Peroneal Tendinitis

Watch the video above to learn about Peroneal Tendinitis, and how I approach treating this with my patients. There's also more information below. As always, when you're ready, fill out the form on this page to request a consultation.

They went above and beyond. They really care about the work they do. I feel like I am a human again — Chase

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Peroneal tendinitis occurs when there is inflammation along one or both of the tendon sheaths and/or tears along a portion of the tendon.  This can result in ankle instability, pain, or elevation of the arch of the foot.

Symptoms

  1. Pain can be felt along the entire course of the tendons
  2. Swelling
  3. Tenderness along the involved tendon
  4. Heightening of the arch of the foot
  5. When there is an injury to the peroneal fascia, the tendons can subluxate. This felt as a popping or dislocation of the tendons along the outside of the ankle

Diagnosis

Diagnosis is made by a comprehensive foot and ankle exam by Dr. Stewart along with x-rays of the foot. Imagining studies such as ultrasound and MRI are sometimes required to determine the extent of tendon injury.

Treatment

Peroneal tendinitis generally takes 6-8 weeks to improve and early activity on a healing tendon can result in a set back in recovery. Non-compliance can double the recovery time and can be very frustrating for patients.

Early and aggressive conservative treatment is recommended to prevent further tendon injury. Dr. Stewart terms peroneal tendinitis a pro-active condition. Although we can never offer a 100% guarantee, the majority of Dr. Stewart’s patients improve with conservative (non-surgical care).

After I was diagnosed with peroneal tendinitis and receiving treatment that was ineffective, I began to think that foot and ankle pain was something I would just have to endure for the rest of my life. It was apparent to me that Dr. Stewart genuinely cared about my recovery and I was not just another number. Dr. Stewart reassured me that there were treatment options available that could improve my quality of life. – Amber Pruitt

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Conservative treatment for Peroneal Tendinitis includes:

  1. Immobilization of the foot and/or ankle. Depending on the severity of the condition, this may require cast immobilization with crutches, a walking boot, a hinged ankle foot orthosis with supportive shoe gear, a multi-ligamentous ankle brace with supportive shoe gear, or custom foot orthotics with supportive shoe gear
  2. Modification of physical activity including avoidance of walking, jogging, running, and the elliptical for exercise; recommended exercises include circuit training, swimming, and bicycling
  3. Stretching and strengthening exercises with a Theraband
  4. Therapeutic laser
  5. Compression therapy generally with prescription compression stockings
  6. Physical therapy
  7. Weight loss and dieting
  8. Medications including anti-inflammatory medications (NSAIDs), Tylenol, oral steroids, and in some cases narcotic pain medication
  9. Ice along the tendons 2-3 times per day for 20 minutes at the area of maximum tenderness. Elevation is recommended while icing
  10. Avoidance of flip-flops, flats, and barefoot walking
  11. Supportive shoe gear including a motion control running shoe such as Brooks, Asics, New Balance, or Saucony; Keen and Merrell style shoes are also recommended
  12. Custom foot orthotics
  13. Steroid injections into foot and/and or ankle joints

If all conservative intervention fails, then surgical intervention maybe required. Dr. Stewart will determine which procedure is best for you.

Surgical treatment for Peroneal Tendinitis includes:

  1. Tendon debridement and repair
  2. Tendon transfer
  3. Repair of the peroneal fascia and peroneal groove on the fibula
  4. Cutting of the fibula bone and fixation with screws or plates
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