All About Extensor Tendonitis: Causes, Symptoms, and Treatment

Written by Erica Halpern on October 30, 2025

Medically reviewed by Sarah Higgins, D. Ch.

Extensor tendonitis is a common foot condition that affects the tendons running along the top of your foot. These tendons connect your muscles to your toes and help lift your toes and foot during walking and other activities. When these tendons become inflamed or irritated, it can lead to pain and difficulty moving your foot comfortably.

What Is Extensor Tendonitis?

Extensor tendonitis refers to inflammation or irritation of the extensor tendons on the top of the foot. This condition often results from overuse, repetitive strain, or injury. People who are active in sports, wear tight footwear, or have certain foot structures may be more prone to developing extensor tendonitis.

Causes of Extensor Tendonitis

Overuse: Repetitive activities such as running, jumping, or walking long distances.
Improper Footwear: Shoes that are too tight or have insufficient space on the top can compress the tendons.
Foot Mechanics: Flat feet, high arches, or gait abnormalities can put extra strain on the tendons.
Injury: Trauma or sudden impact to the foot.
Underlying Conditions: Arthritis or inflammatory diseases may contribute to tendon irritation.

Symptoms of Extensor Tendonitis

Pain and tenderness on the top of the foot, especially over the affected tendon.
Swelling or redness along the top of the foot.
Difficulty lifting the toes or foot.
Pain worsens with activity and improves with rest.
Occasionally, a burning or tingling sensation.

Treatment Options

Rest and Activity Modification

Avoid activities that aggravate the pain and allow the tendon to heal.

Proper Footwear

Wear shoes with adequate space in the toe box and good support to reduce pressure on the top of the foot.

Ice Therapy

Apply ice packs to reduce inflammation and pain.

Physical Therapy

Stretching and strengthening exercises can improve tendon flexibility and foot mechanics.

Orthotics

Custom orthotics may help correct biomechanical issues that are causing excess strain on the extensor tendon and muscles on top of the foot.

Medication

Non-steroidal anti-inflammatory drugs (NSAIDs) can reduce pain and inflammation.

When to See a Specialist

If pain persists beyond a few weeks or worsens, consult a chiropodist or foot specialist for a biomechanical assessment and personalized treatment plan.

Do you have pain on the top of your foot?

If you’re experiencing persistent pain on the top of your foot, don’t wait. Schedule an appointment with Feet First Clinic today for expert diagnosis and treatment of extensor tendonitis.

About Author: Erica Halpern

Erica is the operations manager at Feet First Clinic. Since 2021, she has been writing, researching and editing website and social media content. She also oversees Feet First Clinic’s daily and strategic operations to ensure the best possible experience for our clients. Her goal is to ensure patients are equipped with the knowledge and solutions they need to help with their pain.

