Peroneal Tendonitis Treatment: Find Relief for Peroneal Tendonitis with Our Expert Therapy Treatments

Peroneal tendonitis is a condition that occurs when the peroneal tendons in the foot become inflamed or irritated. The peroneal tendons run down the outside of the ankle and foot and are responsible for stabilising the ankle and helping with movement.

When these tendons become inflamed, it can cause pain, swelling, and stiffness in the ankle and foot. Peroneal tendonitis is most commonly caused by overuse or injury, but can also be due to other factors such as foot structure or improper footwear. It is important to seek treatment for peroneal tendonitis to prevent further damage and reduce pain and discomfort through physical therapy and rest, medications and proper footwear.

Peroneal tendonitis is typically diagnosed through a combination of a physical exam and imaging tests. During a physical exam, the doctor will check for swelling, tenderness, and weakness in the affected area. They may also ask you to move your foot and ankle to check for pain and instability.

Imaging tests such as X-rays, ultrasound, and MRI may also be used to help diagnose peroneal tendonitis. X-rays can help rule out other causes of foot and ankle pain, while ultrasound and MRI can provide detailed images of the tendons and surrounding tissues to help identify any damage or inflammation.

Peroneal tendonitis is caused by repetitive overuse of the peroneal tendons. It often occurs in athletes or individuals who engage in activities that require repetitive ankle movements, such as running, jumping, or pivoting.

Other factors that may contribute to the development of peroneal tendonitis include improper footwear, ankle instability, and weak ankle muscles. In some cases, a traumatic ankle injury or a sudden increase in physical activity can also lead to peroneal tendonitis.

The symptoms of peroneal tendonitis may include:

• Pain or tenderness along the outer edge of the ankle
• Swelling or redness in the affected area
• Stiffness in the ankle or foot
• Weakness or instability in the ankle
• Difficulty walking or running
• A popping or snapping sensation when moving the ankle.

Non-surgical peroneal tendonitis treatment may include:

Rest and immobilisation

Resting the affected foot and avoiding activities that aggravate the condition can help reduce inflammation and pain. Immobilisation through the use of ice and brace treatments, cast, or walking boot may also be necessary to allow the tendon to heal.

Ice and heat therapy

Applying ice packs to the affected area can help reduce inflammation and pain. Heat therapy, such as warm compresses or a heating pad, can also be helpful in promoting blood flow and relaxation of the muscles.

Physical therapy

Physical therapists can help develop an exercise program to strengthen the muscles and improve range of motion in the foot and ankle. They may also use techniques such as massage, ultrasound, or electrical stimulation to reduce inflammation and pain.

Medications

Over-the-counter pain relievers such as acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help relieve pain and reduce inflammation.

Orthotics

Wearing custom-made shoe inserts or orthotic devices can help support the foot and ankle, relieve pressure on the peroneal tendons, and reduce the risk of further injuries.

In severe cases of peroneal tendonitis that do not respond to non-surgical treatments, surgery may be necessary. There are a few surgical treatment options that may be recommended, depending on the specific case:

Tendon debridement

In this procedure, the damaged tissue in the peroneal tendons is removed, and the healthy tissue is repaired.

Tendon transfer

If one of the peroneal tendons is too damaged to be repaired, a nearby tendon may be transferred to take its place.

Osteotomy

If peroneal tendonitis has caused damage to the ankle bone, an osteotomy may be performed to reshape or reposition the bone, relieving pressure on the tendons.

Arthroscopy

This minimally invasive surgery involves the insertion of a small camera and instruments into the ankle joint to remove any inflamed tissue, smooth out bone spurs, or repair any damage to the peroneal tendons.

Tenodesis

This involves moving the peroneal tendons to a new location, such as in front of the ankle, to help prevent future damage.

Here are some tips for recovering from peroneal tendonitis and returning to normal activities:

Rest

The first step in recovering from peroneal tendonitis is to rest the affected area. Avoid activities that aggravate the pain and swelling.

Ice

Applying ice to the affected area can help reduce pain and swelling. Apply ice for 20 minutes at a time, several times a day.

Compression

Using compression wraps or compression socks can help reduce swelling and provide support to the affected area.

Elevation

Elevating the affected leg above heart level can help reduce swelling.

Physical therapy

Physical therapy can help in strengthening and stretching the peroneal muscles and tendons, improving flexibility, and restoring normal range of motion.

Medications

Over-the-counter pain relievers such as ibuprofen or acetaminophen can help reduce pain and inflammation.

Proper footwear

Wearing proper footwear can help reduce stress on the peroneal tendons. Use shoes that provide good arch support and have a wide toe box.

Gradual return to activity

After the pain and swelling have subsided, start with low-impact activities and gradually increase the intensity and duration of the activity. It is important to follow the instructions provided by your doctor and physical therapist and not to rush back into activities before the area has fully healed.

Here are some tips for preventing peroneal tendonitis:

• Choose shoes that fit well and provide proper support and cushioning. Avoid wearing worn-out or ill-fitting shoes, as they can put unnecessary stress on your feet and ankles.
• Incorporate stretching exercises into your daily routine, especially before and after exercise. This will help to improve flexibility and prevent tightness and strain on the peroneal tendons.
• Perform exercises to strengthen the ankle and foot muscles, including the peroneal muscles. This can include calf raises, ankle rotations, and resistance band exercises.
• Avoid overdoing activities that put stress on the peroneal tendons, such as running on uneven surfaces or playing sports that require sudden changes in direction.
• Gradually increase the intensity and duration of your exercise routine. Sudden increases can put too much strain on the peroneal tendons and lead to injury.
• Pay attention to any pain or discomfort in your feet and ankles. If you experience any symptoms of peroneal tendonitis, take a break from physical activity and seek treatment if necessary.

Written by Sophie Young, Director & Podiatrist. Reviewed by Kirti Mann, Director & Podiatrist