Peroneal Tendinopathy
Definition
Tendinopathy is an injury to the tendon. It can cause pain, swelling, and limited movement. The injury can include:

  • Tendonitis—inflammation of the tendon
  • Tendinosis—tiny tears in the tendon tissue with no significant inflammation
The peroneal tendons run along the outside of the ankle bone. Treatment depends on the severity of the injury.

Causes
Peroneal tendinopathy often occurs as a result of:

  • Repetitive overuse injuries which may occur from regular activities
  • Trauma to the ankle such as a sudden twisting of the ankle or foot
  • A sprained ankle that turned inward
  • Overstretching the foot
Risk Factors
Factors that increase your risk of peroneal tendinopathy include:

Symptoms
Symptoms include pain, tenderness or swelling along the bottom of the foot or side of the ankle. You may also experience weakening or instability in the foot or ankle.

Diagnosis
Your doctor will ask about your symptoms and medical history. A physical exam will be done.

Your doctor may also need images of the foot and ankle. These may be taken with:

Your doctor may also inject a medicine in local structures. This can help your doctor confirm what structures are causing the problem.

Treatment
Talk with your doctor about the best plan for you. Treatment options include the following:

Immobilization
A cast, splint, or brace may be needed. They will help keep your foot and ankle from moving to let the tendon rest. You may also be asked to wear special shoes or inserts.

Medications
To help manage pain, your doctor may recommend:

  • Over-the-counter pain relievers, such as acetaminophen or non-steroidal anti-inflammatory medication (NSAIDs)
  • Prescription pain relievers
  • Corticosteroid injections
Physical Therapy
Physical therapy exercises will help to regain strength and range of motion within the foot and ankle. Other physical therapy methods include ice, heat, or ultrasound to reduce pain and swelling.

Surgery
Surgery may be needed in some cases. It can help to repair the tendon or adjust support structures of your foot.

Prevention
To help reduce your chance of getting peroneal tendinopathy, take the following steps:

  • Avoiding activities and sports that repeatedly stress the ankle.
  • Do not put yourself at risk for trauma to the ankle.
  • Build strong muscles to support your joints.
  • Gradually increasing the frequency and intensity of exercise.
  • Learn proper technique for sports and exercise.



RESOURCES:
American Academy of Orthopaedic Surgeons

American Orthopaedic Foot & Ankle Society

CANADIAN RESOURCES:
Canadian Orthopaedic Association

Canadian Orthopaedic Foundation

References:
ACR Appropriateness Criteria chronic ankle pain. AHRQ National Guideline Clearinghouse website. Available at: http://www.guideline.gov/content.aspx?id=15735. Accessed May 6, 2013.

Heckman D, Reddy M, Pedowitz D, et al. Operative treatment for peroneal tendon disorders. J Bone Joint Surg Am. 2008; 90:404-418.

Peroneal tendon injuries. American College of Food and Ankle Surgeons website. Available at: http://www.foothealthfacts.org/footankleinfo/peroneal-tendon.htm. Updated December 18, 2009. Accessed May 6, 2013.

Peroneal tendinopathy. EBSCO Dynamed website. Available at: http://www.ebscohost.com/dynamed/what.php. Accessed May 6, 2013.

Last Reviewed May 2013



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