Should I use tape if I have extensor tenosynovitis? Well, that is what we’re talking about today on the Doc On The Run Podcast.
If you get pain on the top of your foot where you have these extensor tendons that you can kind of see right here, those are extensor tendons on the back of your hand, we got them on the top of your foot, and if they start to hurt, they can be very painful.
Somebody asked me recently about using athletic tape. Well, athletic tape has been helping athletes get back to activity after injuries for a very long time and one of the newest and most popular types of athletic tape, it’s lightweight, stretchy, supportive, and a lot more comfortable than the kind of athletic tape that the trainers put on me when I was in high school running cross-country.
You’ll see this everywhere. If you go to an Ironman triathlon, or an ultra-marathon, or even your local marathon, or maybe even a turkey trot, you’re going to see athletes that are covered in Some of them at these Ironman events will come out of the water and they have it from their wrist all the way up to their shoulder, across their back, down the sides of their legs, around their calf, all over the place. And it’s usually multi-colored strips of tape, so it’s very attention-getting. But you can see these athletes covered in this kind of tape on almost any imaginable body part that a triathlete could injure or strain.
Since it seems like this kind of tape can help almost anything, you might be wondering, could it help the tendons or the tendon sheath on the top of your foot that gets irritated and aggravated when you’re either running uphill and you strain it because your toes are pulling too hard, or the laces are compressing those tendons and squishing the tendon sheath, and then you get inflammation on the inside of the tendon. But if you have this thing called tenosynovitis, where you have inflammation of the tube that surrounds those tendons on the top of the foot, maybe taping could help.
Well, there’s a couple of things that tape could do that could help tenosynovitis. Now, if you’ve been diagnosed with this, then you probably ought to ask your doctor if this is a good idea or not. But tape doesn’t just hold things together. That kind of tape in particular, because it stretches, it can do a couple of different things all at the same time.
The first thing is that you want to provide support when you’re taping something theoretically and the idea is that if the toes move and the tendon slides or glides through an inflamed tendon sheath, it’s going to cause more and more friction and irritation and pain. And so, if you create external bracing over that structure that is been injured, then theoretically the tape will help calm it down because it helps hold it still. It immobilizes it a little bit.
That extra support can be very helpful when you have extensor tenosynovitis. But there’s a trick with it. The problem is, let’s say that you get irritation of the tendon sheath because your laces on the top of the tendons were too tight. Well, if you just wrap tape around it, then that compression might cause more discomfort and more pain. But this tape really can provide a lot of extra support.
For example, if you have ligaments where you’re holding two bones together, if you wrap tape around those two bones, it provides external support over the ligament itself, and it provides external stability and bracing for that joint where the ligament that supports and stabilizes the joint. Then the tape over that ligament that stabilizes that joint provides bracing and it supports it and holds it still. If you wrap tape in a certain way that holds the toes still, it will stop some of that movement too.
The next thing is compression. This tape, because it stretches, if you wrap it all around something, it does apply compression. Now, the way that that works for a swollen calf muscle, let’s say, is that you put the tape around, it squeezes, and it pushes the inflammatory fluid out. Again, you don’t really want to squeeze and compress the extensor tendons a whole lot because that may cause pain. So, if you’re trying to use the tape as a form of compression when you have tenosynovitis, particular extensor tenosynovitis on the top of the foot, it might make things worse. So, you want to be very cautious about this. But it is a really simple way to provide some external compression as well as bracing and support.
But the goal is to hold those tendons still and so just wrapping around the foot this way is not really going to help because your toes move up and down through a tendon sheath and you already have a retinaculum or a band of tissue that holds those tendons there, so it doesn’t bowstring and stick out away from the foot. So, you want to basically just focus on holding the toes still. If you’re applying tape, the goal is simply to hold the toes still and keep them from moving as much.
There’s lots of different ways to accomplish that. But that is the main thing that really helps when somebody has extensor tenosynovitis. They’re trying to tape the foot. Again, if you go around the foot in a number of different directions and it feels more stable, but it hurts, I would definitely not do that. You definitely do not want to do that. So, the extensor tenosynovitis is a tough problem. And I know that most of the people who get this are really desperate for solutions because it can hurt a long time and I know because I had it.
I over-tightened my laces before the Salt Lake City Marathon when I was in residency. I was on track for a PR, and I remember vividly at eight miles I looked at my watch. I was perfectly on pace and my foot was starting to hurt every single foot strike because I had over-tightened my laces. By the time I got to Liberty Park where there’s only a few miles till the finish line in downtown, totally flat, I should have sailed all the way to the finish line with a new PR. And instead, I could barely walk because at that point, since I had not adjusted my laces, every time I took a step, it felt like somebody hitting the top of my foot with a hammer. It was killing me.
It really hurt the next several days and because I was spending all day standing in the operating room or walking around the hospital on rounds, I ended up having to inject it with cortisone to get it to calm down because it really, really hurt. So, understand why you’re looking for other solutions when you have this problem.
If you like this episode, please like it and please subscribe and no matter what injury you have, even if it’s extensor tenosynovitis, you might want to check out the 12 steps presentation I’ve put together for you, which is basically the 12 steps that any injured runner can use to follow to actually really start to fast track the healing process and getting back to running a lot faster.
That training that I put together for you is completely free. You can go to www.docontherun.com/12steps. So, go check it out and I’ll see you in the training.
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