The extensor tendons to the foot come from the relatively small muscles in the front of the leg. The two main extensor muscles are the Extensor Hallucis Longus muscle (EHL) and the Extensor Digitrorum Longus muscle (EDL). The tendons from these muscles cross the front of the ankle, pass across the top of the foot and attach into the big toe (EHL) and lesser toes (EDL).
These tendons function to pull the foot upward and work with resistance from the Achilles tendon and the calf muscles (flexor muscle group) that pulls the foot downward.
When these tendons become over stressed they become inflamed and painful. Swelling may accompany the inflammation. Most commonly it is the extensor tendon to the big toe (EHL) that is affected. In other instances the extensor tendons to the lesser toes (EDL) is affected. The most common factors that cause extensor tendonitis are excessive tightness of the calf muscles, over exertion during exercise and falling of the foot arch. A simple test to determine if the pain on the top of the foot is due to extensor tendonitis is to flex the foot downward and have a friend provide resistance to the top of the toes. Try to pull the toes upward against resistance. If you experience pain across the top of the foot or along the course of a tendon on the top of the foot then the diagnosis is likely extensor tendonitis.
In mild cases of extensor tendonitis treatment consists of calf muscle stretching and oral anti-inflammatory medications. In more sever cases treatment may include a removable below the knee cast, calf muscle stretching and oral anti-inflammatory medications. Many podiatrists may also recommend long term treatment with inserts for the shoes called orthotics
Other conditions that mimic the symptoms of extensor tendonitis are metatarsal stress fracture, atypical gout and degenerative arthritis. For further information consult with your podiatrist.
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