Peroneal Tendonitis – Tendinopathy Treatment

Specialists in peroneal tendonitis treatment in Valencia

I am Miguel Alfonso Porcar, orthopedic surgeon and traumatologist of recognized prestige.

At Regenerat Traumatology Clinic we are specialists in the diagnosis and treatment of peroneal tendinitis.

Our objective is to:

• Determine the cause of your peroneal tendonitis.
• Perform appropriate diagnostic tests to determine the extent of your condition,
• and apply the treatment of regenerative traumatology or orthopedic surgery to relieve your pain so that you can recover your wellbeing as soon as possible.

We don’t just focus on reducing pain, we treat the cause of your tendonitis.

This will ensure that your tendonitis heals and is less likely to recur.

We aim to help our patients by using the safest, most successful, and least invasive treatments possible!

What is peroneal tendonitis?

Peroneal tendinopathy is a condition that usually causes pain around the outside of the ankle or foot, which is relieved by rest and worsens with activity, such as walking, running and jumping.

Treatment of peroneal tendinopathy in the early stages usually begins with exercises that can be performed at home.

What are the peroneal tendons?

The peroneal tendons are located on the outside of the ankle joint.

They play an important role in stabilizing the ankle joint, contribute to strength by pushing on the ankle/foot and also allow the ankle to rotate outward (eversion).

There are three peroneal tendon muscles, called peroneus brevis, peroneus longus and peroneus tertius. The latter is rarely injured.

• The other two tendons can be injured in the setting of a severe ankle sprain.
• Most often, tendons become inflamed as a result of overuse or training error.
• In middle-aged and elderly active patients, the tendon may degenerate and be prone to rupture.

The main function of the peroneals is to provide stability to the ankle when walking, and to prevent it from falling on the ankle causing an ankle sprain.

If these muscles are weak or overused, the tendons have to work much harder.

Causes of peroneal tendonitis

The main causes are those derived from sports and the anatomical or genetic causes of the patient.

Sports that cause overuse of these tendons can result in small injuries to the tendon fibers that can cause pain.

Repetitive stress and microtrauma cause the normal healing ability to slow down, which can result in injuries occurring to the tendon at a faster rate than the body can heal.

• Peroneal tendinosis or tendinitis is seen in patients who practice running sports, jumping and sudden stops such as tennis, paddle tennis, soccer or basketball.
• Spending long periods of time standing, walking or running, especially with a sudden increase in these activities.
• Poor exercise or training technique and lack of recovery between activities.

Other factors that contribute to the development of peroneal tendinopathy, specific to each patient, are:

• In middle-aged and elderly active patients, the tendon may degenerate and be prone to rupture.
• If the patient has a highly arched ankle foot (pes cavus valgus) this may predispose the patient to peroneal problems.
• Advanced age, overweight and diabetes have been associated with an increased risk of developing peroneal tendinopathy.
• Inflammatory diseases, such as rheumatoid arthritis, psoriatic arthritis, etc.
• Weakness and/or tightness in the muscles of the feet or legs.
• Wear unsupportive footwear, such as sandals.
• Prolonged use of oral corticosteroids and a certain family of antibiotics (fluoroquinolones).
• Previous surgeries/trauma to feet and ankles.

Symptoms of peroneal tendonitis

The most representative symptoms are pain and/or swelling around the outside of the ankle – above, behind or below the outer ankle bone.

• Pain on the outer edge or instep of the foot.
• Feeling of instability when walking and difficulty with uneven surfaces.
• Lack of balance on one leg on the affected side.
• Patients will present with acute or chronic onset of pain and swelling along the peroneal tendons.
• Tendons are usually tender to palpation and there is pain with loading activities.
• In patients with tendon instability, part of a torn tendon or the entire tendon is displaced out of place and is described as a painful snapping sensation when the tendon is displaced out of place (with eversion and dorsiflexion) and re-enters.

There is usually a gradual onset of symptoms with worsening of pain during activity.

Causes of foot – ankle pain

Anyone can be at risk for foot or ankle pain, as it can result from injury or everyday wear and tear.

Some factors can increase the likelihood of a person suffering from foot and ankle pain include the following: 

• Ankle osteoarthritis: Occurs when the surface of the cartilage of the ankle begins to wear away. This causes inflammation, stiffness and pain in the joint.
• Achilles tendinitis treatment: For the inflammation of the Achilles tendon, which can be very painful. In the absence of treatment, it becomes a long-term chronic problem that makes walking difficult.
• Peroneal tendinopathy:Peroneal tendonitis causes pain on the outside of the foot and leg when walking or running. Peroneal tendonitis is rare and is caused by overuse that affects athletes, such as runners and long distance runners.
• Injections for plantar fasciitis: Plantar fasciitis is a degenerative disease of the thick band of tissue (fascia) on the bottom of the foot, which runs from the heel to the toes.
• Bunions: mainly affect women due to the use of narrow shoes or heels. They manifest as painful bumps on the big toe. When the pain is persistent or the deformity is severe, the percutaneous bunion operation percutaneous bunion operation is the best solution.
• Other foot and ankle conditions: calcaneal spur treatment without surgery…