Pain on top of your Foot While Running? Extensor Tendonitis Causes and Treatment

The extensor tendons run along the top of your foot, allowing you to lift and straighten your toes. When these tendons become inflamed, they can cause pain while running, referred to as extensor tendonitis. Though rare, you can also get extensor tendonitis in your hand.

In both cases, the tendons are vulnerable because they aren't protected by bones, muscle, or fatty tissue. Here is what you need to know about extensor tendonitis, which is often responsible for pain on top of your foot pain while running.

Top of the Foot Pain While Running

Experiencing pain on top of your foot is a common complaint among walkers, runners, and other exercisers. Top of foot pain is usually felt right under your shoelaces. It has various causes, the most common being inflammation of the extensor tendons resulting in a condition called foot extensor tendinopathy or "tendonitis." It can be due to overuse injuries or shoes that are too tight.

Symptoms of Extensor Tendonitis

If you’re dealing with extensor tendonitis, you’ll feel pain on the top of your foot while running or walking. You may see swelling on top of your foot and notice a large bump somewhere along the tendon.

A simple test to determine if the pain on the top of your foot is a result of extensor tendonitis requires you to have a friend assist you. First, flex your foot down and push down on your toes. Now, provide resistance by having someone press on your toes. Then, try to pull your toes up against the resistance.

If you're feeling pain across the top of your foot or along the extensor tendon, extensor tendonitis is likely the cause.

Causes of Extensor Tendonitis

Determining the cause of your foot pain is the first step to finding ways to treat it. Common factors that may lead to extensor tendonitis include:

• Tight calf muscles: Tendons connect muscle to bone. So, if your calves are tight, this creates an extra pull on the bones in the foot. The area can become inflamed and pain occurs.
• Overtraining: You need recovery and repair time when you constantly place stress on your feet while exercising. If adequate time is not taken, extensor tendonitis can result.
• Fallen foot arch: Flat feet can also contribute to tendonitis on top of the foot. A fallen foot arch changes the foot's structure and can create issues with the extensor tendon and cause it to become inflamed.
• Running habits: Doing a lot of uphill walking or running, especially on a treadmill where you don't alternate with downhill workouts, can place more stress on your foot extensor tendons and lead to inflammation. Downhill running also causes the tendons to lengthen, which could likewise result in inflammation.
• Your shoes: Wearing shoes that are too small or don’t fit properly, or lacing shoes too tight, can all contribute to extensor tendonitis by creating a pressure point along the top of your foot. Non-athletic shoes can also be a problem, so wear comfortable shoes that fit properly when you’re not exercising.

Treating Top of Foot Pain

If you are experiencing pain in the top of your foot, you have two options. You can treat it yourself or you can see a doctor.

Self-Treatment

Extensor tendonitis often clears up after rest, especially if you catch it early. For mild cases, also try stretching your calf. You can do this by using a towel to pull your big toe toward you or by spreading your toes as far apart as possible.

Self-massage using a foam roller helps too, and ice and anti-inflammatory medications can be used to reduce inflammation, swelling, and pain. Compressions and braces may be used to support the foot or ankle, providing greater stability to the pained area.

Additionally, you can loosen your laces and lace your shoes across the shoe tongue in a ladder pattern, rather than a typical crisscross pattern, to relieve pressure on the top of the foot.

It's usually safe to exercise through foot extensor tendonitis if the pain is mild and is not affecting your gait. If running is too painful, take a few days off before attempting it again. Once the extensor tendon is no longer inflamed, you can walk or run relatively pain-free.

When to See Your Doctor

If the pain on top of your foot doesn’t go away after trying the above treatments, you may be dealing with a different injury or condition. Other conditions with similar symptoms include metatarsal stress fractures, atypical gout, and degenerative arthritis.

Consult your podiatrist or another healthcare professional to determine the cause of your pain and next steps. In some more extreme cases, a podiatrist may recommend custom-made orthotics or another treatment, especially if you're dealing with fallen arches.

Prevention of Top of Foot Pain

By taking a few simple actions, you can help reduce your chances of having extensor tendonitis, or of it reoccurring if you've been diagnosed previously.

Preventing foot extensor tendonitis begins with not overly stressing your foot with too much training or placing too much pressure on your feet at any time. Instead, build the strength and resilience of the soft tissues around your feet slowly over time.

Wearing properly fitting shoes is important too. If your shoes fit correctly, the tops of your feet are less likely to become irritated or inflamed while running. This involves choosing shoes meant for the exercise you do, whether walking, running, or other gym exercise.