How to Treat Extensor Tendonitis

Medically reviewed by Erik Kramer, DO, MPH

Last Updated: February 10, 2022 References

Extensor tendonitis, also known as extensor tendonitis or tendinopathy, is inflammation of the extensor tendons along the top of the foot or hand. Commonly found in runners or those who spend long periods of time on their feet, it can be caused by anything from running to typing too often. Tendonitis is most commonly caused by excessive tightness in the calf muscles, overextension during exercise, and fallen arches. Luckily, there are a few ways to treat this condition and hopefully get you pain-free!^{[1]
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Method 1

Method 1 of 2:

Treating Extensor Tendonitis on Your Own

1
Apply ice for 10 minutes every hour. Reduce the frequency as required over the next 48 hours. You can also use a wet tea towel, ice pack, or reusable cold therapy and compression wrap. Don’t apply ice directly against your skin.^{[2]
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- Once the acute pain stage has passed, try applying a heat pack wrapped in a towel for 15 to 20 minutes at a time.^{[3]
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2
Take NSAIDs to reduce pain and inflammation. NSAIDs are non-steroidal anti-inflammatories like ibuprofen, naproxen, and aspirin.^{[4]
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Trustworthy Source
Cleveland Clinic
Educational website from one of the world's leading hospitals
Go to source} Painkillers or muscle relaxers like acetaminophen and cyclobenzaprine won’t be useful because they don’t treat inflammation.^{[5]
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- Ask your physician about using NSAIDs if you have hypertension, asthma, a history of kidney or liver disease or ulcer, or are older than 65.
- Consult your doctor if you are on any other medications, as NSAIDs can impact the effects of other medications.
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3
Stop overusing the tendons until you’re completely pain-free. This can take several days to a couple months. Identify what motions are creating the problem (such as running) and take a break from that activity as best you can. If the tendonitis flares up at work, see if your employer will let you switch to a different activity.
- Since this injury usually occurs from overuse, trying to resume your previous level of activity even when your pain seems lessened can worsen your injury and increase the time it needs to fully heal.^{[6]
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- If your tendonitis becomes chronic it can lead to tendinosis, which is a non-inflammatory degeneration of the tendon that takes 3-9 months to heal.^{[7]
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  PubMed Central
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4
Begin rehabilitation once you can walk or flex your hands without pain. Do stretching exercises like toe raises if you’re experiencing foot tendinitis. If you have hand tendinitis, try placing your hands palms together in front of your face, then raising your elbows out and upwards while keeping your hands still. Hold for 15 seconds and repeat 3 times.^{[8]
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- To stretch your feet, kneel down with your feet pointing backwards underneath your bottom and flatten your ankles towards the floor.
- Tight calves can contribute to foot tendinitis. Stretch your calves by standing on a step with the heel hanging off the back of the step and dropping your heel down, which should be done for no more than 3 times, 30 seconds each.^{[9]
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- Once your foot tendinitis improves, loop a resistance band over your toes and pull down gently on the band while extending your toes against the resistance. Repeat 10-15 times for 1-3 sets to strengthen your foot’s extensor muscles.^{[10]
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5
Wear appropriate footwear correctly, if suffering from foot tendonitis. Your shoes must fit and cannot be laced too tightly. Try a different lacing pattern by tying your knot at the side or skipping one of the lacing holes near the area causing you pain. This will place pressure on different spots of your foot.^{[11]
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- Orthotics, or inserts and insoles for your shoes, can pad and support your foot and take away some stress from your tendons.^{[12]
  X
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  Harvard Medical School
  Harvard Medical School's Educational Site for the Public
  Go to source} A podiatrist can help fit orthotics correctly for you.
- Running shoes should be replaced after 300–500 miles (480–800 km) of running. After this, the midsole starts to degrade.^{[13]
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Method 2

Method 2 of 2:

Consulting a Doctor

1
Identify the location and nature of your pain. Tendinopathy presents as pain on the top of the foot, usually described as aching, or an inability to fully extend one of your fingers.^{[14]
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Research source} If the tendonitis is on your hand, your finger may be jammed, your hand may feel numb or weak, or there may be a cut on the back of your hand or fingers.^{[15]
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- Diffuse swelling or mild bruising along the top of the foot may be present.
- Curling your toes may hurt because it stretches the tendons on the top of your foot.
Tip: If you have pain in the top of your foot, flex your foot downward and have someone apply gentle resistance to the tops of your toes. Try to flex your foot back up against the resistance. If you experience pain while trying to push up, it is likely caused by extensor tendonitis.
2
Ask your doctor for a diagnosis and treatment options. Doctors can assess whether you have tendonitis and how severe it is, sometimes by using an ultrasound or MRI. They can also refer you to physical therapy, splint your finger, or for very serious cases notify you that you may need surgery.
- Your doctor can also prescribe you over the counter NSAIDs.
3
Follow your doctor’s instructions if given finger splints or stitches. Jamming injuries are typically treated with splints or pins which then hold the tendon in place. They should be worn until the tendon is healed, which usually takes 8-12 weeks.^{[16]
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- Make sure your splint is not so tight that it cuts off blood flow.^{[17]
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- Contact your doctor if your stitches come apart or you feel sudden numbness around the wound.^{[18]
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4
Inquire about anti-inflammatory/pain-relieving creams or gels. These can be used as an alternative to oral NSAIDs. Because the drugs stay where they are applied, there will be less build-up of the drugs in blood and more remote tissues over time. This is best if you would otherwise be taking oral NSAIDs for more than 3 weeks.^{[19]
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Trustworthy Source
Harvard Medical School
Harvard Medical School's Educational Site for the Public
Go to source}
- Common side effects include flu-like symptoms and a rash or burning sensation at the application site.
- Generally, the cream or gel must be rubbed on the appropriate area 2-4 times a day.
5
Ask your physician about steroid injections for tendonitis on your feet. These can reduce inflammation but will temporarily weaken your tendons. Steroid injections are useful for short-term pain relief and increased mobility, but are not necessarily a long-term solution. In some rare cases, they could even cause your weakened tendon to tear.^{[20]
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- If you use blood thinners or certain dietary supplements, you may need to stop taking them for several days to reduce the risk of bleeding or bruising.^{[21]
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  Mayo Clinic
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- Injections can take a few hours to a few days to begin relieving pain.^{[22]
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  National Health Service (UK)
  Public healthcare system of the UK
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- After an injection, you may experience pain and discomfort around the injection site for a few days.^{[23]
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  National Health Service (UK)
  Public healthcare system of the UK
  Go to source}
6
Try physical therapy if your doctor recommends it. Physical therapists will give you stretches and strengthening exercises tailored to your injury, be it to your hands or feet.^{[24]
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Research source} Some can also use therapeutic ultrasounds or infrared light waves to decrease inflammation and encourage healing.^{[25]
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