Extensor Tendonitis: Ankle and Foot Pain Causes and Treatment

Extensor Tendonitis is a common foot and Ankle condition involving tendons. A tendon is a strong connection from muscle to bone in order to create movement, in the case of the foot there are extensor tendons that create an extension or lifting of the toes. The extensor tendons attached the lower leg and ankle to the toes.  A swollen extensor tendon from injury is referred to as tendonitis, degeneration of tendon from chronic injuries is called tendinopathy. Tendonitis is one of the most common causes of foot pain. Treatment and causes of tendonitis are discussed below.


Overuse injuries in sports such as tennis and running that require repetitive movements of the ankle and foot and over time can cause tendonitis, which will require treatment. The extensor tendons are just under the skin and can be become easily compressed by tight-fitting shoes which causes friction and eventually tendonitis.

Common sports for foot pain and tendonitis include:

  • Running
  • Hockey
  • Tennis
  • Ballet
  • Football
  • Soccer

Extensor tendinopathy occurs when the cause of the tendonitis isn’t addressed with proper treatment long enough for degeneration to occur.

Early warning signs or risk factors for tendonitis include poor foot toe extensor control, limited big toe extension, excessive uncontrolled foot pronation, and limited dorsiflexion.

Most common extensors to have tendonitis:

  • Extensor hallucis longus
  • Extensor digitorum longus
  • Extensor hallucis brevis
  • Extensor digitorum brevis
  • Tibialis anterior


Tendonitis of the foot extensors comes on slowly over time and usually causes the top of foot pain. Foot pain is usually felt over the extensor tendons directly over the shoelaces.

Pain includes:

  • Lifting toes or dorsiflexion
  • Mild swelling
  • Foot pain worsens during exercise


Conservative treatment is most effective, and surgery is rarely required to treat tendonitis. The first goal to treat tendonitis is to decrease the load to the foot causing the tendonitis in the first place.


  • Activity modification during healing process such as non-weight bearing exercises (pool)
  • Increasing dorsiflexion
  • Increasing big toe extension to 70 degrees
  • Ability to lift each toe separately like playing the piano
  • Foot strengthening exercises
  • Proprioceptive exercises
  • Treat and normalize fascia of the foot

Our editorial practices include evidence-based practices, interventions, and recommendations.


YOU should be able to move the way you’d like to move without experiencing pain. YOU should be able to experience freedom and energy knowing there’s nothing holding back from giving your life 110%. Dr. Dean would like to learn more about your challenges with a quick phone or email before beginning treatment. Contact him today.