FHL Tendinopathy 2026: Causes & Treatment | DPM

Flexor Hallucis Longus Tendinopathy: Diagnosis Guide and Differential

Flexor hallucis longus (FHL) tendinopathy is one of the most commonly misdiagnosed causes of posterior ankle and big toe pain — frequently confused with Achilles tendinopathy, plantar fasciitis, or sesamoiditis. The FHL runs in a fibro-osseous tunnel behind the medial malleolus and under the sustentaculum tali before inserting on the distal phalanx of the hallux. Pathology most often occurs at one of three sites: the posterior ankle (behind the fibro-osseous tunnel), the midfoot (under the sustentaculum — “knot of Henry”), or the hallux (at the sesamoid complex). Accurate localization determines both conservative treatment and surgical approach if needed.

Condition	Location of Pain	Provocative Test	Key Differentiator	Imaging Finding
FHL tendinopathy (posterior ankle)	Posteromedial ankle, behind medial malleolus; may radiate distally into arch	Pain with resisted hallux plantarflexion; pain with passive hallux dorsiflexion (stretches FHL); hallux “trigger toe” (intermittent locking)	Pain localizes BEHIND medial malleolus (not at Achilles insertion); pain worsens with push-off phase of gait specifically (when FHL loads maximally); common in ballet dancers, runners	MRI: tendon thickening, peritendinous edema in posterior ankle tunnel; fluid in FHL tendon sheath; partial tear if severe
FHL tendinopathy (knot of Henry)	Plantar midfoot, medial arch; often confused with plantar fasciitis	Pain with resisted toe flexion against resistance; pain worsens when toes flexed simultaneously with ankle dorsiflexion (stretches FHL across knot of Henry)	Pain at plantar midfoot, NOT at heel origin; NO first-step pain (differentiates from PF); FDL/FHL intersection at navicular-cuboid level; often missed on X-ray and ultrasound	MRI: FHL/FDL intersection thickening; ultrasound may show tendon nodule at crossing point
FHL tendinopathy (hallux/sesamoid level)	Plantar forefoot under big toe; sesamoid region	Pain with hallux push-off; pain with single-leg heel raise (loads FHL); passive hallux extension reproduces pain	Differentiates from sesamoiditis by: pain with ACTIVE hallux flexion (FHL) vs pain with passive extension only (sesamoid); MRI distinguishes; sesamoid X-ray to rule out fracture	MRI: FHL tendon thickening at hallux level; sesamoid X-ray: normal (rules out sesamoid pathology)
Achilles tendinopathy (comparison)	Posterior heel, 2-6cm above calcaneal insertion; may extend to insertion	Royal London Hospital Test (RLHT): pain with palpation eliminated when ankle plantarflexed; arc sign; crepitus	Pain at posterior heel/tendon, NOT behind medial malleolus; no hallux involvement; morning stiffness in Achilles is cardinal feature; FHL: morning stiffness minimal	MRI/US: intratendinous signal change, neovascularization on Doppler; no hallux-level pathology
Posterior tibial tendinopathy (comparison)	Posteromedial ankle, distal to medial malleolus; navicular insertion	Pain with resisted inversion + plantarflexion; single-leg heel raise — unable to complete (PT tendon failure); progressive flat foot deformity	PT tendon: runs ANTERIOR to FHL behind medial malleolus; PT dysfunction causes progressive flat foot; FHL dysfunction does NOT cause flat foot collapse; hallux function preserved in PTT dysfunction	MRI: PTT longitudinal split tears; FHL normal or secondary thickening from adjacent synovitis
Sesamoiditis (comparison)	Plantar 1st MTP joint, directly under sesamoid bones	Point tenderness over sesamoids; pain with passive hallux extension; pain improved with hallux flexion (unloads sesamoids)	Sesamoiditis: pain with passive EXTENSION; FHL tendinopathy: pain with resisted FLEXION; tibial sesamoid most commonly affected; bone scan positive in sesamoiditis; FHL tendon normal on MRI	X-ray: bipartite sesamoid (normal variant — does not cause pain); bone scan/MRI: sesamoid stress reaction or avascular necrosis

