Peroneal tendonitis occurs when the peroneal tendons become inflamed. This happens when there is an increased load on and/or overuse of the tendons. This causes the tendons to thicken over time. If the injury becomes chronic, the tendinitis can progress to tendinosis. This is more serious and takes longer to treat.
Peroneal tendonitis is particularly common in athletes especially runners , more so if their feet roll outwards during gait(over supination).
There are two peroneal tendons in each leg peroneus brevis and peroneus longus. They run side by side down the outside of the lower leg bone (fibula) and behind the bony lump on the outside of the ankle, the lateral malleolus. One peroneal tendon attaches to the outside of the foot at the base of the little toe (fifth metatarsal). The other tendon goes underneath the foot and attaches to the inside of the arch.The peroneal tendons provide stability to the ankle when it is bearing weight and protects it from sprains. They also help turn the foot out and stabilize the arch when walking.
Causes of Peroneal tendonitis
People who take part in a sport that involves repetitive ankle motion are most prone to peroneal tendonitis Factors that can contribute to peroneal tendonitis include:
- a sudden increase in training, particularly weight-bearing activities, such as walking, running, and jumping
- improper training techniques
- inadequate or un-supportive footwear
There are also some other issues that can increase a person’s risk of developing peroneal tendonitis:
- higher foot arches
- lower limb muscles and joints not working well together
- imbalanced muscles in the lower limbs
If someone fails to complete a rehabilitation program following an ankle injury, such as a sprain, they are also more likely to develop peroneal tendonitis. Over time, the damaged peroneal tendons will thicken as scar tissue tries to repair the damaged area. This makes the tendons weaker and more prone to tearing. Treatment can include orthotics to support the foot and take pressure off the tendon, wearing well laced up supportive footwear, very specific rehab program. Also instrument assisted soft tissue work seems to be beneficial, stripping out the tendon and promoting healing.
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