Peroneal tendinitis is a condition that can be acute or become chronic (peroneal tendinopathy) whereby there is irritation to one or both peroneal tendons with subsequent degeneration and inflammation.
The actions of the peroneus longus and brevis are plantarflexion and eversion of the foot in open kinetic chain motion. During weight bearing, the peroneus longus acts as a stabilizer of the transverse arch of the foot, as well as stabilizer of the first ray during propulsion
Location
Signs & Symptoms
Pain in the posterolateral aspect of the ankle along the course of the tendons
Occasionally swelling & warmth
Tenderness on palpation to peroneus brevis insertion at the base of the 5th metatarsal
Pain with turning the foot in or out
Pain exacerbated by rising onto the ball of the foot
Pain with activities such as running, cutting, jogging or even walking on uneven surfaces
Risk Factors
@ risk population groups
Endurance running athletes
Young Dancers
Ice skaters
Sports requiring frequent change of direction or jumping = basketball & netball
Tight calf muscles
Weakness of the peroneal muscles
Inappropriate training loads (training surface, poor recovery or too quick an increase in intensity or duration)
Poor foot biomechanics
Inappropriate footwear
Following acute ankle sprains, chronic ankle instability or post fractures of the ankle
Physiotherapy Management
RELATIVE rest from aggravating activities (complete rest is actually detrimental to tendon remodelling)
Swelling and pain management = ice, massage, dry needling, taping
Ankle bracing or taping during contact sports
Heal raise inserts to offload the tendon
Progressive rehabilitation program including
Stretching
Strengthening
Joint Mobilisation and manipulation
Propripcetive exercises
Assessment of running technique and implement strategies to improve Running Biomechanics
PROGRESSIVE TENDON STRENGTHENING PROGRAM (The Gold Standard Treatment)
Structured Running program focusing on appropriate loading principles