Learn more about Erica Halpern

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January 8, 2026

Top Tips for Winter Hiking

Hiking is a great form of exercise and a fun way to get outdoors during the colder months of the year. However, if you’re planning on going for a hike, you need to know how to keep your feet warm and safe. Not only will this keep you comfortable during your journey, but it will also minimize the chances of you getting frostbite or another cold-related issue. That is why we are highlighting our top winter hiking tips, with a focus on proper footwear and keeping your feet protected in icy and snowy conditions. Continue reading to learn more about how you can protect your feet while hiking in the winter. Wear Boots That Fit Properly Before going on a hike, you need to assess the quality of your footwear. Preferably, you have a pair of warm boots that you can wear. By wearing boots, you’ll be able to walk in deep snowdrifts without worrying about getting your feet wet. Look for boots that are waterproof and insulated. If your boots are not insulated, be sure to wear them with a wool sock (more on that below). However, it doesn't matter how warm your boots are if they don't fit. Tight-fitting boots will restrict circulation, which will make your feet feel cold no matter what you do. That's why boots should fit properly: When purchasing boots, try them on in-store with a warm, thick sock. When in doubt, it's better to go too big than too small. Wear The Right Pair Of Socks Everybody knows that you should never go on a winter hiking trip without a warm pair of socks. Look for thermal socks with thermoregulating materials like merino wool. Materials will not only keep your feet warm; they're also breathable, meaning you won't need to worry about foot sweat (moisture buildup from foot sweat will make your feet cold). Whatever you do, do not double-layer socks; the increased thickness can make your shoes too tight, which will restrict circulation and make your feet colder. If you have poor circulation or suffer from conditions like Peripheral neuropathy (nerve damage caused by diabetes), you may want to wear a pair of compression stockings. Compression stockings are high-quality garments that are made to stimulate the blood flow in your feet and lower body. These garments can help prevent pain in several ways. Some benefits include: Boosting circulation to your lower extremities to help keep them warm Decreased swelling in your ankles and knees Minimizing aching and overall discomfort Reducing leg and foot fatigue If you don’t currently suffer from any of the issues mentioned above, you can still benefit from wearing compression stockings! They can help prevent issues like: Blood clots Varicose veins Complications due to venous disorders Keep Your Feet Dry Keeping your feet dry is just as important as keeping them warm during winter hikes. Moisture from snow, slush, or sweat can quickly lower foot temperature and increase the risk of blisters, irritation, and cold related injuries. Choose waterproof or water resistant boots whenever possible, and consider wearing moisture wicking socks to help pull sweat away from the skin. Packing an extra pair of socks in your backpack is also a smart idea, as changing into a dry pair during or after your hike can significantly improve comfort and help protect your feet from the cold. Wear Shoes with Good Tread Winter can make for slippery conditions. Whether it's slush, snow or ice, it's easy to lose your footing on winter trails. That's why it's important to look for shoes with a good tread and traction. The outsole should be rubber or a high-abrasion rubber compound. Tread depth and tread pattern is also very important. Ideally, the tread depth should be at least 5 mm, and the pattern should have many small shapes. A waterproof hiking shoe or hiking boot usually will do the trick!

November 27, 2025

Top 5 Ways to Take Care of Your Feet

Your feet are essential to your mobility and independence, yet they’re commonly overlooked in everyday health routines. Proper foot care is about more than aesthetics; it helps prevent discomfort, reduce the risk of injury, and support your overall well-being. At Feet First Clinic in Toronto, our chiropodists treat everything from nail and skin concerns to pain and mobility issues. Here are the top five ways to take care of your feet to keep them healthy and strong all year round. 1. Keep Your Feet Clean and Dry Healthy feet start with good hygiene. Wash your feet daily with warm water and mild soap, and don’t forget to clean between the toes. After washing, dry your feet thoroughly (especially between the toes) to help prevent fungal infections like athlete’s foot. If your feet tend to sweat a lot, moisture-wicking socks or antibacterial foot deodorant powder can help keep them dry and fresh. 2. Moisturize to Prevent Cracked Heels and Dry Skin Dry, flaky, or cracked skin on the feet can be uncomfortable and, if left untreated, may lead to infection. Applying a foot cream or urea-based moisturizer daily helps lock in moisture and keeps the skin soft and supple. Focus on the heels and soles, but avoid putting lotion between the toes as excess moisture there can increase the risk of fungal infections. If you have thick, rough skin or painful calluses, a chiropodist at Feet First Clinic can safely debride (shave down) the skin and recommend medical-grade moisturizers to help prevent recurrence. 3. Trim Your Toenails Properly Toenail care is more important than it might seem. Cutting nails too short or rounding the corners can cause ingrown toenails, which are painful and can become infected. Trim your nails straight across and gently file any sharp edges. If your nails are thick, discoloured, or difficult to trim, don’t force it. Our chiropodists have specialized tools to safely and comfortably trim thick toenails, and we can check for signs of fungal infections or other nail concerns. Feet First Tip: The best time to trim your toenails is after a shower when they’re softer and easier to cut. 4. Choose Proper Footwear Your shoes play a huge role in your foot health. Wearing shoes that are too tight, narrow, or unsupportive can lead to corns, calluses, bunions, or heel pain. When buying new shoes, make sure: There’s about a finger’s width of space between your longest toe and the front of the shoe. The heel fits snugly without rubbing or pressure. You can wiggle your toes freely. If you have foot pain, flat feet, or high arches, custom orthotics may be a game-changer. At Feet First Clinic, our chiropodists assess your gait and foot structure to design orthotics that support your body from the ground up. 5. Schedule Regular Foot Checkups Even if your feet feel fine, regular checkups can help prevent problems before they start. Chiropodists are trained to detect and treat a wide range of foot and nail conditions, including: Ingrown and fungal toenails Corns, calluses, and cracked heels Plantar fasciitis and heel pain Diabetic foot complications At Feet First Clinic, we believe prevention is the best medicine. Routine foot care helps maintain comfort, mobility, and confidence — especially as we age or if we spend long hours on our feet. Feet First Tip: If you notice pain, swelling, or changes in your toenails or skin that don’t go away, it’s time to book an appointment. Small issues can quickly become big problems if ignored.

