Peroneal Tendon Strain and Tendonitis

What is a peroneal tendon strain?

A strain is an injury in which muscle fibers or tendons are stretched or torn. Tendonitis is inflammation of the tendon. The peroneal muscles are on the outer side of the lower leg and their tendons attach to the foot. These muscles and tendons help move your foot to the outside.

How does it occur?

During an injury when the foot and ankle are rolled inward, a movement called inversion, the peroneal tendons may be stretched or torn. They also may be injured when your foot is forced upward toward your shin. Peroneal tendonitis results from overuse. Peroneal tendon strain and tendonitis can result from running on sloped surfaces or running in shoes with excessive wear on the outside of the heel.

What are the symptoms?

Symptoms include pain on the outer side of your lower leg and ankle. You may hear a pop or a snap when the injury occurs. You may have swelling around your ankle.

How is it diagnosed?

Your healthcare provider will examine your ankle and lower leg. He or she will move your ankle and leg to test these tendons. X-rays may be taken to see if there is a break in your ankle or in one of the bones in your feet.

How is it treated?

Treatment may include:

• Applying ice packs to your ankle for 20 to 30 minutes every 3 to 4 hours for 2 or 3 days or until the pain goes away.
• Elevating your ankle to help the swelling go away by lying down and placing your foot and ankle on a pillow.
• Wrapping an elastic bandage around your ankle to help keep the swelling down.
• Wearing a stirrup splint (called an Aircast or Gelcast) or a lace-up ankle brace as prescribed by your healthcare provider.
• Doing exercises to strengthen your peroneal muscles and tendons and to strengthen your ankle joint.

While you are recovering from your injury, you will need to change your sport or activity to one that will not make your condition worse. For example, you may need to bicycle or swim instead of run.

How long will the effects last?

The length of recovery depends on many factors such as your age, health, and if you have had a previous peroneal tendon injury. Recovery time also depends on the severity of the injury. A mild strain and tendonitis may recover within a few weeks, whereas a severe injury may take 6 weeks or longer to recover. You need to stop doing the activities that cause pain until your tendon has healed. If you continue doing activities that cause pain, your symptoms will return and it will take longer to recover.

When can I return to my normal activities?

Everyone recovers from an injury at a different rate. Return to your normal activities will be determined by how soon your ankle recovers, not by how many days or weeks it has been since your injury has occurred. In general, the longer you have symptoms before you start treatment, the longer it will take to get better. The goal of rehabilitation is to return you to your normal activities as soon as is safely possible. If you return too soon you may worsen your injury.

You may safely return to your activities when, starting from the top of the list and progressing to the end, each of the following is true:

• You have full range of motion in the injured leg compared to the uninjured leg.
• You have full strength of the injured leg compared to the uninjured leg.
• You can walk straight ahead without pain or limping.

How can I prevent a peroneal tendon strain and tendonitis?

• Keep your ankles and peroneal muscles strong.
• Wear high-top athletic shoes or a supportive ankle brace.
• Warm up properly before starting your sport or activity.
• When running, choose level surfaces and avoid rocks or holes.