The four EDL tendons spread across the dorsal foot to insert into the extensor expansions of the four lesser toes, extending the toes during swing phase to prevent toe drag and assisting ankle dorsiflexion. Their tenosynovitis from overtraining, extensor compartment stenosis, or shoe counter pressure produces dorsal forefoot pain reproduced by resisted toe extension.
Toe 2-5 MTP and IP joint extension; ankle dorsiflexion assistance; swing phase toe clearance
Extensor tenosynovitis on the dorsal foot produces swelling and pain between the extensor retinaculum and the metatarsal heads. It is reproduced by resisted toe extension and passive toe plantarflexion stretching the tendons. Footwear modification, rest, and tendon sheath injection resolve most cases. Tendon adhesions after crush injury may require tenolysis.
Dorsal foot extensor tendon sheath inflammation from overtraining or shoe pressure producing pain with resisted toe extension managed with rest and injection.
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