October 2, 2025

Achilles Tendonitis vs Achilles Tendinosis: Understanding Differences, Symptoms, and Treatments

The Achilles tendon is the strongest tendon in the body. It connects your calf muscles to your heel bone and enables activities like walking, running, and jumping. However, it is also prone to injury -particularly from overuse. Two common conditions affecting the Achilles tendon are Achilles tendonitis and Achilles tendinosis. Although their names sound similar, they differ in causes, symptoms, and treatment approaches. Understanding these differences is crucial for effective recovery and prevention. What Is Achilles Tendonitis? Achilles tendonitis is an acute inflammation of the Achilles tendon, typically caused by sudden increased activity or repetitive strain. It results in swelling, pain, and irritation along the tendon. Typical pain in a male jogger`s achilles tendon. XXL size image. Causes of Achilles Tendonitis: Sudden increase in physical activity or intensity Overuse during running or jumping sports Poor footwear Training on hard surfaces Tight calf muscles Poor biomechanics Symptoms of Achilles Tendonitis: Sharp or burning pain along the back of the heel or lower calf Swelling and tenderness over the tendon Stiffness, especially in the morning or after rest Pain worsens with activity What Is Achilles Tendinosis? Achilles tendinosis is a chronic condition characterized by degeneration of the tendon’s collagen fibers without significant inflammation. It often develops after untreated or recurrent Achilles tendonitis and results in thickening and weakening of the tendon. It's essentially what can happen if Achilles tendonitis goes untreated. Causes of Achilles Tendinosis: Repeated micro-tears and poor healing Chronic overuse without adequate rest Aging and reduced blood supply to the tendon Biomechanical abnormalities Symptoms of Achilles Tendinosis: Dull, persistent pain along the tendon Thickened or nodular tendon Decreased strength and flexibility in the calf and ankle Pain may improve with warm-up but worsen with prolonged activity Key Differences Between Tendonitis and Tendinosis FeatureAchilles TendonitisAchilles TendInosisNatureInflammatoryDegenerative (non-inflammatory)DurationAcute or subacuteChronic, long-termTissue ConditionInflamed tendon fibersDegenerated, disorganized fibersPainSharp, localizedDull, diffuseTreatment FocusReduce inflammation, restPromote tendon healing, strengthen Treatment Options For Achilles Tendonitis: Rest and activity modification Ice and anti-inflammatory medications Physical therapy focusing on stretching and strengthening Proper footwear and orthotics Gradual return to activity For Achilles Tendinosis: Eccentric strengthening exercises to stimulate tendon repair Physical therapy and stretching Shockwave therapy or ultrasound treatments Possible use of platelet-rich plasma (PRP) injections Surgery in severe, unresponsive cases Prevention Tips Warm up properly before exercise Gradually increase activity intensity and duration Wear supportive, well-fitting shoes Maintain calf flexibility and strength Avoid running on hard or uneven surfaces when possible

July 10, 2025

What’s the Difference Between an Ankle Foot Orthotic and a Regular Orthotic?

