Tendons are fibrous bands that attach muscle to bone. Swelling or inflammation of the tendon is called tendonitis. Tendonitis can occur in many different places in the lower extremity. Achilles tendonitis and posterior tibial tendon dysfunction (PTTD) are the most common ones that affect the legs and feet. 

The Achilles tendon is a large tendon that connects your calf muscles to your heel bone. Achilles tendonitis pain may occur at the insertion of the tendon or just above the insertion at its weakest point. The pain in your heel might extend up to the middle of your calf or down into your foot.

The posterior tibial tendon courses through the inside of your foot around your arch. PTTD or Posterior Tibial Tendon Dysfunction occurs when the tendon becomes impinged, inflamed, or torn along its course. The posterior tendon helps hold the arch of the foot and opposes the muscle on the other side when you walk. Patients experiencing PTTD might feel like their foot is unstable when stepping down, may have trouble standing on their tippy toes, and may experience pain on weight bearing. Having flatfeet can worsen PTTD symptoms because the foot structure does not allow the tendon to function properly.



The first noticeable symptom of tendonitis is pain, especially when taking steps after rest. Pain that persists throughout activities should be explored. Swelling and inflammation may accompany the pain and worsen over time. Long standing tendonitis or tendon strain can lead to calcifications within the tendon, tendon tear, and/or loss of joint function. 



The most common causes of tendonitis are:

  • Overuse: This is the most common reason tendonitis develops. It usually means that you have stretched a tendon too far, causing strain. When this occurs, the tendon might pull apart or even tear. It often happens when you increase your activity level by walking, exercising, or playing sports with increased intensity.
  • Abnormal foot structure: Flat feet or high arches may cause an imbalance in the muscles starting or ending in the foot, causing tendon stress and strain.
  • Trauma: Foot or ankle injuries or sudden unexpected motion such as falling can cause the tendon the elongate unnaturally. Micro trauma, such as your foot rubbing against poorly fitting shoes, can cause pain on the top of your foot or the back of your heel.
  • Medical conditions: Conditions that cause general swelling or inflammation in the body can eventually lead to tendonitis. For example, rheumatoid arthritis or gout may be the culprit. 
  • Medications: Certain medications used to treat infections, cholesterol, and prescription anti-inflammatories may cause tendonitis or weakening of the tendon. Please let your doctor know if your medications have changed.


Diagnosis & Treatment

When diagnosing tendonitis, your doctor will ask about your medical history and may also order X-rays or MRIs. These imaging tests will help your doctor identify a broken bone, a build-up of calcium (calcification), or a torn tendon. Once your doctor knows the source of your pain, they will treat it appropriately.

The primary treatment of tendonitis in the foot and ankle is rest, ice, compression with an ACE wrap, and elevation. NSAIDs may help relieve swelling and pain.

If you are in the Chicago area and your pain and swelling do not get better with the R.I.C.E. method or it gets worse, you should seek medical attention from the specialists at Keir Foot & Ankle. Besides rest, your doctor might suggest other treatments such as:

  • A walking boot: This will help immobilize and rest the foot and ankle
  • Soft cast: This will help with inflammation and further immobilization.
  • Orthotics: This could range from recommending the right shoes to prescribing arch supports, inserts, or prescription braces
  • NSAIDs: Doctors may recommend Nonsteroidal anti-inflammatory drugs like ibuprofen or prescription-strength medications
  • Physical therapy: A physical therapist will give you stretching and strengthening exercises that might help to reduce the stress on the injured tendon


We will identify any foot abnormalities that might cause your pain. Then, we will prescribe you the proper treatment to find relief from your tendonitis.

If you have a foot injury or a condition that’s getting worse, don’t live with the pain.

Tendonitis Care at Keir Foot & Ankle Specialists

If you are experiencing tendonitis symptoms in Chicago, trust the experts at Keir Foot & Ankle.

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