Overview

What is peroneal tendinopathy?

Peroneal tendinopathy is a condition characterized by inflammation of the tendons running along your outer ankle bone and the side of the foot. These tough bands of tissue connect the muscles in the back of your leg to the bones in your foot. They stabilize and balance your foot and ankle, thus protecting them from injury.

This tends to be related to overuse but may also come on suddenly after a fall or other foot injury.

Who gets peroneal tendinopathy?

Anyone can develop this condition, but it is most likely to occur in people who engage in sporting activities that make them move their ankles a lot. You are also more likely to develop peroneal tendinopathy if you:

• Are over 40.
• Do not stretch before exercising.
• Have specific conditions such as Diabetes, osteoarthritis, rheumatoid arthritis or gout
• Have previous tendon injury
• Have high arches of your feet
• Are overweight/obesity
• Have Tight tendons
• Are Smoker

What are the symptoms of peroneal tendinopathy?

Some of the common symptoms of peroneal tendinopathy may include:

• Pain along the length of your tendon in the ankle region
• Pain which worsens with physical activity
• Swelling, redness or warmth around your tendon
• Thickening of tendons with a mass or nodule that moves with your tendon

What causes peroneal tendinopathy?

Over time, peroneal tendons can become inflamed due to repetitive overuse of the tendons. Alternatively, it could happen abruptly from an acute ankle injury, like a sprain, which swells the tendons or the lubricated sheath surrounding the tendons so they can't slide smoothly.

How is peroneal tendinopathy diagnosed?

Peroneal tendinopathy is a rather challenging condition to diagnose. Symptoms often mimic other foot and ankle conditions, arthritis, and fractures. In one study of 40 peroneal tendinopathy patients, 60% of the patients were initially diagnosed with another wrong condition.

Nevertheless, your physician would perform a physical examination and will inquire about your symptoms. Your physician may also palpate part of your foot or ankle to check out if they contain swelling or tenderness in those parts. Your physician might also ask you to move your ankle through some range of motion to check the joint's flexibility.

Sometimes, imaging procedures may be necessary to rule out a foot fracture, osteoarthritis, cartilage damage, or even torn tissue. Your provider may also recommend an X-ray, MRI, CT scan, or ultrasound.

How is peroneal tendinopathy treated?

Conservative treatments usually help alleviate tendon pain and inflammation in three to four weeks. If the tendinopathy results from another injury, usually a sprain recovery takes longer.

Common treatments of peroneal tendinopathy include:

• Bracing, where an ankle brace may offer support and stabilization for your ankle if you are required to perform certain movements, such as running or jumping.
• Immobilization may require a soft cast or boot in which your foot is placed to immobilize it and remove weight from your tendons so that they heal.
• Medications: NSAI (Nonsteroidal anti-inflammatory drugs) may help with pain and inflammation. Sometimes, steroid injections are administered along the tendon or into the tendon sheath itself.
• Physical therapy: Your physician will refer you to see a physical therapist who will teach you exercises and stretches to regain strength and flexibility in your foot and ankle. Your therapist may also counsel you on the use of ice, heat, or ultrasound.
• RICE method: At home, you may treat yourself with the RICE (rest, ice, compression and elevation) remedy. Rest because you will avoid any strenuous activities. Put an ice pack or cold compress on your ankle for 20 minutes every two hours. Wrap an elastic bandage around your ankle to minimize swelling and elevate it, ideally on a surface higher than your heart's.

What are the risks of peroneal tendinopathy surgery?

Like all surgeries, ankle surgery for peroneal tendinopathy does pose some risks which include:

• Bleeding.
• Blood clots.
• Infection.
• Nerve damage.
• Recurring tendinopathy or ankle pain.
• Scar tissue formation.

How do you prevent peroneal tendinopathy?

TIPS to avoid pain due to peroneal tendinopathy include:

• Gradually work up to rigorous physical activity.
• Maintain a healthy body weight.
• Never go by the "tough out" foot or ankle pain.
• Quit smoking.
• Take rest after exercise, games or other body exercises.
• Stretch to warm up your feet and ankles before exercise activity.
• Wear ankle braces, supportive shoes, or any other protective apparatus.
• Use orthotics if you have high arches, but only if prescribed by your healthcare provider.

What is the prognosis (outlook) for people with peroneal tendinopathy?

Most people fully recover from this condition in about a month. See your healthcare provider before returning to full activities or your sport. The recovery time from peroneal tendinopathy will be longer if you have surgery. For the first four to six weeks after surgery, you will be in a cast on your lower leg and may need crutches for that time. It is safe to begin weight-bearing across your ankle again when your doctor tells you it is okay to do so. Most patients receive follow-up physical therapy after their operation to regain strength and stability in the ankle.

When to call your health care provider?

Call your health care provider if:

• You cannot take a step or bear your weight on your foot or ankle.
• You cannot bend or rotate your ankle forward, backward or on either side.
• You hear a snapping or popping sensation in the foot or ankle.
• You notice intense pain in your foot or ankle that comes on sharply.
• You find swelling or discoloration of the foot or ankle.

To seek an expert consultation for any orthopedic condition.

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