Adam H. Kaplan, DPM, is a podiatrist who has been in private practice for over 5 years in New Jersey and specializes in a wide scope of foot care.

Tendonitis is one of the most common causes of foot or ankle pain. The muscles of your leg, foot, and ankle are attached to the bone by tendons, which are strong, cord-like tissues.

Tendonitis is swelling that happens around a tendon. It causes pain with activity that usually goes away with rest, only to return when you move it again.

Learn more about what causes tendonitis, how to prevent it, and when to see a healthcare professional.

Tendonitis can affect different parts of the foot and ankle.

Rest and at-home care will usually heal these injuries within a few weeks. The following are common types of tendonitis of the foot and ankle.

The Achilles tendon is the large tendon that attaches the calf muscles to the back of the heel. With Achilles tendonitis, pain is located two to six centimeters (about one to three inches) above the area where the tendon attaches to the calcaneus (heel bone) or at the insertion site of the tendon to the heel bone.

Achilles tendonitis is a common sports injury. It can happen if your activity level has recently increased, you've started playing a new sport, or you've started wearing new shoes. In addition, tight calf muscles can add to the problem.

There are plenty of conservative therapies you can try, and Achilles tendonitis rarely needs surgical intervention.

The tendon of the tibialis posterior muscle (the deepest muscle in the back of the lower leg) wraps around the inside (big toe side) of the ankle and instep of the foot. That is the area where the pain occurs with this type of tendonitis.

Posterior tibial tendonitis is usually associated with flat feet. Flat feet can show the "too-many-toes" sign—where you can see four toes when looking from behind the heel. As the condition gets worse, the foot becomes flatter, and the toes fan further outward.

Physical therapy can be beneficial. You may need a short leg cast or walking boot if you have this type of tendonitis. This allows the tendon swelling to go down. After that, you may need to wear a brace or orthotics (shoe inserts that hold your foot in a better position).

A brace used for this condition should be Ankle Foot Orthotic (AFO), a custom brace that holds the ankle in a certain position to allow the tendon to relax and heal, This is usually worn for over 6 months, with a typical maximum of up to a year, and surgery can be a final solution for some people.

The tendons of the peroneal muscles wrap around the outside (little toe side) of the ankle. With peroneal tendonitis, pain and possibly swelling happen around the outer ankle and just below and above it.

Or it will be painful at the styloid process of the 5th metatarsal, along the pinky toe side between the toe and the ankle where the tendon inserts into the bone.

If you have high-arched feet and a history of ankle sprains, you may be at risk for this type of tendonitis.

Flexor tendonitis causes pain deep in the back of the ankle, on the big toe side. This type of tendonitis usually affects dancers or people who do activities that require a lot of toe balancing.

Tendonitis affecting the extensor tendons on the top of the foot is usually caused by your foot rubbing against your shoe. Less frequently, health conditions that cause general swelling, like rheumatoid arthritis, can cause it.

High-arched feet are more likely to cause shoe friction that leads to this type of tendonitis.

With tendonitis, you will notice pain, especially when you first start an activity, like getting up and walking. The pain may go away for a little while but then return as you keep walking or doing other activities.

The main symptoms of tendonitis include:

Rest usually makes the pain go away, although the affected tendon may still be painful to touch. Swelling is not usually an immediate symptom, though it may occur later. Often, your foot and ankle will become stiff when you have tendonitis.

Several things may cause tendonitis. You have more control over some of the causes than others. For example, you can be careful to stretch and not overuse your muscles. However, you can't control your foot structure or whether you develop certain health conditions.

Common causes of tendonitis include:

Your healthcare provider will take your medical history and may order X-rays or a magnetic resonance imaging (MRI) scan. These tests will help your healthcare provider see whether you have a broken bone, calcification (a build-up of calcium in the tendon), or if your tendon has torn.

Knowing the source of the pain will help guide treatment. For example, a torn tendon must be kept very still with a cast or boot and may even require surgery.

If you often experience tendonitis symptoms, you may benefit from seeing a podiatrist (a healthcare professional who specializes in feet and ankles). They can help identify foot abnormalities that may be causing your problem.

The general idea for treating foot and ankle tendonitis is to rest the injury so the body can heal. This takes time, usually weeks to months. You may be able to manage your tendonitis with self-care until it heals, but if it doesn't get better, you should see a healthcare provider.

When tendonitis symptoms occur, the first thing to do is treat it with R.I.C.E, which stands for rest, ice, compression, and elevation.

To treat with R.I.C.E., do the following:

If pain and swelling don't improve with home care, get worse, or occur while you are resting, you need to seek medical attention as soon as possible.

In addition to rest, your healthcare provider may suggest:

One of the best ways to prevent tendonitis is by doing foot and ankle stretches before exercise. Tight muscles put extra strain on your tendons. 

You also should wear shoes that offer plenty of support and avoid worn-out sneakers. Finally, when you start a new activity or sport, increase your time and intensity gradually.

Tendonitis causes pain and swelling in the tendons of your foot and ankle. There are several types of tendonitis, each affecting different parts of the ankle or foot.

Tendonitis can be caused by overuse, injury, foot problems, and some medical conditions—and often it's a combination of these factors. The first line of treatment is resting the ankle. Your healthcare provider may also suggest shoe inserts or other orthotics, anti-inflammatory medication, or physical therapy.

Stretching your muscles before exercise is a good way to prevent tendonitis. Using proper shoes with adequate support and increasing your activity level gradually can also help prevent tendonitis.

Pain in your foot or ankle from tendonitis is a sign that you need to take it easy. If the pain continues despite rest, see your healthcare provider. They will help you find a treatment plan that works for you. While it may mean weeks away from your favorite activities, the goal is to prevent complications that can sideline you for even longer.

Tendonitis symptoms fluctuate with activity. The pain is typically at its worst when you first start walking on it. As you get moving, the pain usually subsides for a bit, then returns if you overdo it. Rest usually helps to ease the pain, however, the area may still be tender to the touch.

Depending on the extent and cause of your injury, tendonitis can take a few weeks to a few months to heal. It may require physical therapy or orthotics to fully heal.

In peroneal tendonitis, the pain is located on the outer side of the ankle and at the base of the 5th metatarsal bone. Swelling can occur above and below the ankle bone. Peroneal tendonitis is more common in people with high arched feet or frequent ankle sprains.

Yes, people with flat feet are more prone to posterior tibial tendonitis. The posterior tibial tendon attaches from the tibia/ interosseous membrane and fibula and inserts to multiple bones to the bottom of the feet. It runs along the inner side of the ankle and arch. Shoe orthotics are often used to prevent and treat posterior tibial tendonitis.

Flexor tendonitis—felt deep in the back of the ankle on the interior side—is common in ballet dancers. It can also be caused by other activities that require balancing on your toes.

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