What is an Ankle Foot Orthotic (AFO)? An ankle foot orthotic (AFO) is a medical-grade brace that supports the foot and ankle. It often extends partway up the calf. Unlike regular foot orthotics—which fit inside shoes to support the arch and heel. AFOs offer external stabilization of both the foot and ankle joints. AFOs are commonly made of lightweight plastic or carbon fiber and may be custom-made or prefabricated. They assist walking, correct alignment, reduce pain, and help prevent further injury. Who Needs an AFO? Image from https://braceworks.ca/ and the Washington Post AFO's received mainstream attention a few years ago when NFL quarterback Alex Smith returned to the football field after a catastrophic leg injury. The key to his return: an ankle foot orthotic. Due to a post-surgical infection, the nerve that helps flex the right foot was severed. This meant he couldn't lift his foot. So he got an AFO to help and made a brief comeback (with the help of an extensive rehab team). So who exactly needs an AFO? Since AFOs are heftier than regular orthotics, they're typically recommended for patients with more complex conditions than those addressed by traditional foot orthotics. You might benefit from an AFO brace if you have: Foot drop (difficulty lifting the front of the foot) Cerebral palsy or neuromuscular disorders Stroke-related gait issues Multiple sclerosis (MS) Post-surgical ankle instability Tendon or ligament injuries Severe arthritis affecting ankle mechanics Ankle foot orthotics are most commonly indicated for neuromuscular disorders and foot drop. AFOs v Regular Orthotics: What's the Difference? FeatureRegular OrthoticsAnkle Foot Orthotics (AFOs)ScopeFoot support onlyFoot and ankle supportPlacementInside the shoe (underneath the foot)Worn underneath and around the foot, and around the ankleConditions TreatedArch pain, plantar fasciitis, overpronation, high arches, other biomechanical irregularitiesNeurological and structural gait disorders, severe instabilityCustomizationOften custom-fit or prefabOften custom-molded to leg shapeMobility SupportModerateHigh—can aid in walking and balance While regular orthotics focus on redistributing pressure and correcting foot mechanics inside the shoe, AFOs provide external control for more complex biomechanical or neurological issues. Think of it as the difference between cushioning a sore spot and physically guiding your limb’s motion. How Are AFOs Made and Fitted? https://www.youtube.com/watch?v=nA_QklH7AWY AFOs are usually prescribed by a foot specialist or chiropodist after a full assessment. The process may include: Biomechanical Assessment Gait analysis Casting or 3D scanning Custom fabrication Fitting and adjustments Some patients may only need short-term use post-injury or surgery, while others may rely on AFOs for long-term mobility support. Final Thoughts If you’ve been told you need more than just arch support or if your walking pattern has changed due to injury or illness, an ankle foot orthotic could be a game-changer. At our clinic, we assess your full biomechanics and work with you to find the right support—whether that’s a custom orthotic, AFO, or a combination of both.

June 12, 2025

Morning Routine for Foot Health, Longevity and Mobility

When we talk about healthy habits, we often focus on nutrition, mental health, or overall fitness. But what about your feet? These often-overlooked heroes carry you through life and they deserve some attention, too. Incorporating a few gentle foot mobility drills into your morning routine can help improve flexibility, reduce stiffness, and set you up for a pain-free day. Let’s explore a few simple daily foot exercises that support longevity and mobility, all in under 10 minutes. Why Morning Foot Rituals Matter After a night of rest, it’s normal for your feet to feel stiff or tight. That’s because circulation slows down when we sleep, and our muscles and joints aren’t being used. A quick morning routine for foot health helps: Improve blood flow Gently wake up foot muscles Prevent long-term issues like plantar fasciitis or joint stiffness Support better balance and stability throughout the day Plus, it feels great — and your feet will thank you! Your 5-Minute Morning Routine for Foot Health These beginner-friendly exercises can be done from your bed, the bathroom counter, or even while you’re waiting for your coffee to brew. 1. Toe Spreads (1 minute) https://youtube.com/shorts/gOwgyrmU6hM?feature=shared Sit or stand comfortably. Spread your toes apart as wide as you can, then release. Repeat 10–15 times.Why it helps: Improves foot strength and activates the smaller intrinsic foot muscles that support balance. 2. Ankle Circles (1 minute per foot) https://youtu.be/qaatVpZy2ek?feature=shared Lift one foot off the ground and gently rotate your ankle clockwise 10 times, then counter-clockwise 10 times. Switch feet.Why it helps: Promotes circulation and joint mobility to counteract morning stiffness. 3. Towel Curls (1–2 minutes) https://youtu.be/toqnSys_JRw?feature=shared Place a small towel on the floor and try to scrunch it toward you using just your toes.Why it helps: Strengthens the arches and enhances coordination in the foot muscles. 4. Calf Stretch with Wall or Step (1–2 minutes) https://youtu.be/utLavyPDnqI?feature=shared Stand with your hands on a wall or place your toes on a step while your heel stays on the ground. Lean forward until you feel a stretch in your calf and Achilles tendon. Hold for 20–30 seconds per leg.Why it helps: Loosens up the back of the leg and heel — essential for preventing plantar fasciitis and Achilles tendonitis. Bonus: Gentle Foot Massage https://youtu.be/BwhGFoHDkUI?feature=shared Before putting on your socks or shoes, use your thumbs or a massage ball to roll out the soles of your feet. Focus on tight spots in the arch and heel. Just 1–2 minutes can make a big difference. Foot Mobility Drills = Long-Term Foot Wellness Incorporating these foot mobility drills into your morning can support not just your feet, but your entire body. Improved foot function leads to better posture, less knee and hip pain, and more stability with every step you take. And remember — consistency is key. Like any good habit, the benefits of daily foot exercises build up over time. Feature Photo by Aljona Ovtšinnikova

