What’s Causing Pain On The Top Of My Foot?

Last updated: 09-19-2020

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What’s Causing Pain On The Top Of My Foot?

One complaint we hear in our office from time to time is that a patient is experiencing pain on the top of their foot. This then leads to a couple of follow up questions, including whether or not the patient suffered an acute injury or if activity makes the problem worse. If they haven’t suffered recent trauma to the foot and they mention something along the lines of pain worsening when they run or participate in sports, we generally have a decent idea at what could be causing their pain.

The problem they are likely dealing with is known as extensor tendinitis, and it’s caused by inflammation of the extensor tendons that run along the top of the foot. Today, we take a closer look at this condition, as well as how it is treated.
Symptoms of Extensor Tendinitis

Symptoms of extensor tendinitis include:

Pain on the top of the foot
Pain that is made worse when running and that is relieved with rest
Swelling on the top of the foot
Symptoms may be felt when the tendons are stretched, which occurs when the toes are curled

Extensor tendinitis is generally caused by overuse, but it can also be exacerbated by ill-fitting shoes that put too much pressure on the top of your foot. Some people also notice an uptick in symptoms if they change their running habits, like by doing more uphill running or treadmill running.
Extensor Tendinitis Diagnosis and Treatment

Diagnosing the condition is rather straightforward. The most common test a foot specialist will perform is called the resisted dorsiflexion test, where the doctor places downward pressure on the top of the foot while the patient tries to pull their foot upwards. If this causes pain, it’s likely that the extensor tendons are inflamed or damaged. A specialist may also order an x-ray to rule our a metatarsal fracture.

Once you’ve been diagnosed with extensor tendinitis, your doctor will walk you through your treatment options. Treatment is handled conservatively with the goal of reducing inflammation in the tendon. Treatment options include:

Rest
Cold therapy
Compression wraps
Anti-inflammatory medications
Finding a shoe that is looser fitting on the top of the foot
Not lacing your shoes too tightly

Once pain has subsided through conservative measures, treatment will shift towards physical therapy to strengthen the extensor muscles. Your doctor can set you up with a physical therapist or physical therapy exercises to strengthen the area. It’s important to remember that these stretches and exercises should be pain free. Since the condition is often triggered by overuse, if therapy is causing pain, you might be doing more damage that good, and you should circle back to the conservative treatment options listed above.


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