Ankle and Top of Foot Tendonitis

Causes, Symptoms, and Treatment Explained

As a foot and ankle specialist, I frequently see patients who present with pain
on the top of the foot or around the ankle and assume it is a simple sprain.
In many cases, the underlying cause is tendon inflammation, commonly known as tendonitis.

Tendonitis affecting the ankle and the top of the foot can interfere with walking,
balance, and daily activities if not properly treated.

What Is Ankle and Top of Foot Tendonitis?

Tendonitis refers to the inflammation or irritation of a tendon,
the strong connective tissue that attaches muscle to bone.

On the top of the foot and the front of the ankle, the most commonly involved tendons include:

  • Extensor tendons, which help lift the toes and foot
  • The tibialis anterior tendon, which controls ankle motion during walking

When these tendons become inflamed, pain often develops with movement,
pressure from footwear, or prolonged activity.

Common Causes of Ankle and Top of Foot Tendonitis

Overuse and Repetitive Stress

Repetitive walking, running, or standing—especially on hard surfaces—
can overload the tendons and lead to inflammation over time.

Improper Footwear

Tight shoes, poorly fitted footwear, or shoes lacking proper support
can place excessive pressure on the tendons on the top of the foot.

Foot Structure and Biomechanics

Flat feet, high arches, or abnormal gait patterns can increase strain
on specific tendons, making inflammation more likely.

Sudden Increase in Activity

Starting a new exercise program or rapidly increasing intensity
is a common trigger for tendonitis.

Injury or Trauma

Ankle sprains, direct impact, or previous foot injuries can predispose
tendons to irritation and inflammation.

Symptoms of Ankle and Top of Foot Tendonitis

  • Pain on the top of the foot or front of the ankle
  • Swelling or mild redness
  • Tenderness to touch
  • Pain that worsens with walking or exercise
  • Morning stiffness

In more advanced cases, weakness or difficulty lifting the foot may occur.

How Is Tendonitis Diagnosed?

Diagnosis begins with a thorough clinical examination by a foot and ankle specialist.

Imaging studies such as ultrasound or MRI may be recommended if symptoms persist
or if a tendon tear is suspected.

Treatment Options from a Podiatrist’s Perspective

Conservative Treatment

  • Activity modification and rest
  • Ice and anti-inflammatory measures
  • Supportive footwear or ankle bracing
  • Custom orthotics to improve foot mechanics

Physical Therapy

Targeted stretching and strengthening exercises help reduce inflammation
and prevent recurrence.

Surgical Treatment

Surgery is rarely required and is reserved for chronic cases that do not
respond to conservative care.

When Should You See a Foot and Ankle Specialist?

  • Pain lasting longer than one to two weeks
  • Worsening symptoms despite rest
  • Difficulty walking or increasing weakness
  • Persistent swelling or functional limitation

Final Thoughts

Ankle and top of foot tendonitis is a common but often underestimated condition.
Early diagnosis and proper treatment can prevent chronic pain and long-term tendon damage.

If foot or ankle pain is affecting your daily life, evaluation by a foot and ankle specialist
can help restore comfort and mobility.

– Foot and Ankle Specialist, https://www.acefootandankle.com