Calmthetendon,thenrebuildit.

• Foot and ankle tendinitis is irritation or breakdown of one of the tendons that move and support the foot — commonly the peroneal or posterior tibial tendons.
• It usually develops from overuse, a change in activity, or weakness elsewhere in the foot and leg.
• Rest alone rarely fixes it — tendons need progressive, guided loading to heal and get stronger.
• Physical therapy combines hands-on care, a loading program, and movement retraining to resolve the problem and prevent its return.
• No referral is needed in most cases. We see new patients within a few days at Cedar Mill, Tigard, and Milwaukie.

What is foot and ankle tendinitis?

Tendinitis is irritation of a tendon — the strong cord that connects muscle to bone. In the foot and ankle, several tendons are prone to it: the peroneal tendons along the outside of the ankle, the posterior tibial tendon along the inside that supports the arch, and the tendons that run across the top of the foot. When a tendon is loaded faster than it can recover, it becomes painful and, over time, can degenerate (tendinopathy).

It usually develops gradually from overuse — a jump in mileage or activity, a new sport or job, worn-out shoes, or a change in surface. Weakness or stiffness elsewhere in the foot and leg often plays a role, forcing one tendon to do more than its share. Posterior tibial tendon problems in particular can lead to a flattening arch if left unaddressed.

At Creekside Physical Therapy, we identify which tendon is involved and why, calm the irritation with hands-on care and load management, then rebuild the tendon and the surrounding muscles with a progressive program. The goal is not just to settle the current flare but to fix the pattern that caused it. You work one-on-one with the same therapist throughout.

Tendons transmit the force of muscle into movement at the foot and ankle. The peroneal tendons run behind the outer ankle bone and help stabilize the ankle and turn the foot outward. The posterior tibial tendon runs behind the inner ankle bone and is a key supporter of the arch. The tendons across the top of the foot lift the toes and foot. Each can become irritated when it is overloaded or when nearby muscles and joints are not doing their part — and because tendons have a modest blood supply, they often heal slowly and need progressive loading to recover fully.

What it feels like

Foot and ankle tendinitis varies by which tendon is involved, but common symptoms include:

• Aching or sharp pain along a specific tendon, often on the inside or outside of the ankle or top of the foot
• Pain that worsens with activity and eases with rest, at least early on
• Swelling or tenderness directly over the tendon
• Stiffness, especially first thing in the morning
• A feeling of weakness or instability in the foot or ankle
• Pain with specific movements — pushing off, turning the foot, or climbing stairs
• A flattening arch or rolling-in foot in posterior tibial cases

Why it develops

Foot and ankle tendinitis is usually an overload problem, driven by a combination of:

• A sudden increase in walking, running, or standing activity
• A new sport, job, or training surface
• Worn-out or unsupportive footwear
• Weakness or stiffness in the foot, ankle, or hip that overloads one tendon
• A previous ankle sprain that changed how the foot loads
• Flat feet or high arches that stress particular tendons
• Returning to activity too quickly after a layoff or injury

How we evaluate foot and ankle tendinitis

Your first visit is a one-on-one physical therapy evaluation. Your therapist pinpoints which tendon is involved by testing strength, locating the tender area, and reproducing the painful movement, then assesses your foot and ankle mobility, arch support, and how you walk and load. We do not use imaging; if the exam suggests a tear or another problem that needs an X-ray or MRI, we coordinate that with your physician. You leave the same day with a clear diagnosis and a loading plan.

How physical therapy treats it

Foot and ankle tendinitis responds well to physical therapy built around progressive loading. Your one-on-one plan typically includes:

• Manual therapy to the involved tendon, nearby joints, and tight muscles to restore motion and reduce pain
• A progressive tendon-loading program tailored to the specific tendon, advanced as you tolerate
• Strengthening of the surrounding foot, ankle, and hip muscles so one tendon stops carrying too much load
• Activity and footwear guidance, including temporary support or taping while the tendon settles
• Arch support strategies for posterior tibial cases
• Gait and movement retraining to correct the pattern that overloaded the tendon
• Blood flow restriction (BFR) training when heavier loading is not yet tolerated
• A structured home exercise program so the tendon keeps adapting between visits

When to seek care

• Foot or ankle tendon pain that has lasted more than a couple of weeks
• Pain that is getting worse despite rest, or that returns every time you resume activity
• A noticeably flattening arch or a foot that is rolling inward (possible posterior tibial involvement)
• Swelling, weakness, or instability that affects how you walk
• Sudden, severe pain or a pop — get evaluated medically to rule out a tear

Foot and ankle tendinitis is treated by Creekside’s physical therapists at all three clinics. Chad Smurthwaite, DPT, OCS, frequently treats tendon overload in runners and athletes. If a tendon is torn or fails to respond and a procedure is considered, we coordinate with your surgeon and lead the rehabilitation afterward.

Frequently asked questions

• Achilles Tendonitis
  The most common foot/ankle tendon problem — same loading principles
• Plantar Fasciitis & Heel Pain
  Often coexists with foot and ankle tendon overload
• Ankle Sprains & Instability
  Sprains commonly irritate the peroneal tendons
• Running Injuries
  Tendinitis is one of the most common running complaints