Runners expect a certain risk with their sport, such as all athletes do, and they know that there is a chance that they may end up as one of the many injured runners. You expect you might end up with runner’s knee or other common ailment, but sometimes the pain that you are experiencing doesn’t seem to fit any of the usual categories, and a search for similar injuries just doesn’t seem to come up with much. If so, you might have Peroneal Tendonitis.
One of the causes of pain on the outside of the ankle and foot is Peroneal Tendonitis. The main function of the peroneal tendons is to stabilize the foot and ankle and protect them from sprains. Runners who run along slopes, which causes rolling out of the foot, are more susceptible to Peroneal Tendonitis.
So you suspect you have Peroneal Tendonitis, now what?
Causes And Symptoms
Peroneal Tendonitis occurs when the tendons become inflamed. This can occur when there is overuse of the tendons, causing them to rub against the bone. The tendon is a band of tissue that attaches muscle to bone. There are two Peroneal Tendons that run on the outside of the lower leg. These tendons provide stability to the ankle and protect it from sprains.
Some of the common symptoms include: pain at the back of the ankle, pain that worsens with activity, pain when turning the foot, swelling at the back of the ankle, instability when bearing weight, and an area that is warm to the touch.
Diagnosis
It is important to determine that the pain is from the tendons and not the fibula. I will use a variety of techniques during a physical exam to look for symptoms. X-ray, ultrasound and MRI may also be used to diagnose if needed.
Home Treatment Options For Peroneal Tendonitis-Caused Pain
- Resting your foot as much as possible with it elevated to reduce ankle pressure is a good strategy
- Icing your ankle – you can use a freezer gel pack, or use a plastic bag with some ice wrapped in a cloth, then place it on your ankle. You may need to use medical tape or tie a cloth around the ice pack to keep it in position on the ankle
- Anti-inflammatory medications – this includes a topical analgesic gel like Biofreezeor oral pain relievers likeMotrin, Advil or Aleveto bring down the swelling and reduce pain
- Using a Controlled Ankle Motion (CAM) boot or splint will help you keep your foot and ankle from moving and allow the injury to heal
- Once you feel well enough to return to your normal activities, when you run, run on a flat surface. This can help reduce the chance of re-injury
- You may need to change your shoe model. If you do change models, especially going from a neutral shoe to a motion control shoe (or vice versa), you will want a break-in period, as this will create different forces on your foot.
We have put together a home care stretching and exercise guide for dealing with Peroneal Tendonitis. Use this guide as a first step to help alleviate the pain.
Download a Free Copy of our Peroneal Tendonitis Stretching and Exercise Guide
Home treatment is not working? Now what? Perhaps it is time to consider more aggressive treatment in my office. I offer several treatment options to help you manage this condition.
In-Office Treatment Options
- Taping or strapping the foot. I can apply kinesio tape, such as Rocktape, to support and reduce painful symptoms
- Physical therapy is something I can write a prescription for if home stretches are not enough. Physical therapists offer rehabilitation exercises or other modalities to help the ankle to heal
- I also give steroid injections or prescribe stronger anti-inflammatory medication
- Podiatry recommended orthotics – insoles for peroneal tendon problems should place pressure beneath the lateral (outside) border of the sole of the foot and reduce pressure beneath the big toe joint. In essence, raising the outside border from the ground a little, which reduces the strain in the peroneal tendons
- Additional treatment options including surgery may even be discussed
When Can You Return To Running?
Avoiding running while injured is generally the best practice. The good news is this condition does not seem to be overly resistant to healing. So with the right rehab program and a bit of patience you should be back on the track soon!
If you have additional questions please let us know. You can call us or reach out through our contact page.
FAQs
Treatment for peroneal tendonitis begins with ice, rest, and anti-inflammatory medications. Rest is especially important, as the peroneal tendon can heal quickly if the tendons are given a chance to recover. Other conservative treatments include: Compression.
