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Peroneal Tendonitis



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Tendonitis is a common foot problem as our feet take tremendous amounts of stress and rarely get to rest. Peroneal Tendonitis is one of the more common forms of tendonitis that we treat. With this problem your foot may hurt along the lateral (outside) portion. You may also feel sore on the outside of your ankle or have a painful leg.

If you think you may have peroneal tendonitis make an appointment right away to see us in our Seattle clinic. We are experts in treating peroneal tendon injuries fast and effectively.

Anatomy
There are two peroneal tendons – a short one (peroneus brevis) and a long one (peroneus longus). The peroneal tendons start on the outside of the calf and runs behind the ankle bone on the outside of the ankle. The brevis tendon attaches into the base of the 5th metatarsal, while the longus turns to run along the bottom of the foot and attach into the base of the first metatarsal.

A tremendous amount of tension and stress is placed is on this tendon with every step as it helps to support the foot. The amount of stress on the tendon varies from person to person depending on the shape of their foot (flatfeet versus a very high arch).

Symptoms
Symptoms of peroneal tendonitis include pain and swelling along the outside of the ankle and along the course of the tendon. There is often pain on the outside (lateral portion) of the foot. Pain is present with walking, exercise or just standing. This discomfort will usually increase over time. This pain initially is absent when at rest but may progress to the point where pain is present even when not active. In advanced cases the injury to the tendon that started as tendonitis may result in a full or partial tear of the tendon.

Diagnosis
We can usually make this diagnosis very easily by history and examination. Sometimes we will perform an in-office diagnostic ultrasound or order an MRI to determine the extent of damage to the tendon.

Initial Treatment
Treatment can depend on how long the symptoms have been present and the amount of strength that is lost (if any) in the tendon. Initial treatment may include:
• Anti-inflammatory medication
• Orthotics
• Physical therapy,
• Rest

Orthotics for Peroneal Tendonitis
Orthotics for this problem are designed specifically to reduce tension on the injured peroneal tendon. This often requires an orthotic that is deeper than normal around the heel and perfectly matches the arch of the foot (total contact orthotics). Special wedges are often added to decrease tension on the peroneal tendons. The correct orthotic can not only help heal the tendon by reducing tension on it but can also help prevent reoccurrence of the problem.

Treatment for Resistant Cases
This problem should be treated as early as possible in order to prevent damage to the tendon. Call us at our Seattle clinic right away if you are having symptoms.

In more severe cases we may place you in a removable cast (walking boot) from two to four weeks to allow the tendon to completely rest without placing the day-to-day demands of walking on it. If these measures fail to produce acceptable results surgical intervention may be necessary to clean around the tendon and repair any defects in the tendon. Surgical repair is rarely necessary.

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All pages on this website © 2005-2013
Douglas Hale, DPM & Lawrence Huppin, DPM
Foot and Ankle Center of Washington, Seattle
The material provided on this web site is for informative purposes only.
If you need specific medical advice, please contact the office for an appointment.

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