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Extensor tendonitis March 13, 2007

Posted by RegiVizz in Injury, Running, Shoes.
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The 25K went well, but I think I may have laced my left shoe too tightly.  The result: extensor tendonitis?  Maybe?  I’m keeping ice on my foot all day, so we’ll see if that helps.

Yesterday after work, I changed into my running clothes and laced up my shoes…or tried to lace up my shoes.  With a not-so-dull pain on the top of my foot, I knew I wouldn’t be running far.  First though, I stopped at The Runner to see what they thought.  All prepared to buy some new shoes, they sent me away with nothing!  Instead he told me to try and run (I did 2 miles) to see if that would help.  He also said to ice it and take some ibuprofen, so that I did (and am doing). 

No run today, no run tomorrow and I’ll try a short run on Thursday.  Maybe the tongue of my shoe is too thin?  Seems like it might be much thinner than when I bought them. 

I’ve got about 250 miles on these, so maybe it’s time to start breaking in a new pair?  I think I may stop and buy some this afternoon…I mean…if I’m not running, I’ve got nothing better to do right?  :-)

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1. Eric - March 13, 2007

I had major issues with the outside of my right foot when I first started running. Mine was actually because I wasn’t tying my shoes up good enough, and my heel was bouncing around. It took about a month to finally go away. I also made sure to be really careful how I ran on it.

Granted yours is a bit different pain, maybe you should get it checked out also to make sure it’s not something major.

2. zappoman - March 13, 2007

Interesting… I did a 7.5 mile run today… and right out of the gate, the top of my left foot felt a little funny… I was thinking (hmmm… it almost feel like my shoe laces are different between my two feet)… Me being the macho Ironman that I am, I just kept running.

But the truth is, I am a running newbie… and so I just never realized that shoe lace tightness could cause an injury.

Tell me more!

3. tixxx - March 13, 2007

I that when you feel the pain to SMILE, it will convince yourself that it hurts less… no wait, that’s for fatigue !!

Seriously, I think I suffer from the same problem. I solved it though by simply wearing shoes a half size larger than usual, loosening them up, and slapping around in them as my foot strikes the ground. It sounds worse than it is and I got used to the loose feel relatively quickly. It actually allows the foot to expand naturally as it strikes the surface, without undue restriction.

4. RegiVizz - March 14, 2007

I really really think I laced my shoe too tightly for the 25K. Looking up extensor tendonitis online, I found several places that says it can cause your tendon to become inflamed, causing pain on top of the foot, mid-foot. I kept ice on it all day yesterday and will do the same today. We’ll see how the run goes on Saturday…staying off of it and focusing on cross-training until then!

5. lsabin - March 14, 2007

I would check the laces. Maybe your feet are a little swollen. I sometimes feel like I need to make adjustments, especially if I am on my feet for several hours.

6. grinnbearit - March 15, 2007

For the first time ever i’ve been having achiness in my feet too – but i’m positive it’s because the road I run on is very uneven and it’s hard on my poor footsies. Good luck,hope you’re able to heal quickly!

7. Eric - March 17, 2007

I’ve also heard of people who have two sets of shoes, one for super long runs, and one for shorter…where the long ones are a half size larger…

8. Faithful Soles - March 18, 2007

I had a similar injury twice, except mine occurred in both feet when I ran too fast during a race, or ran a very hilly course when I had been training on flat ground. It takes a couple of weeks to get over it, and what I found was that barely lacing my shoes so that it almost felt like they were going to come off was the only thing that worked.

On a side note, I wanted to thank you again for linking to our running Blog Database on the main Faithful Soles web site, which has now grown to bloggers from 38 states in the USA and 21 other countries.

9. Kathy Cote - April 10, 2007

Hi, I just figured out that I have this extensor tendinitis and was wondering how long ot took you to recupperate? I bought new shoes a week ago today and the laces were too tight. I ran 5 miles that day and now my foot is killing me and I haven’t been able to rin since. I’ve been icing it and taking ibuprofen but really miss running:(

10. RegiVizz - April 10, 2007

Kathy: I laid off for about a week and a half, taking several days of icing my foot. Now I can do okay running, but if I lace my shoes too tightly, my foot lets me know really quickly! I suppose that means it isn’t fully healed yet, but well enough so that I can run on it. I’ll let it fully recover after my marathon on April 29th.

