When damage to the peroneal tendons occurs it is referred to as peroneal tendonitis, however, recent research has indicated that peroneal tendinopathy may be a more accurate term to indicate overuse injuries occurring in this tendon. Peroneal tendonitis remains the most common terminology as it more widely known and recognized, so it will be used throughout this article.
The peroneal region of the body lies on the outer portion of the lower leg and is comprised of several muscles that are responsible for moving the foot and ankle away from the center of the body. When these muscles contract or are stretched pressure is placed on the tendons, and if the pressure is excessively repetitive or intense the tendon can be damaged, which can cause inflammation and degeneration to occur. Tendonitis, tears and subluxation are also typical types of injury seen in this area of the body.
Peroneal tendonitis can be chronic (developing over the long-term) or acute (occurring suddenly) and it is often the result of excessive walking or running or from playing sports that demand a frequent change of direction (tennis), or a lot of jumping (basketball or ballet). People with unusually high arches are particularly vulnerable to this condition.
Symptoms of peroneal tendonitis typically start with pain on the outside of the ankle, foot or lower leg during weight bearing activities, particularly if stress placed on the peroneal tendons. The area may also become inflamed and the skin warm to the touch. There may be a gradual onset of pain that culminates with acute pain during physically activities.
This condition is generally diagnosed following a thorough examination by a specialist who may also order an x-ray to evaluate the injury in more depth and to rule out ankle sprains or other forms of damage that can occur in tandem with this condition. Proper diagnosis is extremely important when dealing with peroneal tendonitis as improper treatment may make the injury much worse.
Physiotherapy is a highly recommended form of treatment for this condition as it greatly speeds the quality and rate of healing and reduces the risk of re-injury. Treatment may generally include massage therapy, stretching exercises, joint mobilization exercises, foot taping, cold therapy, crutches, orthotic devices, footwear modification, strength and flexibility exercises, the use of anti-inflammatory medications, and a gradual reintroduction to physical activity.
While the outlook for most patients dealing with peroneal tendonitis is very good the healing process can take a great deal of time and energy. The earlier the diagnosis is made and the earlier treatment is introduced the less time it takes to correct the problem. There are, however, some patients that do not respond to conservative treatments, in which case corticosteroid injections or autologous blood injections may be used. Further examination with an Ultrasound or a CT scan may be needed for deeper examination of the tendon as well.
Only rarely is surgery used to repair the tendons as it is extremely invasive and requires a prolonged period of healing followed by physical therapy. Peroneal tendonitis is an uncomfortable condition requiring immediate diagnosis and treatment, and care should be taken with physical activities to ensure that excessive pressure is never placed on the tendons.