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Everything You Should Know About Extensor Tendonitis

Overview

Key points

  1. Extensor tendonitis affects the tendons in your hands or your feet.
  2. You can usually treat extensor tendonitis with home care.
  3. Surgery may rarely be needed to treat this condition.

Extensor tendons are in your hands and feet. The extensor tendons in your hands help you move your fingers, thumbs, and wrists. The extensor tendons in your feet attach the muscles at the front of your legs to the toes and run across the top of your feet with very little padding to protect them from a variety of injuries. These tendons have an important job and are in vulnerable locations.

If you’ve been diagnosed with extensor tendonitis, an inflammation of the tendons, in your feet, it’s likely because you spend a lot of time on your feet or wearing shoes that are too tight. If you have extensor tendonitis in your hands, it’s usually due to excessive use of the tendons in a short amount of time, or from sports or other activities that use the wrists.

There are many simple solutions that can relieve extensor tendonitis symptoms, as well as some more involved therapies to treat this common injury.

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Symptoms

Symptoms

The main symptom of foot extensor tendonitis is pain on the top of your foot. The discomfort is usually felt around the midpoint of the dorsal (top) of the foot. You may experience extensor tendonitis in both feet, but often only one foot is affected. The pain usually builds gradually as use of the injured tendon continues.

The tendons may also become weaker. This weakness can affect your ability to move your toes or to push off from your toes when you jump, dance, or run. Running or simply being on your feet for an extended period of time may make the pain worse.

Extensor tendonitis in your hand causes pain and stiffness in the top of your hand, often around the wrist. You may also feel numbness or tingling in this area.

Causes

Causes

Foot tendons can be irritated if they rub against shoes that are too tight. If you run and your running shoes or laces are pressing too hard against the tendons, the tendons can become inflamed. Overuse can also cause foot extensor tendonitis. Running uphill is a common culprit.

Inflammation in the hand is usually caused by overuse. For example, a major landscaping or home improvement project that requires excessive work with your hands can strain the tendons. Sports that involve a lot of throwing or other wrist action can tax the tendons, as well. You may be at greater risk for an injury if the muscles and tendons in your hand aren’t used to a lot of work.

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Diagnosis

Diagnosis

If you experience pain in the top of your foot but it goes away after a day or so of rest, it may be a case of mild inflammation. If the pain lingers for days and is made worse when you are active or wear certain shoes, you should contact your doctor.

Extensor tendonitis is a fairly common condition, so your primary care physician or a doctor at a walk-in clinic may be able to diagnose your problem. You may also need to see a podiatrist, a doctor who specializes in feet, or an orthopedist, a doctor who specializes in foot and ankle injuries.

At the appointment, your doctor will ask you about your symptoms and do a physical examination. Sometimes an X-ray may be done to make sure there are no fractures causing your pain. In serious cases, other imaging tools may be used. These include ultrasound and magnetic resonance imaging (MRI), which provide detailed views of tendons, muscles, and other soft tissue. These other screenings can be helpful in making sure no other tendons or muscles are injured, or to identify other areas of the foot that might need medical attention.

Treatment

Treatment

Resting the sore tendons is recommended for both hand and foot extensor tendonitis. Icing the area may also ease the symptoms of inflammation.

You may also want to use nonsteroidal anti-inflammatory drugs (NSAIDs) to help relieve the pain.

Stretching and strengthening exercises are the main ways to regain tendon strength and flexibility, as well as a healthy range of motion. Calf stretches can help tendons in the feet. Tight calves can cause more strain to be placed on the extensor tendons.

Read more: 4 leg stretches for flexibility »

Depending on the seriousness of the tendonitis, physical therapy (PT) may be necessary, both for the feet and hands. PT can help you learn a variety of stretches and strengthening exercises, and can include treatments such as ultrasound to help heal your tendons.

Steroid injections may also be an option for the feet and hands, but these are only used in very serious cases. These injections can weaken the tendons temporarily, which could put them at greater risk for injury in the short-term. The injections may also restrict use of the hand or foot.

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Complications

Complications

Unfortunately, not all cases of extensor tendonitis can be treated with ice, rest, and other non-invasive means. In these cases, where the tendons are so badly damaged or they just don’t respond to other treatments, surgery may be necessary.

Like any operation, tendon surgery carries risks of infection, bleeding and complications from anesthesia. In general, however, the surgery is well tolerated and successful in restoring strength and a range of motion to the tendons. The healing time can take up to several weeks before you can start to resume normal activities with the injured hand or foot. Physical therapy is usually needed after this type of surgery.

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Recovery

Recovery

Your recovery period will depend on the severity of the tendonitis and how well it’s treated. If you’re able to avoid stress on the affected foot or hand, and can keep from overusing those tendons for a few days, you may be able to start some stretching and strengthening activities within a week.

If the injury is in your foot, you may need to avoid certain activities, such as running uphill, for a period of several weeks. Follow the advice of your doctor and your physical therapist, but also listen to your body. If you try an activity and the pain from inflamed tendons flares up, you should stop and not try to push through the pain.

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Outlook

Outlook

Extensor tendonitis in the hand or foot is usually a temporary problem that goes away with rest, ice, and other treatments. Having extensor tendonitis once doesn’t make it more likely that you’ll have the same problem again. You should be aware of what activities and footwear can lead to tendon injuries to help you avoid future injuries.

Tendonitis shouldn’t sideline you for too long. If you don’t treat the problem correctly the first time, however, it could become a recurring problem.

Prevention

Prevention

Healthy feet rely on properly fitted shoes that provide support and don’t irritate the top of the feet. Your shoes should match the activity for which they were designed. In other words, if you run, get a good pair of running shoes.

To avoid extensor tendonitis in the hand, keep your hand muscles and joints strong and flexible. A sudden increase in activity, such as a major house cleaning or giant landscaping project, can cause problems. Take breaks and pay attention to signs that your tendons may be under strain.

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