11. Kathy Cote - April 11, 2007

Good luck with your marathon! I’m training for a half marathon and am anxious to get back running but I think I will lay low until next week and see what happens. Happy Trails!

12. Jennifer - October 17, 2007

Sounds like you might have extensor tendinitis – it is from overuse and runs along the top of your foot. It almost feels like a bruise and can come and go but at times is difficult to walk. Rest is the one thing that will help, use of cold packs and anti inflammatories. Then I would suggest new shoes with plenty of stability and possibly orthodics. I can literally tell the minute my shoes start to run out of steam as the top of my left foot starts hurting again. The orthodics are expensive and most insurance companies do NOT pay for them. The podiatrist can also give you a shot (hurts like hell) right into the swollen tendon at the top of your foot of cortisone. That will take the edge off while you take your rest from running and the orthodics are being made. May sound like a lot however if you don’t fully address the problem your foot will never get better and give you problems for the rest of your running life – yikes! Good luck!!!

13. Robert - June 11, 2008

got this and licked it fairly quickly with two daily DMSO treatmenti
Ibuprofin, rest, and loosly tying my shoes. Three days later I’m rrunning pain free again. Good luck!

14. Cath - June 16, 2008

where do you get DMSO treatment from ??

I have had tentonitus in my 3rd, 4th and little toe which runs up to the top of my foot – i cant wear shoes and its been like this for a week.

Ive iced them and massage my Plantar Facia but they still hurt and i reall ywant to get back to running :(

Any ideas?>?

15. Laura - June 28, 2008

I also had pain in these extensors and went to the physio who correctly identified that the cause of this was actually the muscle down the front of the shin, which I hadn’t even noticed was rock solid and slightly strained from overuse. This was pulling on the extensor causing the pain. He loosened up the muscle through a rather painful massage and suggested I wear flight socks during exercise to keep a good blood supply to the muscle and to ice the muscle (not the tendon) regularly. (10 mins every hour) I also loosened up my shoelaces which helped.

16. Shakti Deh - July 30, 2008

I have had similar kind of pain recently, hurts when I bend my foot acroos the joint on the inside between the ankle foot. The sharp pain is due to two things, excessive pronation and wearing laces too tight. Solutions are more stable shoes, and straight bar lacing technique ( no criss cross overlaps as they create pressure points on the nerves and tendons). Final tip, do not lace up to the top, leave the last couple of eyelets, makes a massive difference.

17. Charlie Atkinson - September 16, 2008

This blog has been extremely helpful to me in that I am an aging but very active tennis player. Got fabulous orthotics a year ago which completely eliminated the pain from five knee surgeries. Wow.

But the orthotics required size 11 1/2 shoes 4E and I found that I had to tighten the laces excessively to keep from running around inside my shoes. As the Brooks Addiction Walker II deteriorated, I got even less support and tightened the laces even more.

Now I see that I most likely have extensor tendinities. That I need to massage my shins, that I need to not lace so tightly, need to get new shoes as necessary, which I just did, and then all of the other inflammatory and conservative management treatments.

Probably will tape the top of my foot and use something to reduce the constriction.

I think that it is not a stress fracture because I can find trigger points in the tendon. But I’ll check that out too.

18. mark - November 3, 2008

just finished a half and 9 mi in started to feel the pain. Ice, rest and putting a little padding under the toes/ball of teh foot dramatically reduced teh pain to barely able to walk to almost no pain. Next on teh list is slightly larger shoes and really watching the laces

19. mark - November 3, 2008

just finished a half and 9 mi in started to feel the pain. Ice, rest and putting a little padding under the toes/ball of the foot dramatically reduced the pain to barely able to walk to almost no pain. Next on the list is slightly larger shoes and really watching the laces

20. George - February 2, 2009

just a random question. Does anyone experiencing this problem have one leg shorter then the other? I do and I think that seems to be the problem….

21. Charles Atkinson - March 17, 2009

Well, I am slightly better off than last fall of 2008 but must now wear a splint at night to prevent extraordinary pain in my extensor tendinitis of the left toe.

It is clear that I have done such damage that I must get a cortisone shot which I have scheduled for early April. Also stretching, strengthening and massaging together with no tight shoe laces.

BTW, I had one leg shorter and the orthotics fixed that but I don’t think it had anything to do with my extensor tendinitis but it sure helped back and sciatic nerve pain.

While I can play tennis without much pain, I can’t sleep without a splint. This is actually pretty serious stuff.

