Peroneal Tendinopathy
Typical Symptoms
Tendinopathy of the Peroneal tendons (PT) usually causes pain around the lateral (outer) aspect of the foot (at their attachment to the foot) or at the level of the ankle (as it curves around the bone). There can be associated swelling, redness, stiffness and difficulty with mobilising, particularly when standing on your toes.
What causes it?
Tendinopathy can arise for different reasons, but it is usually due to an increase in activity, either from doing none at all or a sudden increase without progressive loading. Alternatively, if there is change in footwear, training style or even running route, these can all trigger off they symptoms. Continuing with the same pattern can lead to the problem becoming more chronic in nature. Sometimes it can also arise after a sprain to the ankle.
How can I help myself?
It is useful to think back to how the symptoms came on and what might be continuing to aggravate it. Sometimes, if it is due to running technique or tightness, then working with a coach or sports therapist can be helpful.
If there is considerable pain or swelling offloading with crutches will reduce exacerbating it and also measures such as PRICE can help to reduce swelling. Pain killers can make the symptoms more tolerable.
When to seek help?
If you are having significant symptoms, particularly difficulty with walking or running, or if the self-measures to improve things your symptoms have been ineffective, it would be good to have your problem assessed.
What are the treatment options?
Once your clinician assesses you with a thorough history and examination, they may undertake an X-ray to look for bony changes, or an ultrasound scan to look at the PT. Treatment with rehabilitation and a running gait analysis can suffice for many people with an additional focus on footwear, stride and cadence. In some situations, further treatment with a cortisone may be warranted, but if this is not improving symptoms then an MRI may be needed, with further consideration of PRP or prolotherapy injections.
