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

  • Tendonitis—inflammation of the tendon
  • Tendonosis—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 tendonopathy 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 tendonopathy 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
You will be asked about your symptoms and medical history. A physical exam will be done.

Images may be needed 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 to keep the foot and ankle from moving and allow the tendon to heal. You may also be asked to wear special shoes or inserts.

Medications
Prescription or over-the-counter medication may be advised for pain. Corticosteroid injections may be needed if treatment is not effective.

Physical Therapy
A physical therapist will assess the foot and ankle. Ice or heat therapy and ultrasound may be done to help relieve tension. Other physical therapy methods include ice, heat, or ultrasound to reduce pain and swelling.

An exercise program will be created to help recovery and to strengthen the muscles.

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 tendonopathy, take the following steps:

  • Avoid 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 increase the frequency and intensity of exercise.
  • Learn proper technique for sports and exercise.



RESOURCES:
American Orthopaedic Foot and Ankle Society

OrthoInfo—American Academy of Orthopaedic Surgeons

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=43870. Accessed March 9, 2015.

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.

4/24/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Wise JN, Weissman BN, et al. American College of Radiology (ACR) Appropriateness Criteria for chronic foot pain. Available at: http://www.acr.org/~/media/ACR/Documents/AppCriteria/Diagnostic/ChronicFootPain.pdf. Updated 2013. Accessed March 9, 2015.

Last Reviewed March 2015



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