Question
Dr. Katz,
About 5 months ago I injured my 3rd, 4th, and 5th extensor tendons in my right foot, while dancing at a wedding dance.  About a month after the injury I did end up seeing a specialist, because I couldn't take the pain anymore.  He said that I had pulled those 3 extensor tendons and prescribed some pain medication.  The pain medication worked and I was able to wean myself off the meds after a few weeks.  Around that same time I began coaching volleyball.  About 2-3 weeks after we started practices, my big toe really started to hurt!  I had no swelling, but lost some ROM.  It really hurt to move my toe up and down and I couldn't stand for long periods of time.  It almost felt like there was something in the joint of my big toe.  For the last 2 months, my big toe and the top of my foot has been hurting off and on.  At times my foot will throb (only when I do more standing than usual# and it feels like there is something in my big toe joint #also when I do lots of standing#.  The ROM in my big toe did get better and its almost the same as my other big toe, but it does still hurt when I try to push my toe up and down.  It does at times hurt when I push off while walking.  It seems that the better support my shoes have, the more pain I experience.  I don't wear heels!  Lately, I have been experiencing more and more pain in my big toe and the top of my foot, where I had hurt it quite a while ago.  Icing my foot doesn't really help.  I do notice myself guarding the areas where my foot does hurt and rely on my left leg for more support.  I know the skills I taught my team during volleyball did not make my foot worse, because at the beginning of the season we just worked on fundamentals and the season is now over and the pain is beginning to get worse.  I have had several surgeries on my right knee, but my last surgery was 2 years ago.  I am a very active person and am on my feet all day #I'm an elementary teacher with several high needs children).  Is my big toe pain and extensor tendon injury related?  Do you have any ideas on what might be going on?  Is there anything I can do at home to help?  Should I go back to my doctor?  I'm just tired of the pain and I HATE taking pain meds!
Thanks for your suggestions and time!
Hilee

Answer
Hi Hilee,

I would return to your doctor and have an x-ray and consider an MRI.  Pain medications do not heal these problems and I would avoid them.  They only mask your symptoms.  Physical therapy may also be an excellent option.  You may have injured the joint which could be associated with tendon injury as well.

Marc Katz, DPM
Tampa, FL
Advanced Podiatry
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