Peroneal Tendonitis Treatment Options: Pain Management and More

When the tendons along the outer part of your ankle (the peroneal tendons) become irritated or inflamed, you have a condition known as peroneal tendonitis. This seriously uncomfortable condition can make even some of the most basic activities, like standing or walking (and especially running), uncomfortable and painful.

According to some studies, roughly 10% of all running injuries involve the ankle, and many involve peroneal tendonitis. This is what makes it common in not just athletes but avid joggers, as well.

So, let’s dive a bit deeper into how you can recognize this condition and what the peroneal tendonitis treatment options are.

What are the symptoms of peroneal tendonitis?

Recognizing the symptoms of peroneal tendonitis is the key to getting the right treatment. Because it’s easy to mistake it for a number of other foot and ankle conditions like a sprain, strain, or even a fracture, pinpointing the signs of peroneal tendonitis helps avoid confusion and ensures that you’re tackling the right issue. Ignoring the symptoms or assuming something else could delay the healing and worsen things.

These symptoms are:

• Pain on the outside of the ankle: A persistent ache or sharp pain that flares up with movement.

• Swelling: Noticeable puffiness around the back of the ankle or along the outside of the foot.

• Weakness in the ankle: Feeling like your ankle can’t support your weight, especially during physical activity.

• Instability: A sense that your ankle is giving out or feels wobbly when walking or standing.

• Increased pain with activity: The more you move, the more pain intensifies. This is especially the case if you’re running or jumping.

• Tenderness when pressing on the tendons: Light pressure on the outer ankle may feel sore or tender to the touch.
  
  

By recognizing these early symptoms, you increase your chances of finding the right peroneal tendonitis treatment. The earlier you catch it, and the earlier you go to the right foot and ankle center, the faster and more effective recovery will be.

What are the causes of peroneal tendonitis?

Peroneal tendonitis typically occurs due to overuse or repetitive stress on the peroneal tendons. These tendons are responsible for stabilizing your foot during movement, so when they’re pushed beyond their normal limits, they become inflamed or irritated. So, some of the most common causes are:

• Overuse

• Improper footwear

• Ankle injuries

• High arches 

When it comes to the most common activities that cause peroneal tendonitis, you have:

• Running: Especially on bad terrain.

• Jumping sports: Activities like basketball, tennis, or soccer, which require quick lateral movements and jumping.

• Hiking: Rough, uneven terrain will overwork your tendons.

• Dancing: Constant turning and footwork will put a tremendous amount of stress on your tendons.

Due to this, it would be safe to say that runners, athletes in high-impact sports, and people with issues with foot mechanics might be seen as high-risk when it comes to peroneal tendonitis. They are also the most likely ones to be in need of peroneal tendonitis treatment at one point.

How to treat peroneal tendonitis?

When it comes to peroneal tendonitis treatment, the severity of your case often determines which treatment options will work best. For instance, for mild cases, simple rest and home remedies might be enough, but if you’re dealing with a more severe or persistent case, you might need to explore more advanced treatments, potentially even surgery.

Conservative treatments are:

• Rest and activity modification

• Ice therapy

• Compression and elevation

• Non-steroidal anti-inflammatory drugs (NSAIDs)

• Physical therapy

• Orthotics or supportive footwear

In a scenario where the case is moderate to severe, the response and treatment needs to be more serious, as well. They also cannot be done without the doctor’s involvement. The three most common treatments here are:

• Ankle brace: For more moderate cases, an ankle brace may be recommended to provide additional support while the tendon heals. This helps to reduce further irritation while still allowing some movement.

• Corticosteroid injections: If pain and inflammation are severe and persistent, your doctor might recommend corticosteroid injections.

• Immobilization: In some scenarios, a walking boot or cast may be a necessary peroneal tendonitis treatment. In this scenario, your ankle will be completely immobilized which would give your tendons a rest.

Even though this is rare, in some cases, you might need surgical treatment. This only happens in scenarios where the tendon is torn or doesn’t respond to conservative treatment.

In this case, the three common types of surgery involve:

• Tendon repair

• Tendon release

• Debridement

• Tendon transfer
  
  

While surgery can be effective, it’s typically reserved for most severe cases.

How long does it take for peroneal tendonitis to heal?

Healing from peroneal tendonitis can vary quite a bit, depending on the severity of the condition, how soon the treatment begins, and how well you stick to the treatment plan.

• Mild Cases: If you catch the tendonitis early and start resting right away, you could see improvement in 2 to 4 weeks. During this time, it’s essential to reduce any activities that cause stress on the ankle and follow conservative treatments like icing, stretching, and using supportive footwear.
• Moderate Cases: For more moderate tendonitis, where the pain is more persistent or you’ve been pushing through the symptoms for a while, recovery can take 6 to 8 weeks. In these cases, physical therapy and activity modification are critical to healing. It’s also common to need extra support, like an ankle brace, during this time.
• Severe or Chronic Cases: If the tendonitis is severe or has become a chronic issue, recovery can take 3 to 6 months or even longer. This is especially true if the tendons are significantly weakened or damaged. These cases often require a longer period of immobilization, advanced treatments like corticosteroid injections, or even surgery in the most extreme scenarios. After surgery, recovery can take several months, with physical therapy playing a crucial role in regaining strength and mobility.

This also depends on the amount of time you rest, your adherence to treatment, and any pre-existing conditions.

What are some of the most effective peroneal tendonitis exercises?

When it comes to preventing foot injuries, there’s nothing like strengthening the surrounding area through some special exercises. The most common such exercises are:

• Ankle eversion
  
  
• Calf raises
  
  
• Single-leg balance
  
  
• Ankle alphabet
  
  
• Heel-to-toe walking

These exercises should be done regularly to strengthen the ankle and prevent re-injury.

Wrap up

Addressing peroneal tendonitis early is key to a quicker and more effective recovery. By recognizing the symptoms, understanding the causes, and following the right peroneal tendonitis treatment plan - from conservative methods like rest and physical therapy to more advanced options if needed - you can manage the condition and prevent further damage.

Whether you're an athlete or just dealing with everyday strain, taking care of your tendons will help you stay active and pain-free in the long run.

Explore effective peroneal tendonitis treatment options and comprehensive pain management strategies at the Orthopedic Institute of NJ—your path to relief starts here!