr. Tauber evaluates your condition thoroughly using in-office diagnostic ultrasound and digital X-rays when needed to assess the tendon and identify the extent of injury. Treatment is then customized to your specific tendon, activity level, and goals. Options include:

• Initial RICE protocol (Rest, Ice, Compression, Elevation) to reduce acute inflammation
• Nonsteroidal anti-inflammatory drugs (NSAIDs) for pain management
• Corticosteroid injections to reduce significant inflammation in targeted cases
• Physical therapy to restore flexibility, strength, and proper movement patterns
• Custom orthotics to correct biomechanical issues placing excess strain on the affected tendon
• MLS Laser Therapy to accelerate tendon healing and reduce inflammation non-invasively
• Acoustic Wave Therapy to stimulate healing in chronic or stubborn tendon conditions
• Cryotext Therapy for post-treatment recovery and swelling management
• Bracing or immobilization for severe cases
• Surgical repair for complete tendon tears that do not respond to conservative care

Frequently Asked Questions