Peroneal Tendonitis Treatment in Dallas & Frisco, Texas
Peroneal Tendinopathy, Peroneal Tenosynovitis, Peroneal Tendinosis
Runners and athletes all take on a certain level of risk when engaging in their favorite sport or activity. Unfortunately, even something as simple as running can cause significant foot and ankle pain. This can happen if you fail to stretch properly, experience trauma, or have an underlying condition. Peroneal tendonitis is one of the possible conditions that runners may develop over time.
Peroneal tendon injuries have the potential to generate great pain and instability for patients. That’s why the foot and ankle surgeons at SPORT Orthopedics and Physical Therapy are highly dedicated to diagnosing and treating your injury with great care. If you suspect that your peroneal tendon pain is due to peroneal tendinopathy, we are here to help. To schedule an appointment with our Dallas orthopedic surgeons and physical therapists, please call 469-200-2832 today.
What Are the Peroneal Tendons?
As you may know, tendons attach the muscles in our bodies to our bones. The peroneal tendons are located next to each other behind the outer ankle bone. One of the peroneal tendons attaches to the midfoot, while the other attaches to the foot’s arch on the bottom. They are called the peroneus longus and the peroneus brevis. The peroneal tendons’ main function is to provide support and stability to the foot, preventing an ankle sprain.
What Is Peroneal Tendonitis?
Also called peroneal tendinopathy, peroneal tendonitis is inflammation of the peroneal tendons. Although most people develop peroneal tendonitis due to overuse, some people experience this condition after they suffer a sudden ankle injury. One example of injuries that lead to developing peroneal tendonitis is ankle sprains.
What Causes Peroneal Tendonitis?
As we mentioned before, most peroneal tendon injuries occur as a result of overuse or trauma. Specifically, an ankle joint sprain can cause inflammation of the two peroneal tendons. Peroneal tendinitis causes the tendons to swell, which hinders the smooth movement of the joint. Other potential causes of peroneal tendon disorders include the following.
- Repetitive ankle motion from running on uneven surfaces or on sloped surfaces
- Runners and marathoners are at an increased risk from the repetitive motion necessary to take part in those activities.
- Additionally, those who have tight calf muscles experience more tension on the tendons. More tension creates more friction between the tendons, which can, in turn, lead to tendonitis.
- Those who frequently suffer from ankle sprains are also more likely to develop peroneal tendinitis. This is due to the ankle weakness that accompanies sprains.
Peroneal Tendinopathy Risk Factors
Peroneal tendon problems are more common in those who have the following risk factors.
- High arches in the feet
- Frequent fast-paced running or interval training
- Tight calf muscles
- Failing to stretch before physical activity
- A sudden increase in certain activities, such as weight bearing
- Using poor techniques in a training regimen
- Wearing poor or unsupportive footwear
- You have certain conditions, such as gout, rheumatoid arthritis, diabetes, or osteoarthritis.
- Failing to complete a rehabilitation program after ankle surgery or a tendon injury
How Common Is Peroneal Tendinopathy?
While tendonitis is a common ailment, especially for active people, peroneal tendonitis is not as common as other forms of tendonitis. Achilles tendonitis is much more common. However, there are a large number of runners, marathoners, and active people in the world. Even if only 1% of all runners suffer from this condition, that 1% could mean tens or hundreds of thousands of people. Additionally, some people who suffer from peroneal tendonitis also suffer from pes cavus, or high foot arches.
Peroneal Tendonitis Symptoms
Common symptoms of peroneal tendonitis include the following.
- Ankle pain along one peroneal tendon or along both tendons
- Pain that worsens when bearing weight on the ankle or engaging in physical activity
- Swelling, warmth, or redness around the affected ankle
- Thick tendons that have nodules or masses
- Pain at the back of the ankle
- Pain when turning your foot
- Feelings of ankle instability
What Does Peroneal Tendonitis Pain Feel Like?
It’s important to understand how to differentiate between peroneal tendonitis and another similar condition. Most patients describe peroneal tendonitis pain as sharp and aching sensations along the length of the tendons. You may also feel pain on the outside of the foot or near the ankle.
Generally, the pain will worsen with activity or while running. However, if the pain persists while simply standing without bearing weight, you might have a fifth metatarsal fracture. We recommend speaking with a doctor and undergoing a physical exam for a proper diagnosis.
Can the Peroneal Tendon Rupture?
Yes. A severe peroneal tendon injury such as this can result from an acute injury or from chronic overuse of the tendon. When one or both of these tendons tear, it can greatly impact foot functionality and cause ankle problems.
Tell-tale signs of peroneal tendon ruptures include the following.
