Peroneal Tendonitis - Causes, Symptoms, and Treatment Strategies

Introduction

Peroneal tendonitis is when the tendons that attach the lower leg to the foot get inflamed. This condition can be caused due to any injury to the tendons or overuse of the tendons. When the tendon is overused or overloaded, it rubs the tendons with the bones. The swelling and pain caused in the peroneal tendon get better after several weeks after specific conservative treatments. Read the article to know more.

What Is Meant by the Peroneal Tendon?

There are thousands of tendons present in the body. This tendon helps to attach the bone and the muscles to the tissues, which are very strong and flexible but are less elastic. Tendons are very strong, but they tend to get injured or strained. The common region where the tendons get injured or strained is where they get attached to the bone. The peroneal tendon helps to stabilize the foot, and when it gets injured or strained, it makes it difficult to walk or move the foot as it gets inflamed. When the peroneal tendon gets inflamed due to injury, strain, or overload, it is known as peroneal tendonitis. Usually, peroneal tendonitis occurs due to overuse of the tendon, and in rare cases, it can also be caused due to aging. As a person ages, the blood flow to these tendons reduces, and they become thinner and very prone to injuries.

Who Is More Prone to Peroneal Tendonitis?

Peroneal tendonitis can affect anyone, but usually, people involved in sports activities involving more ankle movements are at higher risk. More prone people are

• Aged people over the age of 40 years.

• Those players who do not stretch before any physical activity.

• People affected with certain health conditions like diabetes, rheumatoid arthritis, etc.

• History of tendon injury or strain.

• People who are overweight.

• People with high arches on their feet.

• People who are smokers.

• Have tight tendons.

What Are the Symptoms Associated With Peroneal Tendonitis?

Some common symptoms are

• Pain and swelling are present in the ankle.

• The pain and discomfort can make the person feel challenging to walk or run.

• The pain can be enhanced during the morning time.

• Presence of ankle pain along the length of the tendon.

• Thickened tendon along with a mass that moves along with the tendon.

What Are the Causative Factors of Peroneal Tendonitis?

Some common causes of peroneal tendonitis are

• Sudden injury to the ankle.

• Gradual pain and discomfort are caused due to overuse or straining of the tendon.

• Aging.

• No proper training technique.

• Inadequate or improper footwear.

• High foot arches.

• The muscles of the lower limb and the joint do not function properly.

• No proper balance of the muscles of the lower limb.

• If there is improper healing of an ankle sprain or injury, that can be more prone to peroneal tendonitis.

What Are the Causes for Athletes Being More Prone to Peroneal Tendonitis?

Those people who are involved in sports and athletes are more prone to this condition because

• They tend to run long distances.

• They run at maximum speed and are involved in high-intensity training.

• Sports people tend to run on slopes.

• Presence of tight calf muscles.

How Is Peroneal Tendonitis Being Diagnosed?

The diagnosis of peroneal tendonitis is very difficult as the symptoms faced by the person are similar to other foot and ankle conditions such as sprains, fractures, arthritis, etc. Most of the people who are affected by peroneal tendonitis are misdiagnosed in the initial stages of the treatment. The doctors usually do a physical examination and ask about the symptoms experienced by the affected person. During physical examination the doctors palpate some regions of the foot and ankle to rule out the presence of swelling and pain. The person may be asked to do some ankle movements to check the range of motion.

Doctors recommend certain image testing to rule out the presence of any fracture, cartilage damage, osteoarthritis, or torn tissue. Some imaging tests are

• MRI (magnetic resonance imaging) helps provide images of all the structures within the body.

• X-ray, which is electromagnetic radiation, helps provide images of the tissues and structures in the body.

• CT scan (computed tomography) produces cross-sectional images of the bone. Soft tissues and blood vessels help rule out any internal injuries.

• Ultrasound utilizes sound waves to produce images of the structures present within the body.

How Is Peroneal Tendonitis Managed?

Usually, it takes about three to four weeks for peroneal tendonitis to heal through conservative treatment methods. In case of this condition caused due to some other injury it may take a longer time to heal.

Some Common Treatment Methods Are

• Immobilization: Immobilization of the foot or ankle should be done using soft cast to reduce the weight over the tendon, which helps in healing.

• Bracing: Bracing helps to stabilize the ankle if the condition is caused due to some movements done by the ankle.

• Medication: Certain medications such as NSAIDs (non-steroidal anti-inflammatory drugs) can be used, which help to reduce the inflammation and pain caused. When the medication does no good, the doctor may recommend steroid injections around the tendon or into the tendon sheath.

• Physical Therapy: Physical therapy helps regain the strength and flexibility lost in the foot and ankle. In some cases, ice, heat, and ultrasound can also help to improve the condition.

• Home Remedies: The person can take complete rest by not straining the affected area further. Ice packs can be applied over the affected region, which helps to reduce the inflammation. Compression or ice packs can be applied over the region for about 20 minutes every two hours, which helps to reduce inflammation and pain.

• Elevation: The affected leg should be wrapped using a compressor band and stabilized in an elevated position, usually above the chest level.

If all these conservative treatments do not improve the condition of peroneal tendonitis, then the doctor may suggest surgery. During the surgery, a synovectomy is done, which clears out the damaged layers of the tissue from the tendon. Some risk factors related to this surgical method are

• Infection.

• Bleeding.

• Formation of blood clots.

• Nerve damage.

• Scar tissue.

How Can Peroneal Tendonitis Prevent?

• There should be a gradual increase in intense physical activity.

• Proper and healthy body weight.

• There should be proper intervals of rest between workouts and physical activity.

• Usage of protective equipment.

Conclusion

Peroneal tendonitis is the inflammation caused in the tendon which connects the lower leg to the foot. This condition is caused due to overuse or injury in the tendon. This usually occurs in people who are more involved in sports activities. Peroneal tendonitis can be improved through conservative treatments, but in some severe cases, surgery is required.