May 29, 2025

Can Dehydration Cause Foot Pain? Surprising Ways Water Intake Affects Your Feet

When you think of dehydration, you probably imagine symptoms like dry mouth, fatigue, or dizziness, but what about your feet? It may surprise you to learn that dehydration can directly contribute to foot pain, cramping, and even swelling. Since your feet are at the farthest point from your heart, they rely heavily on healthy circulation and fluid balance to function properly. Let’s take a look at how your water intake affects your fee and why staying hydrated is more important than you might think. 1. Dehydration and Foot Cramps If you’ve ever woken up in the middle of the night with a painful foot cramp, dehydration might be the culprit. Proper hydration is essential for normal muscle function. Without enough fluids, your muscle (especially in your feet and calves) can tighten up unexpectedly. Cramps often occur when your body is low on essential electrolytes like potassium, magnesium, and sodium, which are lost through sweat. Since water helps regulate these minerals, not drinking enough can increase your risk of sudden, painful cramps in the feet. 2. Hydration Supports Circulation in the Feet Good circulation is critical for healthy feet. Water plays a major role in keeping your blood flowing efficiently. When you’re dehydrated, your blood volume decreases, making it harder for your heart to pump blood to the extremities—including your feet. Poor circulation can lead to sensations of numbness, tingling, or a “pins and needles” feeling in your feet. In more severe cases, chronic dehydration could contribute to long-term circulatory problems that make foot pain worse over time. 3. Water Helps Lubricate Joints and Reduce Pain Your feet contain more than 30 joints, all of which rely on synovial fluid for smooth, pain-free movement. Dehydration reduces your body’s ability to produce this fluid, leading to stiff, achy joints—especially in people with arthritis or other joint conditions. Drinking enough water each day can help reduce joint discomfort and improve mobility in your feet and ankles. 4. Is Water Retention the Opposite Problem? Interestingly, dehydration can also lead to swollen feet—but not for the reason you might think. When your body senses it's not getting enough water, it holds onto the fluids it does have. This can result in swelling (also known as water retention) in the feet, ankles, and lower legs. Staying properly hydrated signals your body that it can safely release excess fluids, helping to reduce swelling and bloating in the feet. 5. Tips to Keep Your Feet (and the Rest of You) Hydrated Aim for 8–10 glasses of water per day, and more if you're physically active or it's hot outside. Avoid too much caffeine or alcohol, as these can dehydrate your body. Eat water-rich foods like cucumbers, oranges, and watermelon. Listen to your body—if you're feeling thirsty, you're likely already slightly dehydrated. When to Seek Help If you’re experiencing regular foot pain, cramping, or swelling—especially if increasing your water intake doesn’t help—it’s time to speak with a foot care specialist. At Feet First Clinic, our chiropodists can assess the cause of your symptoms and recommend personalized treatment options to get you back on your feet comfortably. Final Thoughts Dehydration doesn’t just leave you feeling tired—it can seriously impact your foot health. From muscle cramps to water retention, the way you hydrate has a direct effect on how your feet feel and function. So next time your feet are aching or swollen, take a moment to consider your water intake. A simple increase in hydration might be the first step toward relief.

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