- Lower leg pain
- A popping sensation or snapping feeling when the injury occurs
- Warmth and redness in the affected area
- Feelings of weakness or instability in the foot
While it is rare for both peroneal tendons to rupture, it is possible. In most cases, if one tendon tears, the other will function in its place. It is imperative that you seek immediate medical attention if you suspect a ruptured tendon.
Diagnosis of Peroneal Tendon Injuries
In order to diagnose your peroneal tendon injury, we will begin with a physical examination. It’s important to achieve an accurate diagnosis, as going too long without proper treatment can be highly detrimental. During the physical exam, we look for redness, swelling, warmth, and weakness. Once we pinpoint the location of your injury, we might order an imaging test to confirm the diagnosis.
Sometimes, these injuries are accompanied by other similar injuries, such as a high ankle sprain. It is even possible to experience nerve damage as a result of a serious injury. Chronic overuse injuries involve repetitive ankle motion and may be as mild as a stretched ligament. Depending on the extent of your injury, we will develop a personalized treatment plan for you.
Peroneal Tendonitis Treatment
Usually, we begin with conservative treatments unless we have confirmed a tendon rupture. Our main goal is to reduce pain and improve mobility over time. Below, we list the conservative treatments that we recommend for these injuries.
- Ankle brace: Wearing a brace and having the proper footwear might be enough to improve your symptoms. Ankle braces will provide added support and stability, especially while you’re active.
- Over-the-counter medication: Nonsteroidal anti-inflammatory medications reduce pain and reduce swelling. We may also recommend corticosteroids injected around the tendon sheath.
- Physical therapy: Working with a physical therapist is critical in restoring strength and range of motion. We will focus on strengthening exercises and manual therapy until your symptoms improve.
- RICE: Rest, ice, compression, and elevation make up the RICE method. For minor injuries, this might be all it takes to relieve pain and swelling.
Peroneal Tendonitis Exercises
One of our sports med professionals will work with you to strengthen your foot and ankle after the injury. Below, we list helpful exercises that you can perform at home to prevent peroneal tendonitis.
- Before any form of physical activity, stretch your calf muscles, ankle muscles, and peroneal muscles.
- Use a towel while sitting down to stretch your lower leg muscles.
- Perform a standing calf stretch using a door or wall.
- Perform heel raises by using a chair, table, stairs, or other elevated surfaces.
- Stretch your plantar fascia by rolling the bottom of your foot along a foot roller or tennis ball.
- Perform an ankle flexion with a resistance band.
Patient education is highly important to us. We will instruct you on how to properly perform the above stretches and exercises.
Peroneal Tendonitis Brace
The type of ankle brace you will need depends on the extent of your injury. Braces offer a range of benefits, from added support to full immobilization. We recommend speaking with your podiatric medicine specialist to ensure that you properly protect your foot and ankle during the healing process.
Peroneal Tendonitis Surgery
In severe cases, surgical treatment might be necessary. Painful tendon ruptures and chronic dislocation of the peroneal tendons are common reasons why we might recommend surgery. The peroneal tendon attaches muscle in your calf to the bones in your foot. In other words, they are incredibly important for foot and ankle health.
Two popular options for surgical intervention include tendon repair and tendon debridement. Tendon repair involves dividing the tendon sheath and either removing the torn portion of the tear or suturing the tear back together. Then, the sheath is repaired. Tendon debridement involves dividing the sheath, clearing out the damaged tissue, and allowing the space to fill with scar tissue.
Peroneal Tendonitis Recovery Time
Your recovery time depends largely on the extent of your injury. For mild cases, conservative treatments should yield positive results within two to four weeks. If your case requires surgery, your recovery time will be much longer. Strictly adhering to your doctor’s recovery plan is essential to prevent further injury and ensure a speedy recovery.
How to Prevent Peroneal Tendonitis
Sometimes, it is not possible to prevent peroneal tendonitis. If your case results from an injury or from high foot arches, there might not be much you can do about it. However, we’ve listed a few preventative measures you can take to reduce your chances of peroneal tendonitis.
- Maintain a healthy weight.
- If you feel foot pain, rest. Don’t push through the pain.
- Stop smoking.
- Gradually increase the intensity of your physical activity.
- Be sure to rest after a workout or game.
- Always stretch before engaging in physical activity.
- If you experience pain, consider wearing special ankle braces or supportive footwear.
Do You Have Peroneal Tendonitis?
At SPORT Orthopedics + Physical Therapy, our top priorities are treating your pain, guiding you through recovery, and ensuring that you can get back to your active lifestyle. Our highly skilled orthopedic surgeons have extensive experience treating a number of conditions. If you suffer from peroneal tendonitis or a similar condition, we’re here for you. To schedule an appointment with one of our professionals, please call 469-200-2832 today.