What are foot tendon tears?
- Posterior tibial tendon. The posterior (rear) tibial tendon attaches the calf muscle to the bones of the inside of the foot. It holds up the arch of the foot and supports the foot during walking. A tear to this tendon is usually from a fall. But it can also be injured from overuse. This is most common in athletes who put a lot of stress on the ankle during sports like basketball or soccer. The anterior (forward, or front) tibial tendon runs from the shin to the top of the foot. Injuries to this tendon are much less common than to the posterior tibial tendon.
- Peroneal tendons. The two peroneal tendons run down the outer part of your lower leg and behind your ankle bone on the outside of the foot. One tendon attaches to the middle of your foot on the outside. The other attaches to the bottom of your foot near the arch. Tears in these tendons are usually caused by an ankle sprain or a blow to the ankle. It can also be caused by overuse, usually in athletes who repeat movements that put stress on the ankle.
- Achilles tendon. The Achilles tendon connects the calf to the heel bone and is important for walking, running, and jumping. It is the largest tendon in the body. It can tear if sudden high stress is put on it, especially if the calf muscle is stiff or weak and can’t take its share of the stress. For example, the Achilles tendon can tear when a sprinter pushes off at the start of a race.
Symptoms
- Pain. The moment of injury can be quite painful, and the injured area can be sore for a while until the injury heals. Pain usually gets worse when you try to move the foot or put weight on it.
- Swelling, redness, and warmth. The injured area is often swollen and red right after it is injured, and may also be warm to the touch.
- Weakness or loss of function. Your foot may feel weak or unstable. You may not be able to do the things you usually do.
Causes
Foot tendon tears are usually caused by a fall on the foot or sudden pressure on the tendon. It can also be caused by repetitive use of the foot and ankle in ways that put stress on the tendon. This is more likely to happen to athletes who put repetitive stress on their ankles. In addition, people with high arches have a higher risk of foot tendon tears.
Diagnosis, Treatment, & Prevention
Diagnosis & Tests
To properly diagnose a foot injury, you may need to see an orthopedic specialist who is trained to detect and treat foot and ankle injuries. During the exam, the doctor will:
- Ask about the injury, ask how your foot feels now, and when it hurts most
- Examine your foot and ask you to move it in certain ways
- Recommend imaging tests such as an:
- X-ray to check for broken bones and look for other damage
- MRI or CT scan if there is any question about which part of the foot is injured or the severity of the injury
Treatments
Treatment tendon tear in the foot will depend on how serious the tear is and your overall health, but may include any of the following:
- Rest. You may need to take a break from any activities that put pressure on the injured tendon.
- Ice. Cold packs may help to reduce pain and swelling. Ice the injury right after it happens, and then 3 or 4 times a day while it is healing. Put ice in a towel or cloth and ice for only 20 minutes at a time. Don’t put ice directly on your skin. When you start back to your usual activities, it may help to ice the area that was injured for 20 minutes after activity to prevent swelling.
- Nonsteroidal anti-inflammatory medicine (NSAID). NSAIDs like ibuprofen can reduce pain and swelling after the injury. Ask your doctor about the appropriate dose for your injury and how long you should take them.
- Brace or cast. Your doctor may recommend you use a brace, cast, or boot to support your foot and keep it still while it is healing.
- Orthotics. An orthotic is an insert that goes in your shoes to support your foot and help you use it the right way. Sometimes a tendon injury changes the shape of your foot, which may require special support.
- Steroid (cortisone) injections. Cortisone shots can reduce inflammation and pain that come with a tendon injury.. Your doctor will help you decide if this is the right treatment for you.
- Exercise and physical therapy. Exercises that stretch and strengthen your muscles and tendons may help. A physical therapist will teach you the correct way to do these exercises and coach you as you do them when you first start your exercise program.
- Surgery. If your tendon is ruptured or your pain and swelling doesn’t go away, surgery may be recommended to repair or replace a tendon. Surgery may also be done to remove any inflamed tissue around the tendon or to change the muscle or bone that the tendon attaches to.
Prevention
It’s not always possible to prevent injuries. But you can lower your risk of a foot tendon tear by taking care of the muscles that tendons attach to. Know your limits and don’t push your muscles to do what they are not ready to do.
If you have a foot tendon injury, you can prevent further damage and future injuries by getting the right treatment.