Hello and welcome to this episode in our series on sports podiatry. Today, we’ll be covering pain in the outside of the foot, which is commonly known as peroneal tendonitis.
In the foot, there are three muscles that run around the outside of the foot, ankle and leg. They’re known as peroneus tertius, peroneus longus and peroneus brevis. Their role during gait is to prevent the ankle from rolling and also to stabilize the foot during motion. Peroneal tendonitis is inflammation within the tendon and pain usually occurs within the muscle and the tendon. The most common cause for peroneal tendonitis is excessive load during exercise or activity.
The most common signs and symptoms of peroneal tendonitis usually involve inflammation and pain within the tendon that can extend up into the peroneal muscle belly. Pain most commonly occurs after periods of rest and then warms up as activity occurs. Pain usually starts and most commonly occurs during activities that involve walking and running on uneven surfaces as well as sports that involve side to side motion.
Some of the most common causes of peroneal tendonitis involve the muscles so having tight calf muscles and also having weakness through the peroneals and the surrounding muscles of the ankle. Also having a foot posture such as a high arch places people at more risk of ankle sprains which then can lead to chronic ankle instability which overloads the peroneals. Another very common cause of peroneal tendonitis is footwear so if you’re in the wrong footwear for your foot type or is you’re in a shoe that pushes you out too much when you’re walking, this can overload the peroneals and lead to peroneal tendonitis occurring.
The most common treatments for peroneal tendonitis usually involve addressing muscle tightness and muscle weakness. This is done with an exercise program involving stretching and strengthening. TheraBand is a very useful tool that can be used at this point in treatment. Icing will also be recommended and also strapping will be used to try and place the foot into a more pronated position. This will offload the outside of the foot and the peroneals.
Footwear is really important at this point of treatment and will usually involve taking stress off the outside of the foot after a full biomechanical assessment’s performed. At the next phase of treatment you’re looking at trying to get some sort of offloading with an orthotic so orthotic inside the shoe will aim at placing the foot in a more pronated position to further take pressure off the outside of the foot.
At this same point of treatment dry-needling can be very effective and usually involves a few sessions. If all these treatments are not successful in reducing peroneal tendonitis and pain a surgical referral may be required.
If this condition goes untreated it can be very debilitating and affect your quality of life. It is best to treat the condition early as the condition is around for longer becomes a lot more difficult to treat. The information in this video is general and if any signs and symptoms develop it is best to seek a medical opinion. If you’d like to book an appointment with us you can book on our website or you can call one of our local clinics.