The Center for Podiatric Care and Sports Medicine

Big Toe No No: Five Common Causes of Flexor Tendonitis (and How to Get Rid of It)

Posted by on Friday, November 2nd, 2012


Can you bend your big toe up and down? Yes? Then give a big thank you to your healthy flexor tendons! Uh oh, do you have some pain when you try to flex that toe? Then uh oh, you might have flexor tendonitis…

Okay, I know, you’re wondering, “What the heck is a flexor tendon and what does it have to do with my big toe?” Good question! Let’s clear that up.

The flexor hallucis longus tendon (the full formal name, to be precise) connects to your flexor hallucis longus muscle. The tendon runs from your lower leg, down past the inside of your ankle to the base of your big toes. It helps you bend your big toe up and down, and plays a part in flexing your foot (the flexor digitorum longus tendons help flex your other toes).

Tendonitis is an overuse injury, a strain or tiny tears in a tendon that causes it to become inflamed and painful. Flexor tendonitis occurs when you bend your toe a lot. Here are the primary causes:

  • Dance – Ballet dancers are probably the most likely candidates for flexor tendonitis,  just because they use and bend their toes more than your average person; think how often you see ballet dancers rise up and down on the balls of their feet or their toes.
  • Running and jumping – Runners and athletes who jump are also prone to flexor tendonitis, from pushing off and landing on their bent toes.
  • Poor biomechanics – Whether you’re a dancer, runner, jumper, or just an average person, you can still damage your toes if you have awkward biomechanics that make you put undue stress on your big toe. This is especially common in people with flat feet.
  • Incorrect technique – Whatever you’re doing, make sure you’re doing it right. Your toe can put up with a lot of use if you are moving it and the rest of your body the right way, but if you don’t have the correct moves in place, you can wear out your toe quickly.
  • Bad shoes – Wearing the wrong shoes for the wrong activity or wearing shoes that are too big can contribute to flexor tendonitis.

How do you know if you have flexor tendonitis? You’ll notice pain in the area of the tendon–both the base of your toe and the inside of your ankle. You’ll feel pain if someone pushes your toe up, bending it. The pain will also be more noticeable after an activity rather than before or during. After a while, though, you’ll feel it during the activity. The best way to get a definitive diagnosis is to see a podiatrist at The Center for Podiatric Care and Sports Medicine (212.996.1900  ).

Treatment involves icing the painful area for about twenty minutes at a time several times a day for a few days. You may also take anti-inflammatory drugs such as aspirin or ibuprofen to help reduce swelling. And of course, you will need to rest the foot and take a break from the activity that caused the injury. After the pain has gone down a bit, you can do some stretches to promote healing–try these stretches at eHow. Livestrong recommends gently massaging the painful toe.

So there you go–many things can go wrong with a big toe and flexor tendonitis is another of those things. Therefore, always be happy when you can bend your toe without pain!


If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.