What is the fastest way to cure peroneal tendonitis? ›
Treatment includes the RICE principle (rest, ice, compression, elevation) as well as anti-inflammatory medications such as ibuprofen (Advil, Motrin, and others), massage, physical therapy, and stretches and strengthening exercises for the foot and calf.
Is it OK to walk with peroneal tendonitis? ›
If your condition is mild, you may be able to walk without pain or discomfort. However, if your peroneal tendonitis is more severe, walking may exacerbate your symptoms and cause further damage to the tendons.
What aggravates peroneal tendonitis? ›
Spending long periods of time standing, walking or running, especially with a sudden increase in these activities.
Does peroneal tendonitis heal on its own? ›
Peroneal tendonitis is irritation or inflammation in the tendons that run along the outside of your ankle and foot. It's usually due to overexertion and typically heals with a few weeks of conservative treatments. But untreated tendonitis can get worse, leading to a tendon tear.
Is it OK to massage peroneal tendonitis? ›
Massage. Your therapist may use soft tissue massage techniques to improve peroneal tendon mobility on the lateral side of your ankle. Massage may help improve tissue flexibility and circulation, and it may be used prior to exercise and stretching to improve overall mobility.
How long does peroneal tendonitis take to heal? ›
Treatment. Peroneal tendinitis generally takes 6-8 weeks to improve and early activity on a healing tendon can result in a set back in recovery.
Should I wear a brace for peroneal tendonitis? ›
An ankle brace for peroneal tendonitis can help support the ankle and protect it from further injury during healing. This can range from full immobilization with an ankle boot to a snug fitting brace, or even simply taping the ankle for added strength.
Should I wrap my foot for peroneal tendonitis? ›
Peroneal Tendonitis taping provides effective relief from outside ankle pain. It shortens the tendon to reduce its workload through the gait cycle.
Why is peroneal tendonitis so painful? ›
The peroneal tendons are bands of tissue that support your feet and protect your ankles from sprains. They allow you to move your foot in an outward motion. Because the tendons sit close together, they can begin to rub together and cause discomfort.
Peroneal tendonitis occurs when one or both of the peroneal tendons swell and become painful. Often, tendonitis results from repetitive activities or overuse, but sometimes, aging can also be a factor. As you get older, blood flow to your tendons decreases, and they become thinner and easier to injure.
What mimics peroneal tendonitis? ›
A type of tendonitis that is sometimes overlooked as the cause of foot and ankle pain is peroneal tendonitis that affects the two tendons that run along the outside of the foot.
Can shoes cause peroneal tendonitis? ›
Most commonly, peroneal tendonitis is caused by sudden increases in training, and the use of badly designed footwear. People who also have hindfoot varus posture are more likely to experience peroneal tendonitis.
What happens if peroneal tendonitis is left untreated? ›
If left untreated, peroneal tendonitis can worsen and may even lead to peroneal tendon rupture. To make a diagnosis and to rule out damage to other structures, like a bone fracture, your doctor may prescribe the following imaging tests: X-rays. MRI.
What happens if peroneal tendonitis goes untreated? ›
But what happens if tendonitis goes untreated? It can lead to tendinosis, which is a far worse, more painful, condition. Tendinosis means a tendon has ruptured and it can lead to further tendon degeneration and abnormal blood vessel growth.
How do you sleep with peroneal tendonitis? ›
Apply compression to the inflamed area with an ACE bandage in order to reduce swelling and inflammation. Finally elevate your ankle when resting or sleeping – this will help to keep swelling down and reduce feelings of soreness or tightness.
Is ice or heat better for peroneal tendonitis? ›
Stick to icing the area for just 15 to 20 minutes every four to six hours — and make sure that you put a towel or cloth in between the ice pack and your skin. After the first three days, heat may provide better benefit for chronic tendinitis pain.
Is heat good for peroneal tendonitis? ›
Heat may be more helpful for chronic tendon pain, often called tendinopathy or tendinosis. Heat can increase blood flow, which may help promote healing of the tendon. Heat also relaxes muscles, which can relieve pain.
