woman holding top of footExtensor tendonitis is a form of tendonitis that develops on the top of the foot where your tendons attach to your toes. The extensor tendons are responsible for lifting your foot when you walk or run. They also allow you to wiggle your toes. The skin over the extensor tendons is very thin and unprotected from muscles or fatty tissue. This makes them more susceptible to injury.

What Causes Extensor Tendonitis?

Stress and pressure on the tendons can cause this condition. The pain builds gradually over time through use of the injured tendon. Several factors can put you more at risk for this condition:

  • Spending too much time on your feet
  • Repetitive motion, typically through exercise
  • Wearing shoes that are too tight, particularly if you’re physically active.
  • Running uphill and downhill can be particularly problematic in the development of this condition.
  • Tight calf muscles can contribute to this condition.
  • Also, commonly found in dancers, skiers, and figure skaters.


Some of the signs and symptoms of extensor tendonitis include:

  • Redness, warmth, and swelling at the front of the foot.
  • Stiffness in the joint around the tendon
  • Problems moving your toes
  • Pain and discomfort on the top of the foot, most often during physical activity
  • Numbness or tingling around the tendon
  • Crepitus, which is a crunchy feeling or sound over the tendon


Your podiatrist will ask you about symptoms, conduct a physical examination, and take an X-ray to rule out a fracture. To learn about further damage an MRI may be ordered.


Treatments for extensor tendonitis are primarily focused on reducing the inflammation and typically take two to four weeks to heal.

  • Rest
  • Application of ice
  • Anti-inflammatory medication
  • Steroid injection
  • MLS laser therapy
  • Wearing shoes that are supportive and designed for the sport you engage in.
  • Custom orthotics if foot imbalances are part of the reason for the tendonitis
  • Stretching tight calf muscles – tight calf 
  • Physical therapy


  • Get your feet measured when you buy new shoes to ensure a proper fit. Purchase new shoes every 500 miles.
  • Avoid activities that aggravate the extensor tendons such as running up and down hills.
  • Custom orthotics can prevent reoccurrence.
  • Exercises to strengthen the top of the foot.
Dr. Rion Berg
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A podiatrist in North Seattle treating families for over 40 years.