FHL Tendinopathy Treatment: Evidence-Based Protocol by Stage

Stage	Timeline	Clinical Features	Treatment Protocol	Return to Activity
Stage 1: Reactive	0-6 weeks	Acute onset; point tenderness; pain only with specific loading; no structural change on imaging; often follows sudden increase in training load or hill running	Load modification (reduce FHL-loading activities 50%); relative rest — no complete immobilization; NSAIDs 7-14 days; ice post-activity; avoid passive hallux dorsiflexion stretching (provocative); NO corticosteroid injection at this stage	Return when pain-free with daily walking; typically 2-4 weeks if load modified promptly; do NOT push through pain — reactive tendinopathy progresses rapidly to degenerative with continued overload
Stage 2: Tendon Dysrepair	6-12 weeks	Persistent pain with loading; palpable tendon thickening; nodule possible at knot of Henry; morning stiffness; MRI: intratendinous signal change beginning; partial response to rest	Isometric FHL loading program (hallux plantarflexion against resistance, 5×45s, 4× daily — reduces pain via cortical inhibition); physical therapy for calf/intrinsic strengthening; low-load eccentric program beginning at week 8; orthotics if pronation present (reduces FHL load at midfoot)	Return to running with gradual load increase protocol; minimum 8-10 weeks; pain monitoring: ≤3/10 during activity, ≤0/10 next morning = safe to progress
Stage 3: Degenerative	3+ months	Persistent pain despite conservative treatment; fusiform tendon thickening on imaging; possible trigger toe (locking/snapping of FHL in posterior tunnel); pain with most activities; MRI: degenerative change, possible partial tear	Structured heavy slow resistance program (12+ weeks minimum); corticosteroid injection to tendon SHEATH (not tendon) for refractory synovitis — single injection only; low-level laser therapy (LLLT) as adjunct; if “trigger toe” present — surgical decompression of posterior tunnel has high success rate (95%+)	Return to sport timeline 16-24 weeks for Stage 3; surgical cases: 3-6 months post-decompression; full return to dance/running achievable with appropriate rehab

Related Conditions

You bend your big toe to push off during a run or a ballet relevé — and a sharp pain shoots behind your ankle. You may even feel a pop or a catch, as if the tendon is grabbing. That sensation belongs to the flexor hallucis longus tendon, one of the most mechanically loaded tendons in the foot, and one that goes underdiagnosed because it hides behind the ankle where plantar fasciitis treatment and Achilles problems get all the attention.

In our Howell and Bloomfield Hills clinics, FHL tendinopathy accounts for a meaningful portion of the “my ankle has been bothering me for months and nobody figured it out” cases we see. Once it’s correctly identified, treatment is straightforward — but getting the diagnosis right is the critical first step.

What Is Flexor Hallucis Longus Tendinopathy

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The flexor hallucis longus (FHL) tendon originates in the deep posterior compartment of the lower leg, passes behind the medial ankle through a fibro-osseous tunnel at the back of the talus, travels under the foot through the tarsal tunnel and a second constriction point called the “knot of Henry,” and attaches to the base of the distal phalanx of the great toe. Its job is to flex the big toe — critical for push-off in running, jumping, and dance.

Tendinopathy refers to a spectrum of pathology within the tendon itself: acute inflammatory tendinitis, chronic degenerative tendinosis, or stenosing tenosynovitis — a thickening of the tendon sheath that causes triggering or locking of the big toe. All three can occur along the FHL, and all three require slightly different management approaches.

Ballet dancers earn the unofficial title of highest-risk group. The en pointe and demi-pointe positions load the FHL at extreme angles repetitively, and the tendon rubs against the posterior talar process with every relevé. Runners are the second most common group we treat — particularly those who have increased mileage rapidly or switched to minimalist footwear that demands more great toe flexion.

Symptoms of FHL Tendinopathy

The location of pain shifts depending on which part of the tendon is affected, which is one reason this condition is often misdiagnosed. Pain at the posterior ankle points to the tarsal tunnel segment. Pain along the plantar midfoot or at the great toe MTP joint suggests involvement at the knot of Henry or the distal tendon sheath.

• Posterior ankle pain — deep ache or sharp pain behind the medial ankle, worse with push-off
• Big toe triggering or locking — the hallmark of stenosing tenosynovitis; the toe clicks, catches, or temporarily locks when you try to flex or extend it
• Pain with resisted big toe flexion — pressing your big toe downward against resistance reproduces the pain
• Plantar midfoot aching — when the knot of Henry is involved, pain sits in the arch rather than the heel or ankle
• Night cramps — cramping in the great toe or arch at rest is a less-known but classic FHL sign
• Swelling behind the medial ankle — visible or palpable fullness in the tarsal tunnel region
• Weakness in great toe push-off — reduced power when standing on tiptoe or during late-stance phase of gait

Importantly, FHL symptoms are usually unilateral (one side) and activity-dependent at first, progressing to pain at rest in more advanced cases. If both feet are affected simultaneously, consider a systemic inflammatory condition rather than mechanical tendinopathy.

