Unfortunately, running and training can lead to injuries. One of the common injuries affecting runners of all ages in peroneal tendonitis. Often misdiagnosed as a lateral ankle sprain due to its location, peroneal tendonitis results in inflammation around the tendons on the outside of the ankle. The peroneal muscles located in the lateral part of your leg actually consist of two muscles: peroneus longus and peroneus brevis. The tendons of these muscles travel together around the outside of your ankle and eventually insert into two different bones located on opposite sides of your foot. For this reason, the peroneal muscles are responsible for the side to side movement of your foot while running.
Causes:
One of the most common causes of peroneal tendonitis is running on uneven or sloped roads which result in excessive rolling or eversion of your ankle. This dangerous part of the road is usually located adjacent to the curb or grass. It is best advised to avoid running on roads like this or opt to run on the grass or flatter terrain. This should be a consideration for those who are trail runners and have these symptoms. Another cause can be due to over-pronation or flat feet due to the excess stretch and strain placed on the peroneal tendons. Lastly, overuse and overtraining without adequate stretching prior to exercising has been attributed to peroneal tendonitis.
Symptoms:
- Ankle pain, swelling, redness, tenderness
- Hearing a “snap” or “pop” sound to the ankle
- Chronic instability in the lateral part of the ankle
- Pain on palpation of the peroneal tendons on the outside part of the ankle
Diagnosis:
Your doctor can typically diagnose you with peroneal tendonitis clinically in the office with confirmation using an MRI (Magnetic Resonance Imaging) to detect inflammation, synovitis, or degeneration.
Treatment:
- Rest and ice
- Non-steroidal anti-inflammatory drugs (ibuprofen/aspirin)
- Ankle brace or AFO
- Custom Molded Orthoses (CMO’s)
- Laser treatment
- Stretching and strength training
- Surgical options when symptoms continue or conservative treatment fails.