Overuse injuries in sports account for 50% of all injuries. Of these, a majority of overuse injuries occur in runners, with
Peroneal tendinopathy is a type of overuse injury that often occurs in athletes, such as in long-distance runners and basketball players. Dancers, people who have had ankle sprains, or those who simply have weak ankles are also often affected.
Peroneal tendinopathy is characterized by an aching along the outside surface of the ankle that worsens with activity, and improves with rest.
Our senior physiotherapists can help relieve symptoms caused by this condition by providing ankle physiotherapy treatments, including stretching and strengthening exercises to help the ankle become more mobile, strong, and stable.
Peroneal tendinopathy is characterized by an aching pain and swelling in the peroneal tendons located in the lower, outside portion of the ankle. A tendon is soft-tissue that attaches a muscle to a bone.
The muscles involved in this condition are the 2 peroneal muscles in the lower leg, called
(In some texts, the muscles are referred to as the fibularis longus and the fibularis brevis.)
The peroneus longus muscle originates on the fibula bone, which is located on the outside of the lower leg. It wraps around the bone on the outside of the ankle (the lateral malleolus) and attaches to the plantar (bottom) aspect of the base of the big toe.
The peroneus brevis muscle also originates on the fibula, but attaches to the base of the fifth toe.
These muscles are responsible for moving the foot in an outward direction, and pointing the toe and foot downward. Together, they help to balance and stabilize the foot and ankle.
Most ankle sprains occur as a result of the ankle rolling inward (inversion type ankle sprain). One reason for this is that the peroneal muscles and tendons are not as strong as the muscles on the inside of the ankle. If these muscles are weak, they may not be able to prevent the ankle from rolling inward.
These same muscles and tendons can also be overworked if the foot isn’t hitting the ground in proper alignment. If the foot hits the ground more on the outside of the foot (supination), the peroneal muscles have to work harder to stabilize the force of gravity with weight-bearing activities.
Proper footwear or orthotics can help with proper foot alignment.
Peroneal tendinopathy will usually worsen with activity, such as running or walking and improve with rest. It is an overuse injury, meaning the tendons can become
Symptoms of peroneal tendinopathy include:
Our senior physiotherapists will perform a thorough evaluation that includes asking about your health history.
We will also check your posture and evaluate what type of shoes you wear to determine if they support your foot properly.
We will gently touch your ankle in specific areas to determine which tendon or tendons may be inflamed. Special tests may be performed to determine exactly which tendons are involved.
It is important to get proper treatment for peroneal tendinopathy as soon as it happens. A degenerated tendon that is not treated can begin to tear, causing a more serious condition.
With an early diagnosis, ankle and peroneal tendon physiotherapy can successfully treat peroneal tendinopathy. We will develop a treatment plan specific to your condition and goals.
Your individual physiotherapy treatment program may include:
We will help you identify and avoid painful movements, allowing the inflamed tendon to heal.
may be used for pain management.
We may use manual therapy to gently mobilize the joints in your foot, ankle, and lower leg. Soft-tissue mobilizations may also be performed to
You will learn exercises to help the ankle, foot, and toes to move properly, in order to normalize your gait pattern when walking or running.
Stretching exercises will help ease any tightness in the calf muscles and the tissues in the bottom of the foot.
We will determine which muscle groups require strengthening to enable you to return to walking or running without pain.
Navigating uneven surfaces, such as grass, sand, gravel, or trails requires significant ankle strength to avoid unnecessary stress on the ankle.
We may teach you to perform resistance exercises with
As your symptoms improve, we will help you return to your previous level of activity and sport. Sport-specific exercises will simulate certain activities.
You may perform single-leg balance exercises or train on uneven surfaces to challenge the muscles that balance and stabilize the ankle.
We will design an individual home-exercise program to perform after formal therapy has ended, to continue building your ankle and foot strength.
We will recommend proper footwear for the activities you enjoy, so that your foot and ankle have proper support.
It may be necessary to get fitted for a custom foot orthotic (corrective inserts for your shoes) to wear, especially when performing more demanding activities, such as running or walking on uneven surfaces.
You will also learn how to gradually increase and maintain your training regimen to reduce any chance of future injury.