Ron Heinlein

Ron Heinlein


What Causes Top Of Foot Pain And How To Treat It



Remember, one important rule is if the top of your foot is hurting it can be caused by an ill-fitting pair of shoes. If the bottom of your foot is hurting it usually this is the lack of having bottom support in a pair of shoes.

Pain running along the top of your foot can strike seemingly out of nowhere and leave you stranded. Simply walking becomes a dire experience. There may be no visible sign of injury but the pain is real enough to make you stop and take notice. This pain can be mild or severe, depending on the cause and the extent of any possible injury.

Our feet are made up of not only bones and muscles, but ligaments and tendons, too. These parts carry our entire body weight all day long, so it’s not much of a surprise that foot pain is relatively common.

The extensor tendons in your feet attach the muscles at the front of your legs to the toes and run across the top of your feet with a very little padding to protect them from a variety of injuries. These tendons have an important job and are in vulnerable locations.

If you experience pain in the top of your foot but it goes away after a day or so of rest, it may be a case of mild inflammation. If the pain lingers for days you should contact your doctor.

What causes pain on top of the foot?

Pain on the top of the foot can be caused by different conditions, the most common of which are due to overuse in activities like running, jumping, or kicking.

Conditions caused by overuse include:

  • Extensor tendonitis: This is caused by overuse or tight-fitting shoes. The tendons that run along the top of the foot and pull the foot upwards become inflamed and painful.
  • Sinus tarsi syndrome: This is rare and characterized as inflamed sinus tarsi, or the channel found between the heel and the bone of the ankle. This condition causes pain in the top of the foot and outside the ankle.
  • Stress fractures of bones in the feet: Pain can result particularly from fractures in the metatarsal bones, which are located at the top of the feet. This injury will likely have swelling as a symptom.

Other causes of pain on the top of the foot can include:

  • gout, which can cause sudden, intense pain in the joint at the base of the big toe
  • bone spurs, which are painful growths that form along your joints, in the joints in your feet by your toes
  • peripheral neuropathy, which causes pain, prickling, or numbness that can spread up from the feet into the legs
  • common peroneal nerve dysfunction, which is the dysfunction of a branch of the sciatic nerve that can cause tingling and pain at the top of the foot, along with weakness of the foot or lower leg

Extensor tendonitis

Extensor tendonitis causes pain across the top of the foot. This form of foot tendonitis is caused by inflammation or irritation of the tendons that pull the toes up, usually from repeated friction or compression from a poorly-fitting shoe.

Tendons are tough, fibrous tissues that connect muscles to bones. The extensor tendons join the muscles on the front of the lower leg to the toes. They pull the toes upwards away from the ground.

The two main extensor tendons come from extensor hallucis longus, which lifts up the big toe, and extensor digitorum, which lifts the other four toes. Both tendons run down across the front of the ankle, across the top of the foot and then fan out attaching to the tips of the toes.

The tendons sit between the skin and the bones and there is little padding around them, making them prone to injury resulting in pain in the top of the foot.

Common Causes

Extensor tendonitis most commonly occurs due to the foot rubbing against a shoe. It tends to affect people who spend long periods on their feet, people walking or running on uneven surfaces or up and down hills and people who lace their shoes too tightly.

Calf tightness can also contribute to the condition of altered foot biomechanics. 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 tendonitis.

Extensor Tendonitis can also occur after an injury such as if you have dropped something heavy onto the top of your foot or kicking something.

A simple test for extensor tendonitis is to try and draw your toes up towards you while resisting the movement with your hand. If that recreates your pain on top of the foot, you probably have the condition.

Extensor tendonitis is a fairly common condition, so your primary care physician or a doctor at a walk-in clinic may be able to diagnose your problem. You may also need to see a podiatrist, a doctor who specializes in feet, or an orthopedist, a doctor who specializes in foot and ankle injuries.

At the appointment, your doctor will ask you about your symptoms and do a physical examination. Sometimes an X-ray may be done to make sure there are no fractures causing your pain.