Causes and Risk Factors

FHL tendinopathy is almost always a cumulative overuse injury, but several anatomical and training factors stack the deck. Understanding the mechanism helps explain why certain treatments work and others don’t.

Risk Factor	Mechanism	Who It Affects
Ballet / dance (en pointe)	Posterior talar compression on FHL tendon	Dancers at all levels
Rapid mileage increase	Repetitive eccentric loading exceeds tendon repair rate	Recreational and competitive runners
Minimalist / zero-drop footwear	Increased great toe dorsiflexion demand amplifies FHL load	Transition runners
Os trigonum (accessory bone)	Osseous impingement on FHL at posterior talus	~7–14% of population
Hallux rigidus / stiff big toe	Altered push-off mechanics overload FHL	Middle-aged adults
Cavus (high-arch) foot type	Increased plantar fascial and flexor tendon tension	Any age

The presence of an os trigonum — a small accessory bone behind the talus present in roughly 10% of the population — dramatically increases FHL impingement risk. When plantarflexion compresses the os trigonum against the calcaneus, the FHL tendon gets pinched between them. We use weight-bearing lateral X-rays and MRI to identify this in patients who fail conservative care.

How FHL Tendinopathy Is Diagnosed

Diagnosis begins with a careful history — specifically asking about activity type, pain location, triggering sensation in the big toe, and whether symptoms started after a training change. The physical examination includes several targeted tests that are highly specific for FHL involvement.

The FHL stretch test: With the ankle in neutral, passively extend the great toe. Pain behind the medial ankle or a click in the toe reproduces the diagnosis with good sensitivity. Adding ankle dorsiflexion increases tension on the tendon and sharpens the reproduction of pain.

Resisted great toe flexion: Ask the patient to press their big toe downward against your resistance. Pain or weakness in this test strongly implicates the FHL, while a normal result shifts suspicion toward plantar fascia or intrinsic muscle pathology.

Triggering test: Passively move the great toe from flexion to extension while palpating the medial ankle tendon sheath. A palpable pop or audible click confirms stenosing tenosynovitis — the tendinopathy subtype most likely to need procedural intervention.

Imaging: Weight-bearing X-rays screen for os trigonum and arthritic changes. Ultrasound performed dynamically — watching the tendon glide in real time as you flex and extend the toe — reveals tendon thickening, sheath fluid, and the triggering phenomenon. MRI provides superior detail of tendon fiber disruption, partial tears, and bone marrow edema at the posterior talus.

In our clinic, we typically start with ultrasound because it’s fast, dynamic, and allows same-visit diagnosis. MRI is reserved for cases where os trigonum syndrome or partial tendon tear is suspected, or when the patient isn’t responding to initial treatment as expected.

Differential Diagnosis

FHL tendinopathy overlaps significantly with several other posterior ankle and hindfoot conditions. Getting the differential right before initiating treatment prevents weeks of misdirected therapy. These are the conditions we most commonly need to rule out in clinic.

Condition	Key Differentiating Feature	Diagnostic Test
Posterior ankle impingement	Pain on plantarflexion, not big toe flexion; no triggering	Posterior impingement test (forced plantarflexion)
Os trigonum syndrome	Often co-exists with FHL; bony posterior tenderness	Lateral X-ray, MRI bone edema
Tarsal tunnel syndrome	Burning/tingling distribution; positive Tinel’s at medial ankle	Tinel’s test, nerve conduction study
Achilles tendinopathy	Pain 2–6 cm above calcaneal insertion; no big toe involvement	Palpation, Royal London Hospital test
Posterior tibial tendon dysfunction	Progressive flatfoot deformity; pain along medial arch	Single-leg heel rise test, MRI
Plantar fasciitis	Morning start-up pain at medial heel; no ankle or toe symptoms	Windlass test, point tenderness at fascial origin

One nuance worth noting: FHL tendinopathy and os trigonum syndrome frequently coexist. If MRI shows os trigonum bone edema AND FHL tenosynovitis, treatment must address both — treating only one typically results in incomplete resolution.

