Peroneal Tendinopathy Diagnosis and Treatment

Peroneal Tendinopathy Diagnosis and Treatment


Peroneal Tendinopathy, also called peroneal tendinitis, is a relatively rare but painful tendon injury that results from damage and degeneration to the one of the peroneal tendons in the foot. The condition is most often associated with running, but dancers and basketball players are also prone the peroneal tendinopathy. The injury is characterized by pain that begins at the outside of the foot near the ankle and runs up the outside of the lower leg.


Location and Cause of Peroneal Tendinopathy


You actually have two peroneal tendons in each foot, the longus and the brevis, and tendinopathy can occur in either or both. The tendons connect the peroneus longus and brevis muscles to the outside of your foot. The peroneal muscles and tendons work to roll your foot outward, stabilize your foot during physical activities, and assist the calf muscles in helping you rise up on your toes.


Damage to the peroneal tendons often occurs from overuse of the muscles when subjected to daily running, practice, rehearsal and performance. Injuries are most common in people with high arches, which puts greater tension on the peroneal tendons. High arches are considered an asset in dancers, placing them at greater risk. Faster running speeds also increase the workload of the peroneal tendons, and peroneal tendinopathy often accompanies an ankle sprain. The condition worsens with continued activity and improves with rest.


Common symptoms for peroneal tendinopathy include:


  • Pain in the outer ankle when walking or running
  • Pain at rest, particularly at night
  • Pain with physical loading of the foot
  • Increased pain when turning the ankle inward or outward
  • Increased pain with ankle flexion
  • Clicking and snapping sounds in the ankle
  • Decreased foot and ankle strength
  • Reduced ankle range of motion


Diagnosis and Treatment of Peroneal Tendinopathy


To differentiate peroneal tendinopathy from other sources of foot pain, your physical therapist will conduct a thorough evaluation of your health history and inquire about your daily activities.


Additionally, the therapist may run a number of tests, including: 


  • ankle strength
  • ankle range of motion
  • gait analysis
  • leg and core strength assessment
  • posture evaluation
  • evaluation of running shoes
  • palpation of the injured region
  • ultrasonography to identify and confirm the site of injury


Once the therapist has ascertained that the injury is indeed to the peroneal tendon, a treatment protocol will be designed.

Treatment may include:


  • pain management with ice, NSAIDs and ultrasound
  • ESWT (extracorporeal shock wave therapy)
  • strengthening exercises
  • flexibility training
  • postural correction
  • gait retraining


Treatment is often multi-modal and geared to the needs of the individual patient.


Ankle Injury Treatment in NYC


If you are experiencing pain in your foot and ankle, failure to treat the condition could make it worse, interfering with physical activity and reducing your quality of life. The foot pain specialists at NYDNRehab use a range of diagnostic and treatment methods to ensure that your ankle is restored to optimal function. Our Manhattan clinic features the latest technology and cutting edge therapies not found at other rehab clinics. Contact NYDNRehab today, and see why we are the foremost clinic for foot and ankle rehabilitation in NYC.


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