Understanding Peroneal Tendonitis: Symptoms and Treatments

Peroneal tendonitis is a common overuse injury that affects the tendons located on the outer part of the ankle and foot. It often results from repetitive motions or sudden increases in activity, leading to inflammation and irritation of the peroneal tendons. If left untreated, it can cause persistent pain and compromise ankle stability.

Symptoms of Peroneal Tendonitis

Recognizing the symptoms early can lead to more effective treatment and quicker recovery. Typical signs include:

- Pain: Sharp or aching pain along the outer ankle, particularly behind and below the lateral malleolus (the bony prominence on the outer ankle).
- Swelling and Tenderness: Localized swelling over the peroneal tendons, which may be tender to touch.
- Instability or Weakness: A feeling of ankle instability, especially during activities that involve side-to-side movements.
- Crepitus: A creaking or snapping sensation when moving the ankle.
- Pain with Activity: Increased discomfort during walking, running, or jumping, typically worsening with activity and improving with rest.
- Pain at Rest: In more advanced cases, pain might persist even at rest.

Causes and Risk Factors

Peroneal tendonitis is often caused by repetitive ankle motions, sudden twisting injuries, or overuse during sports such as running, basketball, or tennis. Factors increasing the risk include:

- Overtraining or sudden increase in activity
- Improper footwear
- Flat feet or high arches
- Previous ankle injuries
- Tight calf muscles

Treatments for Peroneal Tendonitis

Most cases of peroneal tendonitis respond well to conservative management. The goal is to reduce inflammation, restore normal function, and prevent recurrence. Common treatments include:

1. Rest and Activity Modification

- Avoid activities that worsen symptoms.
- Use crutches if necessary to avoid weight-bearing on the affected ankle.

2. Ice Therapy

- Apply ice packs for 15-20 minutes every 2-3 hours during the acute phase to reduce swelling and pain.

3. Medication

- Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help alleviate pain and inflammation.

4. Physical Therapy

- Strengthening exercises for the ankle and calf muscles.
- Stretching to improve flexibility.
- Balance training to enhance stability.

5. Proper Footwear and Orthotics

- Supportive shoes or custom orthotics can correct biomechanical issues that contribute to tendon stress.

6. Immobilization

- Wearing a brace or ankle splint may be recommended in severe cases to restrict movement and facilitate healing.

7. Gradual Return to Activity

- Once symptoms improve, a structured, gradual return to activity is essential to prevent recurrence.

When to Seek Medical Advice

If pain persists despite home treatment, worsens, or if there is significant swelling, instability, or difficulty walking, consult a podiatrist. In some cases, if conservative treatments fail, surgical intervention may be necessary to repair or debride damaged tendons.

Prevention Tips

- Incorporate proper warm-up and cool-down routines.
- Gradually increase activity intensity and duration.
- Use appropriate footwear tailored to your activity.
- Maintain good flexibility and strength in your ankles and lower legs.
- Address biomechanical issues early with orthotics or physical therapy.

Conclusion

Peroneal tendonitis can be a frustrating and limiting condition, but with early recognition and appropriate treatment, most individuals recover fully. Paying attention to symptoms, modifying activities, and seeking professional guidance are key steps toward a swift and safe return to normal activity.

If you experience persistent ankle pain, don't hesitate to consult a healthcare professional for an accurate diagnosis and personalized treatment plan.