Treatment Options for FHL Tendinopathy

Treatment follows a logical ladder from activity modification and load management through physical therapy, orthotic support, and procedural options — with surgery reserved for the minority who fail conservative care over 3–6 months.

Stage 1: Load Management (Weeks 1–3)

The FHL tendon cannot heal while it is being repeatedly overloaded. For dancers, this means a temporary modification of pointe work — not complete cessation, but replacing relevés with demi-pointe and eliminating forced turnout until pain resolves. For runners, reduce weekly mileage by 40–50% and eliminate hill work and speed intervals temporarily.

Footwear matters immediately. A shoe with a slight heel-to-toe drop (8–10mm) reduces the dorsiflexion demand on the FHL and provides passive offloading. Switching from zero-drop or minimalist shoes to a structured trainer during the recovery period accelerates healing in most patients we see.

Stage 2: Physical Therapy (Weeks 2–8)

The evidence base for FHL tendinopathy rehabilitation is extrapolated from Achilles and posterior tibial tendon data, but the principles are the same: progressive eccentric and isometric loading to stimulate tendon remodeling. Key exercises include:

• Isometric great toe flexion holds — press the big toe down against the floor for 30–45 seconds; isometric loads reduce pain quickly in the acute phase
• Eccentric heel lowering off a step — loads the entire posterior chain including FHL; 3 sets of 15 daily
• Towel scrunches and marble pickups — intrinsic strengthening reduces compensatory FHL overload
• Calf stretching (both straight-leg and bent-knee) — gastrocnemius and soleus tightness amplifies FHL tension; must be addressed
• Single-leg balance progression — restore proprioceptive control before returning to full activity

Stage 3: Orthotic Support

A full-length orthotic with a Morton’s extension (a rigid extension under the great toe) offloads the FHL by limiting great toe dorsiflexion during push-off. This is particularly effective for runners and patients with hallux rigidus contributing to FHL overload. We frequently pair this with a PowerStep Pinnacle as an over-the-counter bridge while custom orthotics are being fabricated.

For pain management alongside orthotics, Doctor Hoy’s Natural Pain Relief Gel — formulated with arnica and camphor — provides topical anti-inflammatory effect without the systemic risks of oral NSAIDs. Apply to the posterior ankle and plantar arch twice daily. Unlike Biofreeze (which we no longer recommend), Doctor Hoy’s works on the inflammatory cascade rather than just masking sensation with menthol.

Stage 4: Ultrasound-Guided Procedures

For cases not responding after 8 weeks of conservative care, ultrasound-guided corticosteroid injection into the FHL tendon sheath — not the tendon itself — can break the inflammatory cycle and restore gliding function. The sheath injection is safe and effective; injecting into the tendon substance carries rupture risk and should be avoided.

Platelet-rich plasma (PRP) injection is an emerging option for tendinopathy that has failed cortisone or for patients who prefer to avoid steroids. Evidence in FHL specifically is limited, but the broader tendinopathy PRP data supports its use as a second-line procedural option.

Stage 5: Surgery (Refractory Cases)

Surgery is needed in less than 15% of FHL tendinopathy cases in our experience. When it is needed, the procedure depends on the pathology: tarsal tunnel release decompresses the fibro-osseous tunnel at the medial ankle, while a knot of Henry release addresses the distal constriction point. Os trigonum excision is performed arthroscopically in most centers and dramatically improves outcomes when an impinging accessory bone is confirmed on MRI.

Recovery after surgery is typically 6–10 weeks non-weight-bearing followed by 6–8 weeks of rehabilitation. Return to dance or competitive running averages 4–6 months post-operatively.

Red Flags — See a Podiatrist Promptly

Most Common Mistake with FHL Tendinopathy

The most common mistake we see is treating FHL tendinopathy as plantar fasciitis. Both conditions affect the foot’s plantar and medial structures, both worsen with activity, and both are common in runners — so they get conflated constantly. The critical difference is that plantar fasciitis produces its worst pain in the first few steps in the morning at the medial heel, while FHL tendinopathy causes pain behind the ankle or at the ball of the foot during push-off, with no notable morning start-up component.

The fix: before prescribing plantar fasciitis stretches or cortisone, perform the FHL stretch test and resisted great toe flexion test. If either is positive, you’re dealing with the FHL. Plantar fasciitis stretches won’t hurt the FHL tendon, but they won’t help it either — and six weeks of the wrong treatment delays correct diagnosis and frustrates the patient.

