Shin splints are a common ailment that affects runners, but another common complaint I hear is that people are suffering from pain on the top of their feet during or after a run. If you haven’t suffered a forceful trauma to the area, odds are it is being caused by an issue with the tendons on the tops of your feet. These tendons are known as the extensor tendons, and they run along the top of your foot to give you the ability to flex and straighten your toes. Pain in these tendons is likely due to inflammation, which can lead to extensor tendonitis.
Causes and Symptoms of Extensor Tendonitis
There are a number of biomechanical and physical causes of extensor tendonitis. Some of the more common causes are a combination of:
- Overtraining
- Tight calf muscles
- A falling of your foot’s natural arch
- Overlacing/tying your running shoes too tightly
- Wearing shoes that are too small
- Excess uphill running, common in treadmill runners
If you notice that your running shoes are putting abnormal pressure on the tops of your feet, upgrade to a bigger size or try loosening up the laces a bit to give the top of your foot some extra room.
As we mentioned above, the most common symptom of extensor tendonitis is pain on the tops of your feet when walking or running. Another symptom you may notice is swelling on top of your feet, or a noticeable bump somewhere along the top of your foot.
Diagnosis and Treatment of Extensor Tendonitis
Extensor tendonitis can be diagnosed with a physical exam and a series of tests. The most common test involves flexing your foot downward. A doctor will place his hand on the top of your foot and provide resistance as you attempt to flex your foot upwards. If that action causes you pain on the top of your foot, you’re probably dealing with extensor tendonitis
Treatment for pain on the top of your foot caused by extensor tendonitis involves a number of conservative options to take stress off the tendons. Based on the causes listed above, treatment strategies are pretty straightforward. Lace your shoes a little looser, buy a better fitting pair of shoes, scale back the distance or amount of running you’re doing, avoid running uphill for extended periods and make sure you really stretch your calf muscles before athletic activity. You can also care for your feet by icing your feet after a run to reduce swelling and by taking approved anti-inflammatory medications. If those treatments fail, talk to your doctor about custom orthotics, as they may be able to naturally shift your foot into a position that relieves the stress on the top of your foot.
If after a couple of weeks none of the treatment options have stopped the pain, you may need to head back in to the doctor’s office. Extensor tendonitis usually resolves with conservative treatment, and continued pain could be a sign of another issue in that area of your foot, like a metatarsal stress fracture or gout. For more information, contact a foot specialist.