Tendonitis & Overuse Injuries

Tendonitis and overuse injuries are among some of the most frequent causes of foot and ankle pain, especially for active individuals, athletes, and anyone whose daily routine places repetitive stress on the lower extremities. These conditions occur when the tissues that support movement become irritated or overloaded, inflammation can develop, leading to pain, stiffness, and reduced mobility. However, not al forms of tendonitis or overuse injuries are the same.

Some of the most common types of tendonitis and overuse injuries include:

• Achilles tendonitis (irritation of the tendon connecting the calf to the heel)
• Posterior tibial tendonitis (often linked to flatfoot or progressive arch collapse)
• Peroneal tendonitis (outer ankle tendon irritation commonly seen in runners)
• Extensor tendonitis (top-of-foot pain from repetitive strain or improper footwear)
• Flexor tendonitis (inner ankle or arch pain aggravated by overuse)
• Plantar fasciitis (heel and arch inflammation from strain along the plantar fascia)
• Stress fractures (small, repetitive-load bone injuries often mistaken for soft-tissue pain)
• Shin splints / medial tibial stress syndrome
• Ankle sprains with associated tendon overload

Some of the most common specific causes of tendonitis and a repetitive stress foot injury include:

• Repetitive overuse from running, jumping, or high-impact sports
• Sudden increases in training intensity or duration
• Improper footwear that fails to support foot and ankle biomechanics
• Flat feet or high arches, which place added stress on tendons and supporting structures
• Tight calf muscles or limited flexibility
• Poor walking or running mechanics
• Uneven terrain or exercising on hard surfaces
• Occupational strain from prolonged standing or repetitive motions
• Previous injuries that weaken surrounding tissues and increase reinjury risk

Who is Most at Risk?

Those most commonly affected include:

• Runners and endurance athletes
• Dancers
• Court-sport athletes
• Hikers and trail runners
• Workers on their feet all day, such as nurses, retail workers, teachers, and warehouse staff
• Construction and trade workers
• Military personnel and first responders
• Cyclists
• Recreational fitness enthusiasts
• Hobbyists with repetitive motions, such as gardening or long-distance walking

Early recognition is key, as these injuries often start subtly and progress if stress on the foot or ankle continues. By identifying symptoms early, you can help prevent more serious damage and support faster recovery.

Here are some signs and symptoms to watch for:

• Pain that worsens with activity and improves with rest
• Tenderness along the affected tendon or surrounding soft tissues
• Swelling or warmth in the injured area
• Morning stiffness or discomfort after periods of inactivity
• A feeling of weakness or instability in the foot or ankle
• Limited range of motion or difficulty bearing weight
• Aching or throbbing at night after a day of activity
• Crepitus (a subtle crackling sensation) when moving the tendon

Diagnosing tendonitis or an overuse injury begins with a detailed clinical evaluation, including a review of your symptoms, activity level, and medical history. This is followed by a hands-on exam to identify areas of inflammation, weakness, or biomechanical imbalance. If needed, our specialists will use advanced imaging, such as digital X-rays, ultrasound, or MRI, to confirm the diagnosis and pinpoint the exact source of pain. This helps ensure we’re crafting a precise and personalized treatment plan.

At the Foot & Ankle Center of Arizona, we tailor our treatment plans to the individual—focusing first on relieving pain, reducing inflammation, and correcting the underlying biomechanical factors that contribute to tendon strain. 

If you have tendonitis or an overuse injury, your podiatrist will start with one of the following treatment options: 

• Activity modification and rest to reduce repetitive stress
• Ice therapy to calm inflammation and manage early pain
• Anti-inflammatory medications when appropriate
• Custom orthotics to improve alignment and reduce tendon overload
• Physical therapy focusing on stretching, strengthening, and mobility
• Immobilization with a walking boot or brace for more severe cases
• Ultrasound-guided injections (corticosteroid or regenerative therapies, as indicated)
• Surgical intervention for persistent or advanced tendon damage

Tendonitis and overuse injuries don’t have to limit your mobility or keep you sidelined from the activities you enjoy. With early evaluation and expert care, most patients experience significant improvement and a faster return to stable, pain-free movement. If you’re concerned you may be developing tendonitis or an overuse injury, our team at the Foot & Ankle Center of Arizona is here to help.