Peroneal Tendonitis Risk Factors

We touched on some of the underlying causes of peroneal tendonitis in the intro, but it’s imperative that you are aware of who may be at risk for the condition because it is highly treatable if caught early. If you try to power through the pain, the issue can worsen, prolonging symptoms and your treatment timeline. Here’s a look at some groups that may be at a heightened risk for chronic peroneal tendon inflammation.

1. Runners/Athletes – If you’re regularly putting a lot of stress on your feet, you may be overstressing your peroneal tendons and triggering an inflammatory response. We don’t want you to shift to a sedentary lifestyle, but you need to be mindful of not putting too much stress on your feet in too short of a time period. Gradually increase your intensity or your running distance, and cut back if you’re starting to deal with pain, stiffness or discomfort in your lower leg during or after activity.

2. Overweight Individuals – If you’re carrying extra weight, your feet and legs will be handling additional stress with every step you take. Again, we want you to be active, because that’s part of an active lifestyle, but you may want to consider some activities that are less stressful on your feet while you’re working to manage your weight. Swimming, weight lifting or rowing are examples of healthy ways you can exercise without putting extra strain on your feet.

3. Certain Underlying Foot Conditions – Individuals with certain underlying foot conditions will be at a heightened risk for peroneal tendonitis based on the way stress is dispersed in their lower leg and foot. Those with the following foot issues may be at risk:

• High foot arches
• Flat feet
• Tight calf muscles

4. Wearing The Wrong Shoes – If your feet aren’t adequately supported in your shoes, they may be forced to handle additional stress, which as we’ve touched on above, can lead to peroneal tendon issues. Always try on your shoes before you buy to ensure they fit your unique foot shape, and be mindful of how your feet feel after long stretches in different pairs, as this could signal which shoes are less than supportive.

5. Untreated Ankle Sprains – A final group of people who are at an increased risk for peroneal tendonitis are those with an untreated ankle sprain. If you never worked to strengthen supportive ankle ligaments after an ankle sprain, even if the sprain itself is no longer painful, you may be at an increased risk for peroneal tendonitis because the ankle is weaker. This means the peroneal tendons may end up handling additional stress, which can lead to faster tissue damage and inflammation.

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Understanding Peroneal Tendonitis

To understand the condition, we first need to understand the roll the tendon plays in facilitating movement. In each leg, there are actually two peroneal tendons – the peroneus longus and the peroneus brevis, which run parallel to one another. Their purpose is to connect the outside of your foot to the peroneus longus and brevis muscles located in your lower leg. These tendons aid in movement by everting your foot (rolling it outward) and assisting your calf muscles during plantarflexion, but they also provide ankle stabilization during weight bearing activities, like walking or running.

When tendonitis sets in, it’s typically caused by damage or tendon degeneration, which is surprising because in other areas of your body tendonitis is the result of inflammation in the tendon. For this reason, your doctor may refer to your condition by another name, like peroneal tendinopathy or peroneal tendon dysfunction.

Peroneal Tendon Injuries and Symptoms

Peroneal tendon injuries are not that common, but we’ve covered some high profile peroneal tendon injuries on our blog before. It is more common in runners than in the average adult, but even then the injury isn’t all that common. A recent study found that peroneal tendonitis makes up about 0.6% of all running injuries. It is thought to be caused by overstressing the area, or by genetic foot conditions, like a high foot arch, that predisposes a person to potential overuse and degeneration.

Symptoms include:

• Pain on the outside of the foot or leg, especially with activity.
• Swelling.
• Tenderness.
• Pain when the foot is flexed in an inward or downward position.

Treating Peroneal Tendonitis

Peroneal tendonitis can be treated with some in-home conservative care methods. First and foremost, you’ll want to take it easy for a bit to avoid overstressing the tendons. Aside from short term rest, you’ll want to focus on restoring proper function to the tendon, and that is achieved through:

• Stretching
• Strenghtening
• Proprioceptive Exercises.

Strengthening and exercise programs should focus on the eversion of the foot against resistance. This can easily be performed with an elastic or therapy band.

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