Recommended Products for FHL Tendinopathy Recovery

In-Office Treatment at Balance Foot & Ankle

At Balance Foot & Ankle, we diagnose FHL tendinopathy in a single visit using in-office diagnostic ultrasound. Dr. Tom Biernacki performs dynamic tendon assessment — watching the FHL glide in real time — to identify the exact segment involved and whether stenosing tenosynovitis, tendinosis, or partial tearing is present. This precision allows us to target treatment exactly where it’s needed rather than applying a generic protocol.

For patients requiring ultrasound-guided sheath injection or PRP, those procedures are also available in-office at both our Howell and Bloomfield Hills locations. We accept most major Michigan insurance plans for diagnostic visits and conservative treatment. Same-day appointments are available — call (810) 206-1402 or book online. Learn more about our full tendon treatment options at our treatments page.

Frequently Asked Questions

How long does flexor hallucis longus tendinopathy take to heal?

Most patients see significant improvement within 6–8 weeks of consistent conservative care — load modification, physical therapy, and orthotic support. Complete resolution to full activity typically takes 10–14 weeks. Cases involving stenosing tenosynovitis or os trigonum impingement often take longer and may require a procedure. Starting treatment early is the strongest predictor of a faster recovery.

Can I keep running with FHL tendinopathy?

Modified running — reduced mileage, no hills, no speed work — is generally acceptable in mild to moderate cases if pain stays below a 4/10 during and after runs. Pain that climbs above a 5/10 during a run, or significant soreness lasting more than 24 hours after running, indicates you are overloading the tendon and need a longer rest period. Running through severe FHL pain risks progression to partial tendon tear.

What is triggering of the big toe, and is it serious?

Triggering — a clicking, catching, or temporary locking when you flex or extend the great toe — occurs when a thickened segment of the FHL tendon catches at the fibro-osseous tunnel entrance at the medial ankle. It is not immediately dangerous, but it indicates stenosing tenosynovitis that typically requires intervention beyond basic stretching. Left untreated, progressive thickening can lead to permanent restricted motion and the need for surgical tendon sheath release.

When should I see a podiatrist for FHL tendinopathy?

See a podiatrist if posterior ankle or big toe pain has persisted longer than 3 weeks despite rest and anti-inflammatory treatment, if you notice triggering or locking of the great toe, if you are a dancer unable to perform relevé without pain, or if symptoms are worsening rather than improving. Early evaluation with ultrasound diagnosis typically shortens total recovery time significantly. Call us at (810) 206-1402 for same-day appointments in Howell and Bloomfield Hills.

Does insurance cover FHL tendinopathy treatment?

Office visits, ultrasound imaging, physical therapy, and standard cortisone injections are typically covered by major Michigan insurance plans. Custom orthotics may require a copay or deductible. PRP injections are generally not covered. We verify benefits before your first visit — call (810) 206-1402 to confirm your coverage.

Sources

1. Khoury NJ et al. “Flexor hallucis longus tendon disorders.” Radiographics. 2019;39(3):697–712.
2. Ribbans WJ, Ribbans HA, Cruickshank JA. “The management of posterior ankle impingement syndrome in sport: a review.” Foot Ankle Surg. 2015;21(1):1–10.
3. Dombek MF et al. “Peroneus brevis tendon tears: a retrospective review.” J Foot Ankle Surg. 2003;42(5):250–258.
4. Abramowitz Y et al. “Outcome of resection of a symptomatic os trigonum.” J Bone Joint Surg Br. 2003;85(7):1051–1054.
5. Murphy GA. “Disorders of tendons and fascia.” Campbell’s Operative Orthopaedics, 13th ed. 2017:4205–4290.
6. Maffulli N, Wong J, Almekinders LC. “Types and epidemiology of tendinopathy.” Clin Sports Med. 2003;22(4):675–692.

Frequently Asked Questions

When should I see a podiatrist?

If symptoms persist past 2 weeks, affect your normal activity, or are accompanied by red-flag symptoms (warmth, redness, swelling, inability to bear weight).

What does treatment cost?

Most diagnostic visits and conservative treatments are covered by Medicare and major insurers. Out-of-pocket costs vary by your specific plan.

How quickly can I get an appointment?

Most non-urgent cases see us within 5 business days. Urgent cases (sudden pain, possible fracture) typically same or next business day.

Frequently Asked Questions

When should I see a podiatrist?

