What is Peroneal tendonitis?

Peroneal tendonitis is a condition that causes inflammation of the peroneal tendons of the foot. These tendons are important in that they stabilise the foot and ankle, thus minimising the risk of sprains.

When there is an increased rate of using the tendons or increased load on the ankle, the tendons rub against the bones. This leads to the inflammation of the tendons, a condition called peroneal tendonitis.

Two peroneal tendons run side by side down the fibula and behind the bony lump of each leg. The bony lump is called the lateral malleolus.

One of the tendons attaches at the base of the fifth metatarsal while the other passes on the lower side of the foot and gets attached to the inner side of the arch.

Other than protecting the ankle from sprains, the tendons provide stability to the ankle when it is bearing weight. They also stabilise the arch and turn the foot out when walking to provide stability when walking.

What causes Peroneal Tendinosis?

Peroneal tendon injuries may occur suddenly or develop over time. The most common injuries involve people who participate in sports and face repetitive ankle motions. Additionally, people who have high arches face a higher probability of developing peroneal tendon injuries. The basic forms of peroneal tendon injuries include tears, tendonitis, and subluxation.

Tendonitis occurs when one or both tendons are inflamed due to activities like repetitive use of the ankle, trauma, for example, a sprain, or overuse of the tendons.

Degenerative tears/ tendinosis usually occurs when the ankle is overused. It develops over a long time (chronic). In this condition, the tendon gets stretched, become thin, and finally frays. Also, high arches predispose you to this condition.

Subluxation is a condition that occurs when tendons slip out of their normal position. Chronic tendon subluxation can be caused by damage to the tissues that stabilise the tendons. These tissues are called the retinaculum.

Podiatrists examine the foot to look for signs of pain, swelling, weakness on the outer side, and warmth. To fully evaluate the injury, they also use other forms of advanced imaging like the X-ray and ultrasound. Podiatrists also look for signs of other injuries related to sprains that may accompany peroneal tendon injuries. This problem could also be detected from prolonged pain even after a simple sprain, thus proper diagnosis is important.

Treatment is dependent on the type of injury. The treatment options include:

  • Rest and immobilisation. To allow the injury to heal, a CAM walker or related equipment may be used.
  • Topically applied or oral medications may be useful in relieving the pain or inflammation.
  • Physical therapy – exercise are prescribed to alleviate the symptoms.
  • Injection therapy. Prolotherapy – treat the inflammation and relieve the pain.
  • Orthotics –  custom shoe inserts that help in maintaining the arch and reduce excessive motion that may cause compression of the nerve.
  • Supportive shoes are helpful to such patients.
  • A ‘trilock’ ankle brace may be useful in reducing the pressure on the foot of patients with nerve damage and severe symptoms.
  • In some cases, surgery may be necessary to repair the structures of the foot that have been injured.
  • Contact us on 03 9077 5915 for further assessment and treatment.