Do you have or suspect you have a big toe tendonitis? Are you looking for information on this topic?
Based on my experience as a physical therapist and the (rare) scientific studies on this subject, I have written this article for you.
Happy reading! 🙂
(Have any questions, remarks, or experiences to share? Feel free to use the comments section at the end of the article! 🙏)
♻️ Last update : February 2024. Written by Albin Guillaud, physical therapist and PhD in public health
👨⚖️ Disclaimer : no affiliate links. Complete disclosure in legal notices.
Table of Contents
Basics
Big toe tendonitis may also be referred to as:
- tendonitis or tendinopathy of the extensor of the big toe or hallux (“hallux” is the anatomical term for the big toe);
- tendonitis or tendinopathy of the extensor hallucis longus muscle.
In big toe tendonitis, the tendon affected is that of the extensor hallucis longus muscle, which attaches to the big toe.
How does one develop big toe tendonitis?
The typical scenario leading to big toe tendonitis involves a combination of:
1️⃣ Wearing ill-fitting shoes or tightly laced footwear, which creates excessive pressure on the top of the foot;
2️⃣ Engaging in moderately to highly intensive and regular activities while wearing such footwear, for example, running.
⚠️ Caution ⚠️
From a tendon perspective, what may be low-intensity activity for some could be intense for others. We are all different!
Note: This tendonitis can also occur after a significant impact or a series of moderate impacts on the extensor tendon of the big toe.
Certain kicking techniques in some combat sports can cause these impacts (in practices such as taekwondo, for instance).
Symptoms of big toe tendonitis
The symptoms of big toe tendonitis include:
- A rather diffuse pain on the top of the foot; at its worst, this pain may occur at rest (without any activity).
- Pain when palpating the tendon of the long extensor of the big toe. This tendon is clearly visible on the top of the foot.
- Pain when attempting to raise the big toe; this pain intensifies when resistance is applied to the top of the big toe.
- Pain when stretching the big toe downwards.
- Possibly swelling (edema) at the level of the extensor tendon of the big toe.
- Possibly redness at the same level as the swelling (see previous point).
The absence of other possible explanations and a typical history (uncomfortable footwear and relative overactivity).
⚠️ Caution ⚠️
These symptoms may not all occur simultaneously. Additionally, similar pains may result from other issues besides tendonitis.
What else could be mistaken for this tendonitis?
Several other situations besides tendonitis can lead to pain on the top of the foot. For example:
- a fracture resulting from trauma;
- a stress fracture;
- a complication of a poorly healed fracture;
- a rheumatic condition.
Consulting a professional ensures that you’re not heading down the wrong path.
How long does it take to heal from this tendinopathy?
The time required to heal from big toe tendonitis depends on:
⚫ the treatment implemented (see the next section);
⚫ individual constitution: we are not all equal in terms of how quickly our tendons can heal;
⚫ what is meant by “healing”. For some, it’s walking 1 km without pain to take their children to school. For others, it’s running a marathon!
That said, assuming you’ve done everything right in terms of treatment, here’s a rough idea:
➡️ up to a few weeks if you’re fortunate enough to heal quickly and your demands are low;
➡️ up to several months (even up to a year) if your healing capabilities are slow and your demands are high.
⭐ The good news? ⭐
Scientific studies on extensor tendonitis of the hallux are very rare and not very sound.
This could be explained by assuming that this tendonitis heals easily in most cases. Thus, researchers may have little interest in studying it!
Treatment for big toe tendonitis
The principles of treatment for big toe tendonitis are relatively straightforward:
1️⃣ Change shoes or loosen laces!
2️⃣ Adapt or temporarily replace the activity causing the problem until the pain subsides.
Note that it’s always preferable to adapt the activity rather than completely stop it.
By “adapt,” I mean, for example, if it’s running, reduce the distance and speed of running, as well as the frequency of sessions.
3️⃣ Gradually increase the activity again until it reaches the desired level.
⚠️ Caution: excessive rest is detrimental to heal a tendon. Tendons need a certain amount of activity to heal properly.
While the principles outlined above may seem simple, they can sometimes be quite challenging to put into practice. To do so, a physical therapist can assist you.
You might also like :
📚 SOURCES
Jena D. Extensor Hallucis Longus Tendonitis: A Rare Cause of Dorsal Midfoot Pain. Indian J Musculoskelet Radiol 2021;3(1):64-6.
NHS UK : Pain in the top of the foot. Accès le 16 novembre 2023.
Note: Specific scientific literature on the subject of extensor tendinopathy of the hallux is extremely scarce! (See image below.)
Result of my PubMed search on big toe tendonitis as of November 16, 2023: Only 7 studies found, none of which were particularly useful.
Written by Albin Guillaud
Physical Therapist and PhD in public health, I really want to give you the best answers possible. For this, I willingly dive into the depths of the international scientific literature.
Between deep dives, I love exploring the beautiful Alpine mountains around me! 🌞❄️