See a podiatrist if: foot or ankle pain has lasted more than 2–4 weeks without improvement, you’re changing your gait to avoid pain, you have an open wound or sore that isn’t healing, you notice nail discoloration or thickening, you have diabetes and any foot concern, or pain is severe enough to wake you at night. Most foot conditions are easier and cheaper to treat early — what starts as a minor issue can become a surgical problem with months of delay.

What is the difference between a podiatrist and an orthopedic surgeon?

Podiatrists (DPM — Doctor of Podiatric Medicine) specialize exclusively in the foot, ankle, and lower leg. Orthopedic surgeons (MD/DO) have broader musculoskeletal training but variable foot/ankle subspecialization. For foot and ankle-specific problems, a podiatrist often has more focused training and experience. For injuries involving the leg above the ankle, complex pediatric cases, or multi-level reconstruction, orthopedic consultation may be appropriate. We frequently co-manage patients with orthopedic colleagues.

How do I know if my foot pain is serious?

Signs that warrant same-day or next-day evaluation: severe pain that appeared suddenly without clear cause, swelling, redness, and warmth that appeared suddenly (possible gout, infection, or Charcot fracture), an open wound that looks infected (redness spreading, pus, warmth), inability to bear weight, or any foot problem in a diabetic patient. Pain that’s been present for weeks and is stable is important but not an emergency — schedule within 1–2 weeks.

Can foot problems cause back and knee pain?

Yes — this is a kinetic chain effect. Abnormal foot mechanics (overpronation, supination, leg length discrepancy) cause compensatory changes in knee, hip, and lumbar alignment. Roughly 30% of patients presenting to our clinic with knee pain have a treatable foot-level biomechanical cause. Correcting foot mechanics with orthotics or appropriate footwear often provides significant knee and back relief. If you have chronic knee or back pain and haven’t had your foot mechanics evaluated, it’s worth a consult.

Are orthotics worth it?

For the right conditions, yes — custom orthotics are among the most cost-effective interventions in podiatry. They’re most effective for: plantar fasciitis, flat feet with secondary knee/back pain, leg length discrepancy, metatarsalgia, posterior tibial tendon dysfunction, and diabetic foot pressure management. Quality OTC orthotics ($35–60) resolve symptoms for 60% of patients with mild-to-moderate conditions. Custom orthotics are appropriate when OTC options have failed or when the biomechanical problem is complex. We cast custom orthotics in-office.

How do I choose the right running shoes?

Start with your foot type (flat, neutral, high arch) and running pattern (overpronator, neutral, supinator). Flat feet and overpronators do best in stability or motion-control shoes. Neutral feet do well in neutral-cushioned shoes. High arches need maximum cushioning with flexible soles. Always buy running shoes at the end of the day (foot swelling peaks then), get properly fitted by a specialist, and replace every 300–500 miles. If you’ve been injured repeatedly, a gait analysis can identify the mechanical flaw driving your injury pattern.

What is the difference between a sprain and a fracture?

A sprain is a ligament injury (the tissue connecting bones); a fracture is a break in the bone itself. Both can occur with the same trauma (ankle roll, fall). The old test — ‘if you can walk, it’s not broken’ — is wrong; many fractures are initially weight-bearable. Key differences: a fracture typically produces localized bone tenderness along the bone itself, while a sprain is tender over the ligament. X-ray is the standard to differentiate. High-grade sprains without proper treatment can be as disabling as fractures.

How do I prevent foot and ankle injuries?

The four most impactful prevention strategies: (1) Supportive, appropriately fitted footwear for your foot type and activity. (2) Gradual activity progression — the 10% rule (never increase weekly mileage or intensity by more than 10%). (3) Regular calf and ankle mobility work. (4) Strengthening the posterior tibial tendon, peroneals, and intrinsic foot muscles. Most overuse injuries are preventable; most acute injuries are not — but ankle sprain recurrence (60–70% without rehab) is prevented by balance and proprioception training.

Related Care at Balance Foot & Ankle

Clinical tendinopathy services at our Howell and Bloomfield Hills offices.

Achilles TendinopathyTendon Repair SurgeryMLS Laser Therapy

American Academy of Orthopaedic Surgeons: Flexor Hallucis Longus Tendinitis

In-Office Treatment at Balance Foot & Ankle

If home treatment isn’t providing relief for your foot and ankle conditions, our podiatry team at Balance Foot & Ankle can help with same-day evaluations and advanced in-office care.