An Overview of Peroneal Tendonitis

1. An Overview of Peroneal Tendonitis Peroneal tendonitis (or peroneal tendinopathy as it’s more accurately known) is typically an overuse injury characterised by tissue damage, swelling and degeneration of one or more of the peroneal tendons. The outer aspect of the lower leg comprises a group of muscles called the peroneals. These muscles originate from the fibula bone (at the outer aspect of the lower leg) and insert into several bones of the foot via their respective peroneal tendons. During contraction, the peroneal muscles move the ankle and foot into eversion (i.e. away from the body’smidline). They are placed under stretch during end of range inversion movements (i.e. movement of the foot and ankle towards the body’s midline).

2. When the peroneal muscles are stretched or contract, tensile forces are placed through the peroneals and their respective tendons. When this force is excessive due to too much repetitious, prolonged or high force, injury to the peroneal tendons can occur. Peroneal tendonitis is injury characterised by microscopic damage, swelling and degeneration of the peroneal tendons. Causes Peroneal tendonitis often occurs in association with excessive running and walking activities, particularly on uneven surfaces or slopes. Sporting activities like volleyball, football, basketball and dancing that involve repetitive jumping or change of direction movements can also cause the condition. Symptoms Patients who have peroneal tendonitis usually experience pain or discomfort around the outer side of the lower leg, foot or ankle. Symptoms are often experiencedwhen engaging in activities that put significant load on the peroneal tendons, or, when resting after these activities (e.g. the next night or the following morning). Provocative activities may include running or walking excessively (particularly on uneven surfaces or slopes) or sports involving repetitive jumping or change of direction movements.Symptoms often develop insidiously over days, weeks or months, with ongoing participation in damaging activities. Pain may also increase when firmly touching the injured tendon. Diagnosis A detailed examination from a qualified physiotherapists usually sufficient to diagnose peroneal tendonitis. Other investigations (for example an MRI scan or Ultrasound) may be indicated to confirm the diagnosis, assess the injury severity and rule out other conditions. Risk Factors There are numerous factors that may increase the likelihood of a patient developing peroneal tendonitis. It is important to identify and address these factors to ensure an optimal outcome. Some of these factors include: Being overweight Muscle imbalances Neural tightness Inadequate rehabilitation after a prior lower limb or ankle injury Insufficient warm-up Poor shoe wear Inappropriate running technique Poor foot biomechanics Inadequate recovery periods from activity or sport Excessive or inappropriate training or activity Joint stiffness

3. Muscle weakness or tightness Physiotherapy Treatment Techniques for Peroneal Tendonitis Physiotherapy treatment can accelerate recovery from peroneal tendonitis and provide an ideal outcome. Appropriate education and lifestyle modification advice are essential. Physiotherapy treatment techniques may include: Education Activity modification advice Exercises designed to improve flexibility, strength and balance A graduated resumption of activity plan Footwear advice Biomechanical correction Heat or ice treatment Crutches use Ankle bracing Foot or ankle taping Dry needling Joint mobilisation Stretches Anti-inflammatory advice Electrotherapy Soft tissue massage Prognosis The vast majority of patients with peroneal tendonitis can expect a full recovery with an appropriate physiotherapy rehabilitation program. The process, however, can be lengthy and may last a number ofmonths in individuals who have had their injuryfor a long time. Minor cases involving early appropriate management usually recover within a few weeks. Early appropriate physiotherapy advice and management is essential for a hasty recovery. Let PhysioAdvisor Help PhysioAdvisor’s team of experienced physiotherapists are experts in evidence-based treatment of injuries such as peroneal tendonitis (peroneal tendinopathy). Their industry-leading step by step injury rehabilitation and treatment guides (for conditions such as peroneal tendonitis) are designed to provide you with all the information you need to take control of your injury and accelerate your journey to wellness (including initial, intermediate and advanced rehabilitation exercises).If you’re struggling with peroneal tendonitis, let PhysioAdvisor empower you! Visit their website to find out more information and access their injury rehabilitation guides!