Peroneal tendinosis (also referred to as peroneal tendonitis) is a swelling and thickening of the peroneal tendon that passes behind the lateral malleolus on the outside of the ankle. This normally occurs during repetitive ankle motion such as running, jumping, or engaging in sports activities.
Causes of Peroneal Tendinosis
The major cause of of this condition is overuse of the tendons, especially in cases of abrupt increase in activity levels or intensity. Other factors may include:
- Improper footwear; wearing old or ill-fitting shoes
- People with a slightly turned inwards heel (hindfoot varus posture) are susceptible to peroneal tendinosis
- Runners who run on uneven surfaces such as slopes can develop peroneal tendinosis
Symptoms of Peroneal Tendinosis
Most patients experience varying degrees of pain and inflammation on the outside of the ankle, sometimes almost reaching the sole. The pain will increase with activity and decrease with rest. Putting pressure on the peroneal tendons outside the ankle may trigger pain. You may experience a stiff ankle after a long period of inactivity. You may feel a “popping” sensation in the ankle area on the affected side.
Treatment of Peroneal Tendinosis
Most cases of peroneal tendinosis will heal without surgery. This is because it is caused by overuse, which is easy to address and fix using conservative treatments. Treatment options include:
- RICE (rest, ice, compress and elevate) approach. Wrap ice and place it on the painful area for 10 minutes every hour, until you feel relief.
- Wrap the ankle in kinesiology tape for support and protection of the ankle.
- Buy new or different shoes. If you are a runner, it may benefit you to shop for running shoes at a local running specialty store, where specialists are better able to help you get the right fit and select a shoe with the support you need.
- Non-steroidal anti-inflammatory drugs (NSAIDs) can reduce pain and swelling.
- Perform strengthening exercises that are focused on eversion of the foot against resistance to restore proper function of the tendons. Do 100 to 200 repeats of the eversion exercise daily. You can start with a weak elastic band. Take breaks in between if you are tired.
- Engage in stretching exercise that is focused on stretching out your calf muscles. You can do straight knee and bent knee calf stretching in three sets of thirty seconds each, three times a day.
If RICE, stretching and strengthening exercises do not fix the problem, see Houston podiatrist Gabriel Maislos, DPM, FACFAS. Imaging (X-rays, Ultrasound or MRI) may be required for diagnosis. Dr. Maislos will be able to recommend a more suitable treatment method, possibly involving custom orthotics, or in advanced cases, surgery.
Pain on the outside of the ankle may indicate perineal tendonitis and should not be ignored. Contact Houston Foot and Ankle Care at (713) 541-3199 to schedule an appointment and start on the road to recovery. Patients often find that resolving foot and ankle pain can help ease other aches and discomfort (in the knee, hip, back), as the body can return to natural form and proper function. We offer same-day and next day appointments, and accept most major medical insurance.