Tendons attach a muscle to a bone. (Ligaments run from one bone to another bone.) When a tendon is overly stressed, usually as a result of poor biomechanics coupled with increased mileage, a tendon can become inflamed. A foot that overpronates does so as a result of too much motion between the bones of the foot, especially the first metatarsal. When the bones cannot stabilize properly, the muscles in the foot and leg try to make up the difference by working too hard for too long. Each muscle is designed to contract and relax while walking and running. Contracting for too long puts excess stress on the tendon and the sheath causing inflammation and pain. Severe trauma may cause tendon rupturing.

Treatment involves reducing the shear forces between the metatarsal heads by controlling the amount of pronation the foot goes through. This is accomplished with the use of an orthotic. Occasionally cortisone injections are also used.

Controlling the amount of pronation with an orthotic, is essential in alleviating the symptoms. Rest, ice, massage and NSAIDs will also help to reduce the inflammation associated with tendonitis.

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