Treatment Options

Treatment aims to reduce irritation, inflammation, and pain in the top of the foot. There are a number of things that can help:

1) Rest: It is really important to avoid aggravating activities for ample time to allow the tendon to heal. If it hurts, stop!

2) Ice: Using ice regularly helps reduce pain and inflammation. Visit the Ice Treatment section to find out how to safely and effectively use ice.

3) Medication: Non-steroidal anti-inflammatories such as ibuprofen and naproxen are often used to reduce pain and inflammation

4) Shoe Laces: The simplest way to treat and prevent extensor tendonitis is to change how you lace your shoes. Either tie your knot at the side or miss out on one of the lacing holes over the most painful area. It sounds simple, but it really does make a big difference.

5) Exercises: Strengthening exercises for the extensor muscles help to improve strength and endurance. Calf stretches can also help as having tight calves puts more strain on the extensor tendons

6) Orthotics: Shoe inserts provide padding and support the foot, taking tension off the tendons.

7) Physical Therapy: Ultrasound therapy can help promote healing

8) Steroid Injection: If the pain fails to settle, a steroid injection can be given to help reduce the inflammation. Care must be taken as it does temporarily weaken the tendon

The general principle for treating foot and ankle tendonitis is to give the injury rest so the body can heal it. This takes time, usually weeks to months. Your doctor may give you a walking boot to keep your foot and ankle immobilized so you aren’t using it, or you may be directed to have no weight bearing on the affected foot.

A few questions that could help your feet in creating comfort, support. balance?


If your 6E width is too tight and you need additional widths. We have those 9E, 10E and 14E width for all Ladies and Men that need these extra – extra wide widths all found at www.dtfootwear.com.

If you’re already in pretty good shape, then walking is an excellent addition to your routine. If you have health concerns or are quite out of shape, be sure to get cleared by your healthcare provider before embarking any new physical activity.

Does your shoe allow you to have wiggle room in your toes?

Does your shoe give you that full arch support?

Does your shoe have one of the strongest mid and heel section in the shoe business? No Bi-lateral- movement.

Do your shoes create no hangover for the bottom of your feet?

Do your shoes offload or take the pressure off your areas that are hurting you?

Do your shoes have a fuller toe box or fuller instep support?

Does your shoe supplier give you up o 3 pairs of Heat Modalble Customized Inserts that will create a feeling of walking on a pillow all day long?

Does your shoe have a steel shank?

Does your shoe have a removable footbed?

Do your shoes come with spacers to help control the fit of your sho

Does your shoe line have all the needed widths for everybody on this planet?

Does your shoe line offer 4A 2A B D E 2E 3E 4E 5E6E 7E 9E 10E 14E in widths for Men and Ladies?

Does your shoe line offer up to a 20 in length for men?

Does your shoe line offer up to a 15, in length, for ladies?

Does your shoe have a protective layer that protects your foot from the ground?

Does your shoe line have an An “AIRFLOW SYSTEM” – IN THE HEEL to help protect you from the outer surfaces when running or walking?

Does your shoe allow an offloading system for heel spurs?

Will your shoe help prevent calluses or corns to your feet?

Does your shoe have a split-gill system to offload the pressure for a bunion?

I just talk, today, with an old shoe dog that been running his shoe store for 45 years and I ask him about a 9E, 10E, 14E and he has never heard of these widths before and he has some great shoe lines in his store.

I told him we just shipped an 18 14E width to a young man in Australia. He stated I can not comprehend such a size and this is an old shoe person.

We at www.dtootwear.com can answer Yes to all these statements above!

Maybe it’s time to look at www.dtfootwear.com very seriously!

Thank you,


CEO of Dtfootwear.com that offers the best footwear found on the internet! GUARANTEE! I have been in the footwear business for over 50 years and been trained by the best in the Therapeutic/Orthotic world.

President/Founder | Cell # 909-215-1622 | heinleinron@yahoo.com

DTFootwear.com Designer Therapeutic Footwear Co.

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