What is it?
The two tendons on the outer (lateral) side of the foot are called the peroneus longus and the peroneus brevis tendons. They are responsible for moving the foot in a downward (plantarflexion) and outward (eversion) direction. In peroneal tendinopathy the tendons become damaged which leads to inflammation and degeneration. Similar to when you have Pain at the front of the ankle, this damage may be due to repetitive motions such as walking and running particularly on uneven terrain. People with higher arches can also be more susceptible to peroneal pathology due to increased forces acting on the tendons.
Patients with this condition present with pain and swelling on the outer side of the foot or ankle. Symptoms gradually become worse with the continuation of aggravating activities. The pain is often most severe first thing in the morning on initial standing. A diagnosis of peroneal tendinopathy can be made clinically but may be confirmed and assessed further with an ultrasound scan.
Treatment of Peroneal Tendonitis
Treatment options include rest, physiotherapy, anti-inflammatory medication, orthotic insoles and ankle supports. If the condition fails to improve with these simple measures further intervention may be requires. Cortisone injections under ultrasound guidance can be useful to reduce pain and inflammation but can carry a risk of rupture of the tendon particularly if it is damaged. Shockwave therapy has been used more recently to help stimulate neo-vascularisation and promote tissue healing. In patients with significant damage to the tendon(s) surgical debridement and repair may be necessary. Peroneal tendonitis recovery time can vary. For more information on recovery time see here.