22. Crista - March 30, 2009

I was misdiagnosed with a stress fracture by my podiatrist 3 years ago after increasing my running distance too quickly. I wore an aircast boot for 2 months along with ibuprofen, and an icing regimen. After the cast came off, the issue was just a bad and a new orthopedic surgeon diagnosed me with extensor tendonitis.

I did 2 months of physical therapy 3x per week and that did help to stretch tight muscles and retrain my body to take the stress off of my foot. I did end up getting 2 cortisone shots into the tendon area at the top of my right foot…ouch. Three years later the tendons will still swell and bruise if I overuse them and or lace up too tight.

My dr. said it would have been alot easier if I would have just broken my foot – it heals up faster.

So – take it seriously – baby those feet when you need to!

23. Joseph - April 23, 2009

Thank you al who have provided great information on this forum.

I suffer from what I just learned to be extensor tendonitis, with a half marathon nine days from now.

Again, thanks for all of the great information.

24. David - May 12, 2009

I think this may be my problem as well, although I have no pain in the top of my foot. Instead, my pain is localized above the fibrous band I think is called the Extensor Retinaculum??

I had a huge knot there between the bones, which Naproxen and regular icing have reduced. However, I still have what I can only describe as squeaking muscles around the site of the swelling when I flex my foot up and down.

Anyone else noticed this weird squeaking? Its not so much a noise as a feeling, so grating might be more appropriate…

25. joanne - June 23, 2009

Yes David I went walking 8 kl quick pace and after approx 6 kl got toes numbing kept walking. now i have same feeling in lower shin grating when i flex my foot . Any body have any idea how to fix this problem? Weight training I find hard when having to use my foot sometimes

26. tarkman1 - July 23, 2009

I’m not sure that orthodics help extensor tendinitis. Actually, I’ve seen that extensor tendinitis is more associated with supination than pronation. Mechanically, this does make a lot of sense.

I am dealing with extensor tendinitis right now (as far as a self-diagnosis goes). I got this on the first hard track workout (intervals) after putting arch supports in a new pair of shoes. I think the supports changed the mechanics of my foot strike. Namely, the arch supports are putting me more on the outside of the foot (towards where supination occurs) than normal. My foot wasn’t used to that.

Oh, I put in the arch supports after having a bout with shin splints. I probably overcorrected for my low arch with the arch supports when a new pair of shoes would have been an ample solution. My old shoes had over 300 miles. Oh, the part of the foot that hurts is pretty much directly above the front edge of the arch support.

My new idea for dealing with running related injuries is not to try too many corrections simultaneously.

27. tarkman1 - August 1, 2009

I think maybe I caught a bad pair of the new shoes. I looked at them from the back and saw one (on the injured side) was canted to the outside a few degrees. Actually, a doctor pointed that out. So it was probably the shoes and not the supports that was putting me on more than normal on the outside of the foot.

I did see a podiatrist. The foot lack of arch and the shoe combined with the distances and speed that I ran served to cause swelling and irritate a nerve in the foot. I didn’t have a neuroma. I didn’t have a stress fracture.

I spend a lot of time elevating the foot. I did Epson salt soaks. I did anti-inflammatories. The swelling is nearly gone. I’m back to running with different orthodics, a modest two miles to start. The jury is out on whether or not my feet will like them. The pain that characterized the injury is gone. Right now, the tendons on the toes 4 and 5 give me noticable discomfort on running. That could be from some of the remnant swelling. Perhaps, my foot is just getting back to normal and sensitive tendons are part of the continuum. I know when the foot was injured my body felt like it was doing all kinds of compensation from the thigh down to the toes.

Oh, I returned the newer shoes and the newer version of the shoes that I ran 300+ miles in without foot problems.

28. Shaun Kjar - September 7, 2009

Very informative!

David- I have noticed the squeaking you speak of. It is as if the top of my foot is creaking instead of the regular smooth movement. I ran 16 miles after I noticed the pain and luckily a couple days later it is going away. The most helpful thing has been to massage my legs. I got into the habit of coming home after a long run and not taking the time to rub down. My body is letting me know that it needs some attention. I’m glad I caught it and I’m glad others have taken the time to post about their experience.

Run on!

