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.
Video: How to Treat Peroneal Tendonitis
Anatomy of the Peroneal Tendons
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 and Diagnosis of Peroneal Tendonitis
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.
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.
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
- Physical therapy
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 recurrence of the problem.
Often a high quality prefabricated orthotic works well for peroneal tendonitis. Our recommended prefab orthotics for peroneal tendonitis is the FootChair Podiatrist Designed Orthotic. This is the only prefab orthotic to incorporate an adjustable arch that can help improve both comfort and function.
For smaller shoes including high heels, flats and soccer cleats, the recommended OTC arch support is the FootChair Slim Orthotic with adjustable arch support. It’s the only effective OTC arch support we have found to fit in women’s heels and flats. It has the same exceptional adjustable arch support as the full-size FootChair but with a much slimmer profile. In addition it flexes to adapt to most heel heights.
In our clinic we often add specific modifications to the prefab orthotics to decrease tension on the peroneals. If you see a podiatrist be sure to take your arch supports with you so they can be modified.
If the prefabricated orthotics do not provide adequate relief then correctly prescribed custom orthotics can reduce far more tension on the tendons.
The taping technique demontrated in this video is very effective at reducing tension on the peroneal tendons and easy to apply yourself. We recommend using Rocktape or another kinesiology tape as these tapes are much more gentle on the skin than standard athletic tapes. You can get Rocktape here.
Treatment for Resistant Cases
This problem should be treated as early as possible in order to prevent damage to the tendon. Contact 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.
Self-Treatment of Peroneal Tendonitis
If you have a mild case of peroneal pain and want to try home treatments first then try our 8-step peroneal tendonitis home treatment plan. If you are not seeing significnant improvement within 3 weeks, however, be sure to make an appointment to see us.