Peroneal Tendonitis Treatment [Tendon Pain, Stretches, Exercises]

What is peroneal tendonitis?

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. If so, you might have Peroneal Tendonitis. You expect you might end up with a runner’s knee or another common ailment, but sometimes the pain you are experiencing doesn’t seem to fit any of the usual categories. A search for similar injuries doesn’t come up with the same.

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. Two Peroneal Tendons run on the outside of the lower leg. These tendons provide stability to the ankle and protect it from sprains.

Some 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, not the fibula. I will use various 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 Tendon Pain

• Resting your foot as much as possible to reduce ankle pressure is a good strategy.
• Icing your ankle – you can use a freezer gel pack or 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 include a topical analgesic gel like Biofreeze or oral pain relievers like Motrin, Advil, or Aleve to reduce swelling and reduce pain.
• Using a Controlled Ankle Motion (CAM) boot or splint will help keep your foot and ankle from moving and allow the injury to heal. 
• Once you feel well enough to return to your normal activities, run on a flat surface when you run. This can help reduce the chance of re-injury
• You may need to change your shoe model. If you change models, especially 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.

In-Office Podiatrist 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 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 sole’s lateral (outside) border and reduce pressure beneath the big toe joint. Raising the outside border from the ground reduces the strain on the peroneal tendons.
• Additional treatment options, including surgery, may even be discussed

When Can You Return To Running & Walking?

Avoiding running while injured is generally the best practice. The good news is that this condition does not seem overly resistant to healing. So with the right rehab program and patience, you should be back on track soon!