-Shaun

29. Bill - September 27, 2009

Joseph- How did your half marathon go? I am scheduled for a half marathon 13 days from now and have been dealing with extensor tendonitis for the last week. I know I should have listened to my body earlier and realize now that I became too much of a slave to my training schedule. Now I’m not leaving myself much time for rest. How much rest do you all recommend from your experiences? I’ve read everything from a few days to 6-8 weeks..Thank you.

-Bill

30. Chris - November 29, 2009

Two weeks ago, I developed sudden soreness in the top of my left foot and less frequently in the front of my left ankle. The top of my foot is tender to the touch and sore just behind the toe joints on the tendons.. You can even feel some knotting/bumps on the tendon that runs to the toe next to the big toe. I didn’t do anything that I know of to cause this.. It developed over the period of a day.

I went to my doctor the following Tuesday which was about 3 days after the onset of the pain, and he diagnosed it as tendonitis (he did not specify extensor tendonitis, but it looks like this is what it is) after seeing nothing wrong on the x-ray, prescribed heat soaks and 4x200mg ibuprofen 3x a day. This didn’t help at all after 3 days, so I called back and was prescribed a 6 day methylprednisoline pack, which I have finished and it has not helped at all either. The pain is worse and more frequent now. I am having to walk on the side of my foot and limp, which is also causing more pain due to the way I’m keeping my foot angled. I am also starting to develop pain in the bottom of my foot behind the toe joints.

I called last Friday to request an appt with a specialist but due to the holiday they were closed, and their message also states that referrals take 72 hours to happen. I’m sure it will eventually but this is getting to be a real problem as I’ve already missed out on a few activities that I had planned (football game, etc) because I just can’t be on my feet that long..

Both things the dr has prescribed haven’t worked and I really don’t want another week of being in pain and trying something else that might not work.

I’m a 29 year old male in otherwise good health, 6’1 200 lbs, average build.

Once I get my specialist appt, I will post back here with the next prescribed treatment.. hopefully my experience will help the next person who comes along seeking info about exensor tendonitis.

31. Chris - December 11, 2009

Follow-up: It ended up being a stress fracture of my second medatarsal. I’m in a boot for a month. We’ll see how this works out..

32. Michelle - January 6, 2010

I just started running last year and always ran with pain. I thought that the more I run the better?I was wrong. Went to physical therapy and was told that I have tendonitis in my legs because I have really flat feet. My therapist wants me to go to a podiatrist to get orthotics. Does anyone know if this will really help? This is my last resort.
Ps. Stopped running for a month to heal legs completely and just started a few days ago to SSSlowly get back into running. Only a mile every other day at a 15 minute mile. That is very long and short. Something that I am not used to.
Any advice will be great and thanks! Michelle

33. Joe - January 9, 2010

many thanks, everyone, for sharing. I’ve just started increasing my weekly mileage to start training for a half-marathon (the one I have in mind is a long, long way off – September) and I had pain at the top of my foot after a four mile run on 12/29/09. I now know the pain felt exactly like extensor tendinitis.

I gave my feet and legs two days of rest, on the third day I ran 3 easy miles and the foot felt better. On the fourth day I rand 3 miles again and the foot felt better yet. On the fifth day the foot felt back to normal.

Since the first incident I ran 20 miles without a problem, but then today, 1/7/10, after two whole days of rest I went out on a run but had to call it short after the top of my foot hurt again after going only four miles.

It sounds like I’ll massage the muscle next to my shin and loosen my laces, and put padding on the front of my foot.

One question I have is – should I put a wrap around my foot? I thought that was a part of RICE – Compression, but if tight laces can cause this, do you want to use a wrap?

34. Amy G - January 13, 2010

Wow – this blog has been most informative!! It’s clear that I’m in the same boat as many of you.

During an 8 mile run on Christmas eve a.m. I noticed this same pain on the top of my foot halfway in. Ran thru it, but immediately took a hiatus from running to focus on ice and advil. Have had prior painful bouts with tendentious in ankle – learned from experience to be conservative.

With the fear of a possible stress fracture, I went to my fav sports med dr when the pain still persisted a week later. He did range of motion tests, observed my gait on a treadmill, etc. I was diagnosed with “soft tissue bruising” from either too-tight laces (wore thinner sock on this run and maybe laced snugger to compensate) or from running on icy roads (the run was the first icy run post snow that I’ve ever done – he said your toes/foot mechanics move differently when on unstable, sand or icy, surfaces).

