Yes. My wife has. It's a tough one. But it is treatable. Don't continue to piss it off and do whatever is necessary to get the inflammation reduced so that the tissues don't continue to be expanded. There is some (not complete) level of permanence to the tissue expansion and scarring. Given time, it will go away most of the way, to the extent it is indeed effectively non-existent or a distant memory. But if you piss it off it will linger and linger and linger. This isn't something to push through.


(I'm open to corrections by experts in this type of tenosynovitis, or anyone with more expertise in this than me. My expertise = phd in sport physiology, and deeply invested husband aiding in the care process for his wife who struggled with it for 18-24 months off and mostly on. Hers was extensor digitorum longus tenosynovitis right under the extensor retinaculum superior to the ankle joint.)

IIRC she did PRP, 3 shots in sequential weeks and it was marginally effective. No more effective than a placebo and equivalently forced rest, though. It was basically expensive forced rest. Sometimes that's what it takes for endurance athletes. :)

If it were me, I'd go the least invasive route possible, and ask "how can I maximally rest this thing?" rather than "how can I work around this darn thing?"

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Dr. Alex Harrison | Founder & CEO | Sport Physiology & Performance PhD
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Thank you. Mine is flexor Tenosynovitis next to 2nd MTP per ultrasound. MRI shows inflammation. I read a case where Amniotic injection healed a woman’s with 3rd MTP flexor Tenosynovitis. Definitely frustrating as I feel I’ve been resting for months. No excess walking or running. Just around the house doing chores etc..I haven’t iced or used heat. Did your wife ice or use heat?

My thought too is it also takes time to heal due to low blood flow in the areas of the tissues at the toe level.

She did everything.


Except really diligently avoid upsetting it by really resting for long periods of time. Rest was the most effective treatment, along with a massage called a "pin and stretch" technique that she asks me to do regularly still. :)

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Dr. Alex Harrison | Founder & CEO | Sport Physiology & Performance PhD
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📱 Check out our app → Saturday: Pro Fuel & Hydration, a performance nutrition coach in your pocket.
Join us on YouTube → Saturday Morning | Ride & Run Faster and our growing Saturday User Hub

Please speak with the MRI radiologist to take a look back at the images, specifically at the plantar plate. Also, can have lower extremity doc do a 2nd MPJ subluxation test.

 Thank you.

Going to see podiatrist tomorrow. I was originally dx with capsulitis and did pt. I believe that further caused more injury and swelling to the tendon sheath. The dx part of this has been an issue.

I stopped pt. I wear a foot pad to take pressure of the area which is right at base of 2 but not quite at MTP head.

Please keep us updated...plantar plate tears are significantly underdiagnosed. Is your 2nd toe angled inward and lifted off the ground slightly when weight bearing? That is also a sign, as if one side of the plantar plate is torn, it will naturally start pulling the other way.

There is no issue with 2nd toe per se with movement or pulling away. It’s all when weight bearing, I feel as though walking on a pebble. No neuroma. Dr. said definitely saw fluid next to tendon. I’m going to ask for reassurance I did not tear tendon. I would think I tore tendon, I couldn’t move toe without pain. Only pain is weight bearing. Coincidentally or not, MRI definitely shows inflammation but it was “equivocal”.

sounds perhaps more like a biomechanics/pressure issue then....do you have a bunion by chance or hypermobility in the 1st metatarsal (hopefully doc checked that too)? that can transfer a lot of pressure to the head of the 2nd metatarsal and cause pain like you are describing as well.

No bunion. Back around the holidays in 2022 I started walking on treadmill at incline of 5 for 2-4 miles per day. That is what started it. Pain has come down but Dr. said PT would help. Nope. PT inflamed it worse. Now I’m stuck in this limbo area of that walking on pebble feeling. Also not a lot of blood flow in this area so healing is slow. Need to jump start healing process.

If no bunion, on xray is the 2nd metatarsal longer than the first? that can also cause more pressure to 2nd met head. PT will definitely NOT help this, that imo was a stupid referral. Look into metatarsal pads to take pressure off the area (placing behind met head area and NOT directly underneath 2nd met head), rocker shoes and/or zero raise heel->forefoot shoes,

Per current podiatrist, 2nd met head not longer than the first on X-Ray. He also agreed PT was bad referral. Wearing a cam boot until treatment starts in 2 weeks. I have Hoka Bondi sneakers. Just want the swelling to go down.

Hi Dr., is your wife healed? Mine is Flexor. When you say some permanence, could you expand on that a little. Will it always hurt? That statement scared me a little. I’m icing 2-3 times per day, in a boot for past month and massaging lightly per Dr.

Yes, I have minimal subluxation. I’m wondering is Dr. got location of effusion wrong and it’s plantar plate and not flexor tendon. Those two tissues are so close to each other.