After a multiyear layoff, I recently decided to resume running. Rather than ease myself into a new running regime, I set off – all guns blazing – on a 5K run, only to find myself hobbling the last kilometer back home.
Something had happened to my ankle. I didn’t realise at the time, but this was a classic case of peroneal tendonitis.
When I finally completed my hobble of shame, I took a shower. Afterwards, as I attempted to walk downstairs I found that I couldn’t put any weight at all on my right ankle. It was really sore around the knobbly bone of the ankle. I knew that I’d injured myself.
It wasn’t all bad news though – as it prompted me to begin a stretching program that has transformed my lower body flexibility as well as my running performance.
A comprehensive stretching regime that includes ballistic and static stretching will not only help your tendonitis to heal, but it will help prevent future recurrences.
What is Foot Tendonitis?
There are three types of foot tendoinitis, named after the three main tendons in the foot: peroneal tendonitis, extensor tendonitis and achilles tendonitis.
If you don’t already know, tendons connect our muscles to our bones. They enable our muscles to exert force across the joints between our bones. This is how we move our bodies.
Let’s look at each type of foot tendonitis individually:
There are two peroneal tendons on each leg: a short tendon and a long tendon.
They run down the side of your shed and behind the lumpy bone on the outside of the ankle.
One peroneal tendon attaches to the base of the little toe, while the other stretches underneath the foot and attaches to the inner arch.
The main function of the peroneal tendons is to stabilize the ankle.
Common symptoms of peroneal tendonitis are:
- instability of the ankle when bearing weight
- swelling at the back of the ankle
- pain when turning the foot in / out
- warm to touch
The extensor tendons in the foot enable you to move your toes. They attach the muscles at the front of your leg to your toes.
Because they run across the top of your fault they have very little protection.
Common symptoms of extensor tendonitis are:
- Pain at the top of the foot
- Visible swelling on the top of the foot
- Stiffness when moving toes
- Crunchy feeling / sound when pressing the tendon
Achilles Tendonitis / Tendinosis
The achilles tendon is the longest and strongest tendon in the human body.
It connects the calf muscles to the heel bone.
You’d be forgiven for thinking that because it’s the strongest tendon in the human body it would also be the least prone to injury.
But because of the high tension it operates under as well as having a limited blood supply, it is a common point of injury.
Common symptoms of Achilles Tendonitis are:
- Stiffness at the back of the heel
- A mild ache that gets worse over time
What Are The Causes And Risk Factors For Foot Tendonitis
So while we have three different types of foot tendonitis, it probably won’t surprise you to learn that they are all caused by the same issues:
- A sudden increase in walking or running activities
- Poor training techniques
- Imbalanced muscles in legs and feet
- Poor fitting shoes
- Lower limb joints and muscles not working synchronistically
It’s the last point that I’m particularly interested in, especially given my experience in the introduction to this article. We’ll look at that in more detail a little later.
How is Foot Tendonitis Treated?
Many medical practitioners recommend that foot tendonitis be treated by the RICE protocol, which, in case you don’t know is:
- Rest – rest until the tendon injury is healed, this could be weeks.
- Ice – use a cold compress or ice on the area affected.
- Compression – bandage the injured tendon to provide support and restrict movement.
- Elevation – keep the affected limb higher than your heart, if possible.
Despite the continued popularity of the RICE protocol, The Sport Journal recently issued a review and recommendation where they contend that the RICE protocol is a myth.
They go on to say that it is completely ineffective and that movement is actually key to facilitating accelerated healing.
If rehabilitation (which we’ll discuss in the next section) isn’t successful, surgery can be the only remaining option. It’s generally the case that tendon surgery is successful and can restore strength and range of motion.
Recovery time from surgery is expected to be 4 to 6 weeks.
Steroid injections are rarely used for foot tendonitis as they can lead to a higher risk of tendon rupture.
Does Stretching Help Foot Tendonitis?
I was interested to see what scientific research has to say to this question. What I found is interesting.
For instance, this study on the role of stretching in tendon injuries concludes:
Recently, it has been shown in humans that a static stretching programme has no influence on tendon stiffness. By contrast, a ballistic stretching programme can increase the compliance of tendons. Therefore, findings have implications for the prevention and treatment of tendon injuries, and both ballistic and static stretching should be incorporated in the prevention and treatment programmes for tendon injuries.
But it’s not exactly a clear picture.
This 2011 systematic review looking at the effectiveness of manual stretching in the treatment of plantar heel pain concluded that there were “…too few studies to assess whether stretching is effective compared to control or other interventions.”
But it also stated that “…there is some evidence that plantar fascia stretching may be more effective than Achilles tendon stretching alone…”
So the science is not saying that stretching doesn’t help, just that there aren’t enough properly conducted studies to say categorically that it does.
Regardless of what the science says, stretching and strengthening exercises form the main part of rehabilitation protocols that are recommended by healthcare professionals.
Patients will be given a variety of stretches, including calf muscle stretches as well as strengthening exercises in order to restore the tendon and it’s function.
They do this because stretching works.
I wonder how many cases of foot tendonitis could have been prevented had the patient invested a little bit of time each day to stretch their legs?
I know my own case of peroneal tendonitis would have never occurred if I had been stretching on a daily basis…
…and had I gently re-introduced running int my fitness regime rather than thinking I was Mo Farah!
So we’ve looked at what foot tendinitis is and we’ve learned that stretching is an effective treatment for it.
Stretching also helps to prevent foot tendinitis in the first place.
However not all stretches are equal and the science suggests that ballistic stretching is the most effective for tendon health.
If you want to learn about the stretching program that I followed which has transformed my flexibility and radically improved my quality of life, then read my review of the Hyperbolic Stretching program.
This program is built around ballistic stretching, with a predominant focus on the lower body, so it is ideal for treating foot tendonitis.
Read our review of the Hyperbolic Stretching Program and learn how we got flexible fast.