Peroneal Tendonitis

Peroneal tendonitis is one of the most common injuries among runners. It usually occurs in people who, due to their sporting activity, generate a repetitive movement of the ankle. Therefore, if you run long distances frequently or are a regular runner, you are exposed to this injury at some point.

Runners with higher plantar arches are also more likely to suffer from peroneal tendinitis.

In this post we will see what the peroneal tendinitis is, which parts are affected, its diagnosis and treatment.

Tendons are the bands of tissue that attach muscle to bones. There are two peroneal tendons in each foot, which begin at the top of the leg, run parallel behind the outer ankle bone and are inserted one on the outside of the foot and the other on the inside.

The long peroneal tendon, one runs through the outside of the middle foot, crossing the sole and inserting at the base of the first metatarsal.

The short peroneal tendon goes below the foot ending in the underside of the arch and is inserted into the fifth metatarsal base of the foot.
The main function of these two tendons and muscles is to stabilize the foot and ankle, avoiding sprains.

The function of the peroneal tendons is very important in the biomechanics of the foot in the different phases of career. Contributes to plantar flexion and ankle pronation. I recommend that you watch the following video to better understand how the foot works when running. You can also read this post on How the Windlass Mechanism Works.

Diagnosis of peroneal tendon injury

As in other cases, if these injuries are misdiagnosed or not properly treated, they can result in more serious injuries. Peroneal tendon injuries are easily recognizable, as in almost all cases pain and instability of the ankle is evident. The symptoms are usually swelling in the area, instability, pain and heat. Your doctor will recommend, if deemed necessary, an x-ray analysis to verify the extent of the injury.

Injuries can be classified into two categories:

  • Acute, when they occur suddenly
  • Chronic, when they develop over a long period of time.

More frequent peroneal tendon injuries

Peroneal Tendonitis

Peroneal tendinitis is an inflammation of one or both of the tendons of the peroneum, usually caused by the practice of sports that repeatedly use the tendons, or by a trauma such as ankle dislocation. Its symptoms in this case are usually pain and inflammation in the affected area.

Acute tears

They are caused by exposing the tendons to repetitive activities or sudden trauma. In this case the symptoms are also pain, inflammation and instability of the foot and ankle.

Degenerative tears

They are caused by overuse or overuse of the joint for long periods of time, even years. This excessive work causes the tendon to lengthen too much and lose its recovery properties, becoming too stretched, thin and weak and may even break.

High arches may also cause this type of injury.

The most common symptoms are:

  • Sporadic pain on the outside of the ankle
  • Ankle instability
  • The height of the arch increases

Partial dislocation or ankle sprain

When one or both tendons move from their normal position. Sometimes this lesion is facilitated when someone is born with a small bone deformation that promotes the displacement of the tendons.

Other times it may be due to trauma or an extreme position adopted by the foot due to some unforeseen trip or slip.

The symptoms of this type of injury are:

  • Snapping sensation around the ankle bone
  • Sporadic pain
  • Ankle instability

Treatment of peroneal tendon injuries

The treatment indicated will depend on the degree of injury affecting the peroneal tendons. Most of the time the recovery will be achieved with rest and baths of water and salt keeping the foot high if it is ankle corners.

For more serious cases the recommended actions could be:

  • Total or partial immobilization depending on the degree of injury
  • Medication
    With both oral and injectable anti-inflammatories as prescribed by your doctor.
  • Physical therapy
    We can apply cold or heat or ultrasonic therapy to reduce pain and inflammation. When both go down we can start with movement exercises to strengthen muscles and tendons.
  • Orthoses
    If recommended by your doctor, the brace may be worn for a short period of time to protect the ankle from overly demanding activities. Or when surgery can be avoided with it.
  • Surgery
    This decision will be left to the doctor if he or she believes it may be necessary to repair the damage to the tendons. As it is logical after the surgery we will be forced to make a physical therapy to recover the mobility and elasticity of them.

I hope this article has helped you learn more about this type of injury. Greetings and see you next time.
Teodoro Vázquez

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About the author

Teodoro Vázquez

Como corredor desde 2007 llevo recorridos más de 43.000 km. De los cuales como corredor Minimalista Evolutivo 38.000 km., los últimos 27.000 km sin ninguna lesión a pesar de correr más de 5.000 km al año durante los últimos 5 años.

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