Why Do I Have Pain When Curling My Toes?

Jul 16, 2019

Usually when we think of foot problems, we expect pain and discomfort to come from the bottoms of our feet. They are, after all, the parts of us that most frequently make impact with the ground, right?

While that may be true, it is very much possible to experience pain on the top of the foot, too! And this is especially true when tendons responsible for pulling the foot upward become inflamed. We call this extensor tendonitis, a condition that causes pain when curling the toes.

But what exactly is extensor tendonitis? What causes this condition in the first place? And how can you treat and prevent it from holding you back?

Let’s discuss this a bit more.

Extensor Tendonitis – A Toe Curling Problem

To understand this painful condition, we must first become familiar with how tendons work.

Tendons are tough, fibrous, bands of tissue that connect muscles to bones. The extensor tendons, in particular, join the muscles on the front of the lower leg to the toes, and are responsible for keeping your toes straight and pulling them upward away from the ground during each and every step you take.

Now, the term tendonitis refers to the inflammation of a tendon. And when inflammation happens in the extensor tendons in the feet, it can become painful to curl your toes in a downward motion. This condition is known as extensor tendonitis.

People who have extensor tendonitis will experience pain in the top of the foot. This pain often gets worse with physical activity or when curling the toes – doing so will cause the inflamed tendons to stretch beyond their capability. Sometimes, extensor tendonitis will also cause swelling across the top of the foot.

Wondering if you have developed a case of extensor tendonitis? Try this simple test:

Flex your foot downward and have someone apply light resistance against the top of your toes. If pain increases on the top of the foot, then it’s likely that extensor tendonitis is the culprit.

Common Causes of Extensor Tendonitis

Wearing shoes that do not fit your feet well or that are laced too tightly can cause pressure on your feet and lead to this condition. For runners, hill running is often what leads to this toe problem: the way your feet have to work when going up or down a hill can affect the tendons on top of your toes.

There are a number of other contributing factors you should keep in mind when seeking to prevent this painful problem:

  • Constant friction. Having your foot rubbing against a tight shoe, either from it being too small or being laced up too tightly, can cause extensor tendonitis.
  • Activity choice. Extensor tendonitis tends to affect people who spend long periods on their feet; especially people who walk or run on uneven surfaces or up and down hills.
  • Calf tightness. Tightness in the calf muscles places the extensor muscles under greater strain, making tendonitis more likely to develop.
  • Abnormal foot arches. People with high foot arches are more likely to have pressure on the top of their foot, and people with flat feet find their extensor tendons under more strain, both of which increase the chance of developing this condition.
  • Injury. Injuries such as dropping something heavy on top of your foot can also lead to extensor tendonitis.

The good news is there are many simple, conservative measures you can take to prevent this problem from holding you back. And you can count on Family Foot Care & Surgery to be there for you every step of the way.

Treating Extensor Tendonitis

if you have developed extensor tendonitis in your foot, what can you do about it? 

Rest will be your first line of defense. Don’t keep pushing through the pain; doing so will only makes matters worse. You may also need a change of shoes.

The following conservative treatment steps are used to reduce irritation, inflammation and pain:

  • Rest. If it hurts, stop! Allowing time for the injured tendon to heal is essential for optimal recovery.
  • Ice. Apply ice to the area in pain for 20 minutes at a time to reduce pain and inflammation. Make sure to use a towel to protect your skin.
  • Medication. Use non-steroidal anti-inflammatories such as ibuprofen and naproxen to reduce pain and inflammation.
  • Shoe lacing. Either tie your knot at the side or miss out one of the lacing holes over the most painful area. 
  • Exercises. Strengthening exercises for the extensor muscles help improve strength and endurance. Calf stretches can also help.
  • Orthotics. These versatile devices will provide padding and support to the foot, taking any undue pressure off the tendons.

Now, if the pain fails to settle, a steroid injection can be given to help reduce the inflammation. Surgery to repair extensor tendonitis is rare and usually reserved for unique cases that do not respond to conservative treatment options.

You should also keep in mind that even if you think you have developed extensor tendonitis, it’s important to have a professional evaluate the injury and rule out the possibility of a metatarsal stress fracture, as this condition shares many similar symptoms.

Find Expert Foot Care at Family Foot Care & Surgery Today

If you are experiencing pain on the top of your foot (or anywhere else in your lower limbs for that matter), contact Family Foot Care & Surgery. Dr. Sanjay Patel can find the cause of your pain and get you started on the right treatment quickly.

Even minor toe pain can cause a hiccup in your life so don’t wait to call. Make an appointment at our office in Milford, CT by calling 203-876-7736 or in Hamden, CT by calling 203-288-4055.