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Peroneal Tendonitis

What is Peroneal Tendonitis?

Peroneal tendonitis is inflammation of the peroneal tendons in the ankle due to an acute or overuse injury. It is common in those participating in sports involving repeated ankle movement such as running.

Causes of Peroneal Tendonitis

The peroneal tendons are two tendons running on the outside of the ankle. They help stabilize the ankle to prevent twisting or sprain injuries. Activities involving repetitive ankle movements can cause the peroneal tendons to rub against the bone leading to irritation and inflammation. Peroneal tendon inflammation and sometimes tears can also occur when the ankle is suddenly overloaded such as during a sprain injury.

You are likely to experience peroneal tendonitis with:

  • A sudden increase in load and activities affecting the ankles
  • Improper footwear during activities
  • Overtraining or using improper techniques
  • High foot arch
  • Muscle imbalance
  • Poor strength of the lower limb
  • Poor rehabilitation following an ankle sprain

The tendons gradually thicken to accommodate the increase in activity and load but are likely to develop scar tissue making them vulnerable to tears.

Symptoms of Peroneal Tendonitis

  • Peroneal tendonitis is associated with:
  • Pain behind the ankle which increases with activities
  • Pain on rolling the foot inward or outward
  • Swelling
  • Warmth
  • Instability while bearing weight

Diagnosis of Peroneal Tendonitis

Your doctor will review your medical history and discuss your activities. A physical examination will be performed during which the ankle is manipulated, and mobility and pain is assessed. Imaging studies such as an X-ray, MRI scan or ultrasound may be ordered to examine the peroneal tendons for tears, swelling and scar tissue or to see if there are other injuries such as a sprain or a fracture.

Treatment of Peroneal Tendonitis

You will be advised to reduce walking and other activities that worsen your symptoms for a while so that the tendons have a chance to rest and heal. Nonsurgical treatments may be recommended such as:

  • Anti-inflammatory medication
  • Cortisone injections
  • Ankle Immobilization in a cast, splint, or boot
  • Bracing
  • Physical therapy

Surgery is rarely necessary for tendonitis. If the tendon or tendons are being irritated by surrounding tissue, surgery may be performed to release the tendon. Surgery may also be performed if the inflammation is associated with a tear that can be repaired. Physical therapy will be recommended following surgery.

Preventing Peroneal Tendonitis

To avoid peroneal tendonitis your doctor recommends:

  • Wearing footwear that is appropriate for your activity
  • Stretching the calf and ankle prior to activity
  • Gradually increasing your training workload
  • Maintaining some activity offseason or during recovery to keep the ankles strong and flexible