Tendonitis or inflammation of the tendon can affect the tendons of the anterior, but also particularly the Achilles tendon (Achilles tendinitis) , the long lateral peroneus and the flexors of the toes at the calcaneus. This is called foot tendonitis. To differentiate in this case from aponeurotic conditions found in the sole of the foot such as Lederhosen plantar aponeurosis. We do not forget the insertion enthesopathies on this same calcaneus.
Symptoms of foot tendinitis
They are identical to those of common tendon pathology: local pain triggered by movements and increased at the end of exercise. Calcaneal tendonitis causes maximum pain in the morning when the patient wakes up when he places his foot on the ground. Achilles tendonitis can be accompanied by local signs of inflammation with the perception of nodules but also that of tendon injury in the form of an “axe blow.”
How is tendonitis diagnosed?
The diagnosis is essentially made with the clinical triad:
Pain caused by passive stretching of the tendon,
or even caused remotely by voluntary contraction against resistance of the tendon,
pain caused when palpating the tendon.
…and now confirmed by ultrasound, the examination of choice in this pathology but not obligatory. Rare forms of calcific tendinitis are of course perfectly demonstrated on simple x-rays. It can be supplemented by a request for biological tests at the discretion of the doctor and depending on the case (Rheumatoid Factors, uric acid, serum calcium, etc.).
The different treatments
It primarily involves resting the tendon and in very inflammatory forms the use of a cold. Oral analgesics are usually more or less combined with anti-inflammatories when possible. It can be supplemented by the use of local topicals derived from capsaicin with a powerful analgesic effect or certain anti-inflammatory molecules such as ketoprofen.
It is supplemented secondarily by physiotherapy with ultrasound or even shock waves and by physiotherapy. Due to the intensity of the pain, certain forms will be directly treated by cortisone infiltration which, however, remains a second-line treatment after the proven failure of previous indications or the insufficiency of its response. A mechanical assessment should be undertaken to eliminate all causes favoring tendinitis (wrong shoes, equipment used, etc.) , a nutritional assessment (lack of hydration, unbalanced diet, etc.).
As soon as the clinical symptoms gradually improve and without waiting for them to become chronic, always possible in forms that seem to drag on, it is important to introduce supplementation of elements suitable for nourishing the tendon and promoting healing. This approach will become systematic in the event of recurrent tendonitis.
