Peroneal Tendinopathy

Did You Know?

The peroneal tendons are very important for stabilising the ankle.

What Is Peroneal Tendinopathy

Peroneal tendinopathy is a condition characterised by inflammation or degeneration of the peroneal tendons, which run along the outer side of the ankle. These tendons help stabilise the foot and assist with movements like pointing the toes and turning the foot outward. When these tendons are overused or injured, they can become inflamed, causing pain and discomfort, especially during sport and activity.

Anatomy

The peroneal tendons consist of two main tendons: the peroneus longus and the peroneus brevis. Both tendons originate from muscles in the lower leg and run behind the bony bump on the outside of the ankle (the lateral malleolus). The peroneus longus tendon extends under the foot and attaches to the base of the big toe, while the peroneus brevis attaches to the outer side of the foot on the base of the 5th metatarsal. Together, these tendons play a crucial role in stabilising the ankle and foot during movement.

Symptoms

The symptoms of peroneal tendinopathy can vary but typically include:

• Pain and Swelling: Pain is usually felt on the outside of the ankle and may worsen with activity. Swelling around the affected area is also common.

• Tenderness: The outer ankle may feel tender to the touch, especially when pressing along the tendons.

• Instability: Some individuals may experience a feeling of ankle weakness or instability, particularly when walking on uneven surfaces.

• Stiffness: Stiffness in the ankle, particularly after periods of rest or in the morning, is a common symptom.

Causes

Peroneal tendinopathy is often caused by repetitive strain or overuse, particularly in activities that involve excessive ankle movement, such as running, rugby, netball, hockey or walking on uneven terrain. Other potential causes include:

• Improper Footwear: Wearing shoes that are very soft and unsupportive. Shoes that encourage the ankle to roll out will increase load on the tendons

• Sudden Increase in Activity: A sudden increase in physical activity levels, such as starting a new exercise regimen, can overload the tendons.

• Ankle Sprains: Previous ankle sprains or injuries can weaken the peroneal tendons & muscles and increase the risk of tendinopathy.

• Foot Mechanics: Certain foot shapes or biomechanics can predispose individuals to this condition.

Treatment

Treatment for peroneal tendinopathy typically involves a combination of rest, rehabilitation, and supportive measures. Here are some common treatment options:

• Rest and Activity Modification: Reducing or avoiding activities that aggravate the pain is crucial. Resting allows the tendons to heal and prevents further damage.

• Ice Therapy: Applying ice to the affected area can help reduce pain and inflammation.

• Strength & Conditioning: Our team of podiatrists can guide you on specific exercises to strengthen the muscles around the ankle, improve flexibility, and enhance overall stability.

• Supportive Footwear and Orthotics: Wearing stable, firmer footwear can help reduce load on the tendons. In some cases, orthotic insoles can be used to reduce load on the tendons.

• Bracing or Taping: Ankle braces or taping techniques can provide additional support and reduce the stress on the tendons during movement.

• Gradual Return to Activity: Once symptoms improve, a gradual return to regular activities and sports is essential. Our team can provide guidance on safely resuming your routine.

• Surgical Intervention: In severe or persistent cases where conservative treatments fail, surgery may be considered to repair or clean up the damaged tendons.