Big Toe Extensor Tendonitis (Top of Foot Pain) Treatment in Mineola, NY

MULLIGAN CONCEPT

Big Toe Extensor Tendonitis

Pain on the top of the foot that follows the tendon running to the big toe is often extensor tendonitis, caused by tight laces, new shoes or running hills. At Enhanced Physical Therapy in Mineola, we check for stress fractures, then use Mulligan big toe and ankle mobilization, taping and lacing changes to ease the tendon.

Certified Mulligan Practitioner Over 10 Years of Experience

Our clinics director is a Certified Mulligan Practitioner (CMP) with over a decade
of experience using this evidence-based approach. Each treatment is customized to
your specific diagnosis and movement limitations to achieve optimal outcomes.

Common signs of big toe extensor tendonitis

Pain on the top of the foot along the tendon to the big toe
Pain worse with tight shoes or laces
Pain running uphill
Mild swelling on top of the foot
Pain lifting the big toe against resistance

What causes it

Tight laces, new or stiff shoes, uphill running, sudden increases in training and a stiff big toe joint can irritate the extensor tendon.

How we examine it

We screen for metatarsal stress fractures and other causes of top of foot pain, test the tendon, and check big toe and ankle movement. We test whether a glide or tape eases walking.

Mulligan techniques we use

First MTP MWM. A gentle glide of the big toe joint while it moves.
Ankle MWM. Improves ankle bending to reduce tendon load.
Taping and lacing changes. Tape and lacing patterns that take pressure off the tendon.
Pain Release Phenomenon (PRP). For pain lasting more than six weeks. Pain Release Phenomenon, not platelet rich plasma.

What the research says

We have not found research on Mulligan techniques for extensor tendonitis. Treatment is based on reducing pressure and load on the tendon and on how your foot responds during testing.

What else is in your treatment plan

Your plan includes lacing and footwear changes, manual therapy, foot and calf strengthening and a gradual return to running.

How long recovery takes

Many people improve within 2 to 6 weeks.

When to see a doctor first

Call your doctor, or get urgent care, if you have any of the following:

Pinpoint bony tenderness on top of the foot (possible stress fracture)
A hot, red, swollen joint (possible gout)
Numbness on top of the foot
Swelling that keeps increasing
A wound or skin change with diabetes

Big toe extensor tendonitis treatment near Mineola

Enhanced Physical Therapy is at 137 Willis Ave, Suite 100, Mineola, NY 11501, a short walk from NYU Langone Hospital-Long Island. We see patients from Mineola, Garden City, Williston Park, New Hyde Park, Carle Place, Westbury, Albertson and Manhasset, and across central Nassau County.

Frequently asked questions

Why does the top of my foot hurt?

Often tight laces or shoes irritating the tendon, but stress fractures need ruling out.

How should I lace my shoes?

Skipping an eyelet over the sore spot often helps. We show you how.

Can I keep running?

Often with lacing and route changes. We guide you.

Could it be a stress fracture?

Yes, which is why we check for pinpoint bone pain first.

Written and clinically reviewed by Jacob Kurian, PT, MSPT, CMP, DPT, Certified Mulligan Practitioner, Enhanced Physical Therapy, Mineola NY. Last updated October 14, 2026.

Move Better, Feel Better

If this is limiting your work, sleep or activity, call Enhanced Physical Therapy at (516) 833-5880 to book an evaluation with Jacob Kurian, Certified Mulligan Practitioner. Mulligan treatment may help reduce pain and improve movement, and we will tell you honestly what to expect.