Peroneal tendinopathy

What is it?

As the name suggests, Peroneal Tendinopathy is a condition that is characterised by degeneration of the Peroneal tendon.  There are two muscles located on the outside of your leg and course down the outside of the ankle bone known as Peroneus Longus and Peroneus Brevis.  Either of these muscles may be implicated in this muscular condition.  The main job of both these tendons is to provide stability and protect one from spraining the ankle. Although this degeneration can occur anywhere along the tendon, it is most commonly found at its maximum fulcrum point; behind the ankle bone, or its insertion onto the outside of the midfoot.

Why did I get it?

Peroneal Tendinopathy can be caused by many factors & is most seen in the active middle-aged population (women > men) and is largely an overuse injury. Most patients with the condition can often present with many of the following risk factors;

  • Overuse – Sudden increase in activity

  • Acute trauma to tendon

  • Increased weight

  • Poor lower limb/foot biomechanics

  • Incorrect footwear

  • Previous injury to tendon

Symptoms:

  • Pain and swelling on the outside of the ankle just below the bony protrusion (lateral malleolus).

  • Pain is often worse during activity, but symptoms improve with rest.

  • You may have pain when pressing in on the outside of the ankle.

  • Pain may be recreated by stretching the peroneal muscles.

How is it diagnosed?

A thorough clinical examination will most commonly diagnose Peroneal Tendinopathy. Depending on severity of symptoms, you may be referred for an ultrasound +/- MRI to determine the extent of the degeneration and to make sure there aren’t any tears in the tendon.

Possible treatments:

  • Rest, ice, compression

  • Padding/strapping

  • Footwear advice

  • Custom insoles

  • Aircast walker

  • Richie Brace

  • Surgery

  • Anti-inflammatories

Prognosis:

Prognosis is largely dependent on the grade of Tendinopathy present. Conservative treatments generally produces successful results for mild cases, however surgery is often indicated for end stage Tendinopathy.

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Plantar Fascial Strain/tear