PERONEAL TENDINOPATHY

“My Painful Ankle!”

PERONEAL TENDONS: CONNECT MUSCLES TO BONES

Common cause of “outside” ankle pain

Usually result of overuse

Slow to heal!

ANATOMY2 Tendons:

Peroneus longusPeroneus brevis

Location: outside part

of ankleFunction: turn ankle

up and out

SYMPTOMS“Burning”pain

Swelling “Catching”“Popping”

SYMPTOMSStiffnessWorse with…

Prolonged standingWalking on uneven surfaces

AT RISK POPULATIONAthletes

Hikers/skiers

SedentaryOverweight

Diabetics

COMMON CAUSESOveruseRunning on uneven surfaces

( sides of road)Tight calf musclesExcessively flat feet

TRADITIONAL NONOPERATIVE TREATMENTRestIce Heel insertDeep tissue

massageOrthoticsPhysical therapy

modalities

IMMOBILIZATION

Walking bootUsually 2-4

weeksOften helpful“Burns no

bridges”

NEWER TREATMENT : SHOCK WAVE THERAPYSafeNoninvasiveIn-office procedureEnhances tendon

healing“Brings blood to tissue with poor blood supply”

SURGICAL OPTIONSDebridement of diseased

tendonRemoval of swollen “scar

tissue” (“synovectomy”)Repair of tearsPossible tendon transfersRequires some

immobilization

OTHER SURGICAL OPTIONS

Tendon transfers

Bone realignment procedures