He told me to take a week off to let it heal. I got impatient and ran a bit sooner (3 days) than he suggested – 4 miles into a 5miler, it started killing me. Had to walk back. Very sad. And cold. Shudda waited. :(

After further aggravating it on this 2nd run, I now believe that my doctor would diagnose me with extensor tendonitis. I now notice the “squeaking” feeling/sound on the tendon when I move my toes up and down. Shaun/David – what do you think causes that?? I thought maybe a swollen tendon rubbing on the tendon sheath?

I’ve been off it for almost 3 weeks, and while it’s getting better it’s still too sore to run. I’m okay spinning and doing the elliptical. Last night I even walked fast on the treadmill, but the fluid action of running still hurts.

What caused this??
Other than the thinner socks and icy road, the only other variable I can think of is shoes. Just coming off of a Nov marathon and I bought the same shoes I trained in but online from a discount retailer. It’s the same exact model/fit/etc. I told my doctor this and he said that these shoes can sometimes be “rejects” for one reason or another. Never had any problem over my 6-mth marathon training, and now I get tendon problems on an 8 miler?? It’s too weird. Should I “can” the shoes??

Lastly, do you think tight lower leg muscles could be the culprit? Do you all think massaging the calfs/shins helps avoid this??

35. Laura - February 3, 2010

I am taking some time off running to give extensor tendinitis time to heal. What cross-training exercises would still be acceptable so I don’t lose too much fitness. I have an elliptical and a bike trainer. I wasn’t sure of either of those would put too much stress on my foot. I also swim twice a week.

36. Laurie - February 6, 2010

I am nursing this injury too….caused by too snug laces on my 10 miler last weekend. I have a 1/2 marathon in a week…my first!!
Am not going to run at all during this week and ice, ice, ice.
Am really needing to know about compression. Will do it as well to help heal. I need a miracle!!!!

37. Kurt - February 23, 2010

First of all good luck to all in getting through this. From my experience don’t try to run through it. I did and all the icing in the world did not help. Rest until there is no pain and then wait another few days before attempting to run.
The other thing that may help is in how you tie your shoes. Check out this site: http://www.fitnesssports.com/lyd_clinic_guide/lydpg28.html. I’ve tried it and it seems to help. I have also been told that elastic shoe laces will help. Plus there are exercises where you rotate your foot clockwise and counter clockwise and then up and back. 20 reps of each, twice daily. This helps relax and strenghten the muscle on the front of your foot/leg. And of course your running shoes should be a 1/2 size larger than what you wear everyday.
Take care
Kurt

38. Ethan - November 1, 2010

I’m pretty sure the creaking sensation, known as “crepitus,” is tenosynovitis (inflammation of the tendon sheath).

39. Jeremy - November 2, 2011

Reviving this thread to give my thanks for all of the information. In my situation, the pain (which is on the top of my right foot) came out of nowhere standing up from my desk 3 days after my most recent run. I have the creaking and the bruised feeling, which sounds pretty common. Unfortunately, my half-marathon is in 4 days so not much time to rest. But I’m hoping that through some combination of ice, ibuprofen, and massage, I will be able to get through the race on Saturday and then rest the injury. I’ve worked too hard to sit this one out! :) My only fear is some of the talk about stress fractures – since it sounds like the symptoms can be very similar. Seeing as I may not have time to get a referral for a podiatrist, does anyone have any advice for self-diagnosing tendonitis vs. stress-fracture?

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49. coolcap - July 21, 2013

I am currently recovering from this same injury! It’s been so annoying since i was in the middle of training for a marathon, and it just sort of happened after i noticed my shoelaces felt pretty tight on my right foot and i decided to run fast intervals on the treadmill anyway. By the third interval i had to stop completely and limp home (and limped for about the next two 1/2 weeks as well)! I’ve done everything to speed it up, with ice, homeopathic therapies, etc. It’s finally feeling better at almost three weeks, and i do think i’ll be able to run again in a couple of days, but it’s been very difficult for me not to, although i’ve been able to ride my bike, take spinning, and more recently do the elliptical. The podiatrist told me it wasn’t a stress fracture and that i probably just sprained it and to apply ice and take ibuprofen, so he really wasn’t much help other than that he assured me it wasn’t a fracture. After researching, i think it could be extensor tendonitis, but all I know is that the only thing that really heals it is rest. It’s nice to see on this page that other people are suffering from the same thing, and a little hard to believe that shoelaces cause this but i do think they were the culprit! Hope you heal fast!

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