Pain On The Top Of Your Foot When Running | Foot Extensor Tendonitis |

Updated: Jul 31

Have you ever experienced pain on the top of your foot when running? That sometimes sharp, deep aching sensation you might experience by lacing your shoes too tight. Perhaps you took the time to untie and retie your shoes, hoping for relief mid-run, but the discomfort lingers. You might be experiencing extensor tendonitis. Good thing there's a fix for this common running injury.

The tendons on the top of the foot include the extensor hallucis longus, the extensor digitorum longus, and the tibialus anterior.

In conjunction, these tendons aid in dorsiflexion (lifting the foot towards the shin), extension of the toes, and foot stabilization when running.

Extensor tendonitis is inflammation, tenderness, and irritation localized to tendons on the top of the foot.

The pain can vary from mild to severe and is typically tender to the touch. Often, extensor tendonitis is caused by runners repeatedly lacing their shoes too tight, wearing running shoes that are too small, or drastic changes in running surface before the feet have become accustomed to the increased demand. Once pain presents, it can become a nagging injury that may become chronic with time if left untreated while maintaining a rigorous training schedule.

Treatment At Home For Extensor Tendonitis

  • Reduce training load while symptoms are present.

  • Apply localized ice to the foot in 10 - 15 min intervals when pain first presents.

  • Elevate foot to reduce swelling.

  • Apply topical ointments to reduce pain and discomfort while the foot heals.

  • Gentle flexion and extension of the foot to facilitate mobility and blood flow to the area.

  • Try alternative lacing techniques to reduce pressure to the top of the foot.

  • Get reassessed for adequately fitting running shoes.

* Avoid using foam rollers or massage guns on the top of the foot. They can result in a greater risk of injury due to the lack of blood flow to tendons and prolonged healing.

Treatment By Medical Professional

  • Mobilization and massage techniques to facilitate healing and proper mechanics with movement.

  • Individualized programming to strengthen the foot.

  • Medications (NSAIDS) to reduce inflammation and pain.

  • Corticosteroid injection in severe cases.

* This trained professional should also consult with you on how to safely return to training once symptoms subside.

How To Approach Training To Reduce The Risk Of Developing Extensor Tendonitis

For beginner runners or runners looking to start ramping up mileage, be mindful of the 10% rule. Ease into the increased mileage gradually.

If you're a road runner and would like to transition to trail running, allow up to a two-month grace period to adjust slowly. Try just one to two trail runs a week first, and allow a day or two following for ample recovery. Opt for smoother trails to reduce overall demand. As you become more comfortable, add an additional day or try a new trail with varying terrain.

For relatively new runners looking to improve speed, start with no more than two quality sessions or speed work a week, and consider adding rest day to help become accustomed to the training.

Although every runners individual needs area different, it's vital that runners listen to their bodies if he or she believes an overuse injury such as extensor tendonitis is developing.