Tendonitis is an inflammation of a tendon caused by an injury.
Muscles end as tendons, and it is the tendons which allow muscles to attach to the bones or joints of the body. You can easily see tendons on the back of the hand, or top of the foot, by moving a finger or toe. The tendon moves back and forth as you move the finger or toe. Most of the tendons in the feet, especially those on the top, are very close to the skin and are not well protected. Thus, they can easily be injured.
Injuries which frequently cause tendonitis include:
1) Twisting injuries of the foot and ankle.
2) Dropping an object on the foot (it does not have to be a heavy object, all it has to do is hit the tendon directly).
3) Tight shoes.
4) Tying shoe laces too tightly.
5) High heel shoes (especially if you are not used to wearing them).
6) Overdoing any weight-bearing activity, such as running too far.
If there is a cut or break in the skin associated with a tendon injury, see a doctor immediately. Tendons have few blood vessels, and an open wound down to the tendon can cause a severe infection. Because of their poor vascularization tendons heal slowly.
Self Treatment should begin immediately after the injury, with a careful examination of the foot.
1. Make sure that the tendon is not torn through and through. If it is severed, you must see a doctor immediately so that the tendon can be repaired. Severe injuries can sever a tendon, without a skin laceration being present. Testing involves moving the toes and foot to see if the tendon moves. If the tendon does not appear to move, it may be severed (comparing the injured tendon and its movement to the same tendon on the un-injured foot may help).
2. If there is extreme swelling and pain (out of proportion to the amount of trauma received), you may have sustained a vascular injury. This type of injury must be seen immediately by a doctor. If you are not sure, see a doctor.
3. If you have multiple injured areas see a doctor immediately, in order to prevent excessive swelling and pain.
If the above exam is negative, then you may proceed with self-treatment.
4. The sooner you begin to treat your injury by following "R.I.C.E.", the better you will feel:
a. Rest is very important. Take off your shoe, get off your feet, and relax.
b. Ice should be applied as soon as possible. Never apply ice directly on the injurued area, as the cold may make the pain worse. Ice should be applied close to the injured site, between the heart and the injury, so that as the blood flows under the ice, it will be cooled. This cool blood flowing into the injured area will help to reduce the swelling and pain. Apply the ice, wrapped in a cloth or over an elastic bandage, to the foot for 30 minutes, every 2 hours, for the first 3 days after an injury. Do not apply ice on the toes. If the ice is uncomfortable, or causes increased pain, do not continue to use it, and see a doctor immediately. If you have poor circulation do not use ice, as this may cause a serious problem.
c. Compression is used to limit swelling, and to give support to the injured area. Compression should be applied to the entire foot, starting first at the toes and working back to the ankle. If it is applied just to the injured area, increased swelling will occur in front and behind the wrapping. Compression should be applied with a 3 inch elastic bandage, begining around all the toes, and then going around the foot and ankle. Compression reduces motion in the injured area and foot, and this decreases the pain, and allows for quicker healing. The bandage should not be so tight that it causes increased pain or throbbing in the toes or foot. It should be comfortable! Do not remove the elastic bandage for the first 12 hours, unless it becomes to tight, or the pain increases, or the toes become pale, blue, or cool. If any of these things happen, immediately remove all bandages, and leave them off for several hours. The normal color and temperature of the toes should return immediately. If not, see a doctor immediately! Continue until the swelling and pain subsides; it could take from several days to several weeks.
d. Elevation of the leg will aid in reducing swelling and pain. Blood rushes to an injured area to bring increased blood cells which aid in healing. Gravity will also force blood to the injured area. Too many cells and too much fluid will apply pressure to the injured nerves and tissues, and cause increased pain and delayed healing. Keep your foot elevated so that it is at least parallel to the ground, or higher if it is comfortable. Do this for at least 48 hours, or until the throbbing subsides, when you lower the leg.
5. Healing will occur more quickly if there is no pressure on the injured tendon, and if the foot is at least partially immobilized. Our Injury Shoe is designed to keep all pressure off of the toes and foot, and allows you to walk without bending the foot. This will partially immobilize the injured tendon, allowing it to heal more quickly. This shoe will decrease healing time and pain. In 30 years of private practice, I have found that this shoe will reduce healing time by half, and allow you to be more comfortable while healing is occurring. We will ship this shoe to you by Priority Mail at no additional charge.
6. Do the above for at least 3 days. If there is no improvement, or if the symptoms become worse, see a foot and ankle specialist immediately. If you see gradual improvement, it is suggested that you continue the above course of treatment until the pain and swelling are gone. It can take inflammed tendons 2 to 4 weeks to heal, so be patient!