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Experiencing discomfort along the outer side of your lower leg? This might be a sign of peroneal tendonitis. While not critical, it can interfere with daily activities, especially for older adults.
In this article, we will explain what peroneal tendonitis is, how it is diagnosed and treated, and how to prevent it from happening through good self-care habits.
By the end, you should feel more empowered to manage peroneal tendonitis confidently and to take steps to improve your overall quality of life. Let’s dive deeper to understand peroneal tendonitis, its treatment, and prevention strategies to keep pain at bay.
Peroneal tendonitis relates to the tendons of the small muscles on the outside of your lower leg, from the upper calf down to the outer foot. These are called the fibularis muscles or the peroneal complex. Their primary purposes include:
Peroneal tendonitis occurs when these tendons become inflamed or irritated due to injury, overuse, or other stressors. This inflammation causes pain, swelling, and tenderness along the outside of the ankle and foot.
Many patients report pain that may be worse when moving their ankle, especially when turning it outward against resistance. The affected area may feel warm or red, and there may be a cracking or popping sound when moving the irritated ankle.
Some of the typical triggers include:
Runners are particularly susceptible to peroneal tendonitis due to the repetitive stress they place on their feet. However, your health history, weight, and overall activity level also play a significant role regardless of age.
Ankle pain is common among my senior patients, and early diagnosis is crucial for effective management. So, how do you determine if you’re dealing with peroneal tendonitis?
Seeking a professional opinion, ideally from an orthopedic doctor or physical therapist, is essential. Diagnosis often involves a combination of your symptom history and a comprehensive physical examination of your ankle, foot, and other body areas that may be contributing to the problem.
During the assessment, the specialist will generally observe your walking patterns and look at the structure of your ankle and the arches of your feet. They will then measure the flexibility of your ankle in various directions.
Once they have done an initial evaluation, they will test the strength and elasticity of the peroneal or fibularis muscles. This is typically done by moving the foot inward and testing resistance.
Finally, they will examine the tendons with light manual pressure for signs of pain, inflammation, or misalignment.
Imaging tests like X-rays or MRI scans might sometimes be recommended. However, a hands-on examination often suffices. Always discuss with your healthcare provider before opting for imaging.
Distinguishing peroneal tendonitis from conditions with similar symptoms is also vital. Your doctor or physical therapist will often screen for these related conditions:
Peroneal tendinosis is a long-standing issue where the peroneal or fibularis tendons undergo wear and tear. This degeneration results from frequent minor injuries and less-than-optimal healing. You can think of tendinosis as a longer-lasting version of tendonitis that has deteriorated the affected areas.
Symptoms: You might notice pain and stiffness along the outer side of your ankle and foot. This discomfort often intensifies during activity and eases up during rest.
This condition refers to a tear in one or both of the peroneal tendons. It can be due to a sudden injury or from constant overuse.
Symptoms: If you’ve experienced this, you’ll likely feel an immediate and sharp pain on the outer side of your ankle and foot. This pain might be paired with swelling, bruising, a feeling of weakness, ankle instability, or even challenges in walking.
In simpler terms, this is when the peroneal tendons move out of their usual place by the ankle bone. It usually occurs if the tendons or their surrounding tissues become overly flexible.
Symptoms: This displacement causes pain along the outer ankle. Those affected often describe a snapping sensation, especially when making movements like flexing the ankle while carrying your body weight.
Treatment for peroneal tendonitis primarily revolves around targeted physical therapy and exercises. The objectives are clear: alleviate pain, initiate healing, regain function, and reduce the chances of future occurrences.
The treatment plan is tailored to each individual’s unique circumstances but often starts with reducing or modifying activities that strain the peroneal tendons, such as running, jumping, or turning the foot outward.
Short-term use of anti-inflammatory medications to reduce pain and inflammation is often reccomended. Engaging in a structured, personalized physical therapy program to bolster the strength and mobility of the ankle is also typically helpful for recovery.
Your PT will help inform you about the causes, symptoms, and prevention of peroneal tendonitis, including proper footwear and biomechanics for optimal ankle health.
Most patients, especially seniors, find relief and recovery within weeks to months with consistent treatment. This timeline may vary depending on other problems or conditions that your therapist might detect.
Surgery might be considered on rare occasions, followed by a rehabilitation period with focused physical therapy, often after a short period of immobilization to promote healing.
Exercising the peroneal or fibularis muscles can be a life-changing treatment for anyone struggling with peroneal tendonitis or seeking preventative options.
These muscles, responsible for outward foot rotation and ankle stabilization, play an integral role in the mechanics of our lower limbs. Strengthening them can significantly enhance the stress tolerance of the peroneal tendons and optimize ankle function.
Let’s delve into my five favorite exercises for home or gym practice. Remember, a proper warm-up and consultation with a healthcare provider are prerequisites, and any sign of pain or discomfort should prompt a pause or modification in the exercise.
This simple yet effective exercise enhances ankle joint flexibility and mobility.
How to do it:
This exercise targets peroneal muscle strength by resisting outward force.
How to do it:
Strengthen the peroneal muscles by utilizing resistance bands.
How to do it:
Enhance stability and coordination in the ankle and foot.
How to do it:
Activate the peroneal muscles through natural sideways movement patterns.
How to do it:
These exercises aim at recovery and risk reduction. Still, modifications may be needed, particularly for seniors or those new to these exercises. Discuss these exercises or others your therapist recommends if you have concerns or if something doesn’t feel right.
Remember, the goal is to ensure your treatment gets you back on your feet so you can move on from your tendinitis to do the things you love again.
Think of them as related but distinct. Tendonitis involves inflamed tendons, often from factors like a sudden injury. Tendinosis, however, is about long-term degeneration due to ongoing minor injuries that don’t heal just right.
Several proactive steps can help: Wear the proper footwear, emphasizing support and cushioning;
Take your time with high-intensity activities; Always warm up before and cool down after exercises; Make ankle stretches and muscle strengthening a regular part of your routine.
Yes, but be mindful. Stay away from activities that aggravate your tendons. Low-impact alternatives like swimming, cycling, and walking are safer choices. And always remember to consult your healthcare provider or therapist if you need clarification or before making any significant changes.
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