When we talk about tendinitis of the foot, in the vast majority of cases, we refer to the acute inflammation of the Achilles tendon, corresponding to the fibrous “cord” present in the back of the ankle, which connects the calf muscles to the calcaneus bone.
The foot area is constantly subjected to strain and movement, and this makes it more prone to inflammation, problems and sprains. Tendinitis (also called achilles tendinopathy), can be extremely annoying and painful. In severe cases, some individuals may also experience a tendon rupture.
Runners, dancers, avid or improvised sportsmen are undoubtedly among the categories of people most at risk of being affected by tendinitis of the foot due to the high acute and chronic mechanical stress they impose on this part of the body. But they are not alone.
Even people who are moderately not very active such as the elderly can experience episodes of inflammation and pain such as to prevent walking for a few days. In this case, at the origin of the problem there are mostly situations of osteoarthritis or arthritis affecting the ankle joint which, involving an unergonomic use of the foot, contribute to irritating the Achilles tendon.
Not surprisingly, it is frequent that inflammation of the tendon can be caused by problems attributable to the anatomy of the leg, foot, and posture. For example, a disease such as rheumatoid arthritis can lead to the development of hollow foot: a malformation that, in addition to causing pain in the foot, can compromise the way you walk and maintain a correct posture.
A further category that tends to be sedentary that, at any age, is exposed to an increased risk of developing this and other forms of foot tendinitis is made up of overweight or obese people, due to the extra workload and mechanical stress imposed on the foot and ankle at practically every step.
If the Achilles tendon is subjected to excessive effort, and with repetitive movements, it can undergo slow but inexorable wear. With excessive weakness, in fact, the anatomy of the foot may not be able to withstand the weight of the body, also risking to cause an injury.
Finally, even infections, fortunately rarer, can affect the skeletal system, and consequently also the tendons, causing problems and inflammation.
How to sedate inflammation and pain
Regardless of the specific cause, tendinitis of the foot is recognized by the gradual onset of acute inflammatory pain, exacerbated by the movement of the affected tendon and, in particular, by flexion and distension, especially under load. In mild-to-moderate cases, the discomfort may be modest, but when tendinitis worsens it becomes difficult to walk or even put on shoes.
In addition, continuous and prolonged effort, during inflammation of the Achilles tendon, could also cause pain in the surrounding areas. The muscular apparatus of the leg, for example, could be affected, as well as the knee joints.
Fortunately, most of the tendinitis that can arise in daily life is not serious and can be alleviated by keeping the foot at rest for a few days.
You can apply ice to reduce swelling and non-steroidal anti-inflammatory drugs (NSAIDs) for pain and inflammation, you can choose between topical formulations, such as ibuprofen-based gel, or swallowing tablets, always based on ibuprofen or naproxen sodium.
Self-medication therapy with NSAIDs is usually 4-5 days, after which it is good to seek medical advice where the pain persists. It is good to consult a specialist even if painful episodes are frequent, perhaps as a result of physical activity or long periods spent standing, to avoid the presence of articular or anatomical alterations that predispose to the onset of tendinitis. In both cases, you can make use of common over-the-counter formulations, which can be purchased in pharmacies, without a prescription.
A medical consultation becomes, however, important when the pain is objectively very intense and is not attenuated by topical NSAIDs or by mouth (for example, ibuprofen or naproxen sodium tablets), taken for 3-4 days at the dosages indicated on the packages or by the pharmacist.
In these cases, it is important to check that the tendon is not injured: if so, more invasive treatments (surgery) will have to be planned. But it should be noted that this is a fairly rare eventuality that, in general, concerns only those who have suffered a trauma or have practiced a very intense sporting activity for a long time, improperly or with unsuitable footwear.
Surgery, in the case of tendon rupture, consists in repairing the lesion by means of a special suture. Without it, the tendon may not be able to compensate on its own and completely, causing recurrences and frequent recurrence of pain, especially in more active patients.
An orthopedist or a sports doctor should be consulted even if a tendinitis of the foot of a certain importance often recurs, causing frequent interruptions of sports or work activity. In these cases, it is necessary to understand if there are articular or anatomical alterations at the level of the ankle or foot that predispose to the onset of tendinitis. The instrumental investigations useful for this purpose are radiography, ultrasound and magnetic resonance imaging (the latter, in reality, necessary and appropriate only if it is assumed to intervene surgically to repair a significant lesion of the Achilles tendon).
Once the symptoms have been verified, and the necessary tests have been performed, the orthopedics specialist will be able to recommend the most suitable strategies to relieve pain, and bring the tendon back to an excellent state of health.
In some cases, an ultrasound treatment may be recommended, directly on the painful area, to try to decrease the discomfort and inflammatory state.
Additional precautions
After a tendinitis of a certain importance and in case of recurrent tendinitis, it may be useful to provide a cycle of physiotherapy aimed at strengthening the supporting muscles of the foot and ankle, in addition to the tendon itself, and to learn a more ergonomic support and walking technique.
Physiotherapy is especially recommended for the elderly who, precisely because of their age, have weakened support muscles, less toned and elastic tendons and ligaments and compromised joint tissues. Targeted exercise will make walking safer, also helping to reduce the risk of falls, with potentially very negative outcomes in old age.
An additional help, useful for all ages, is instead represented by the shaped insoles to be inserted in the shoes to better support the arch and reduce the stresses transmitted to the Achilles tendon and to the tendons of the extensors of the fingers.
For people who have suffered from tendinitis or other foot disorders in the past, such as plantar fasciitis, it is advisable to implement daily prevention strategies. For example, the use of heeled shoes could strain the sole of the foot excessively, leading to the onset of posterior tibial tendinitis.
Preventive measures, recommended especially for those who habitually practice a sports activity that involves the foot, but beneficial for everyone include:
- choose comfortable footwear, which adapts perfectly to the foot, and replace them periodically
- alternate the type of physical activity practiced, providing training sessions that do not stress the foot
- precede each workout/competition with a warm-up phase and perform stretching exercises of the foot / ankle at the end
- Before starting to practice a sport (including running) contact an experienced instructor to learn the correct technique and the appropriate use of the equipment
- choose and adapt sports equipment to your physical characteristics.
Joycelyn Elders is the author and creator of EmpowerEssence, a health and wellness blog. Elders is a respected public health advocate and pediatrician dedicated to promoting general health and well-being.
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