Peroneal tendinopathy describes the damage to the peroneal tendons which travel down the outside of your leg and cross the outside of the ankle to attach to the bottom of the foot. It is often referred to as peroneal tendonitis or tendinosis.
There are two peroneal muscles called the Peroneus Longus and Peroneus Brevis. They follow the same path down the leg and behind the bony bump (lateral malleolus) on the outside of the ankle but attach at different sites at the base of the foot. The peroneals play an important role in our ability to walk and move out feet.
Peroneal tendinopathy is typically an overuse injury that is caused by overloading the peroneal tendons past a point that they can safely handle before incurring damage. Any action that everts the foot (rolls out the ankle) will stretch and place greater strain on the peroneal tendons, and may cause them to rub against surrounding bones and become inflamed. Often, patients may not be able to think of a definitive cause for the pain, feeling that it just ‘came on’ for no significant reason or during activity. Contributing factors to the development of peroneal tendinopathy can include:
Symptoms can range in severity depending on the extent of the damage to the peroneals but can include:
Without effective management, the symptoms of peroneal tendinopathy can progressively worsen. Treatment first begins by managing the current painful symptoms by following the PRICE principles (protection, rest, ice, compression and elevation).
Treatment then focuses on addressing the cause of the tendinopathy so the tendons can effectively heal and to reduce the risk of the problem recurring in the future. This can involve:
It is very important to rest the foot and limit the activities that bring on the painful symptoms. It is also important to note that steroid use may further damage the tendon, so this must be discussed with your GP and podiatrist. Unless there is a rupture or a significant tear of a peroneal tendon, this condition typically does not require surgery.