Pain on the Outside of the Foot or Ankle? Could be Peroneal Tendonitis

Pain on the Outside of the Foot or Ankle?

Could be Peroneal Tendonitis

I commonly see patients complaining of pain on the “outside” of the foot by the side leading up to little toe. These patients have been previously diagnosed as having arthritis, ankle instability, or a pinched nerve. However, after performing a thorough clinical and biomechanical examination I am usually surprised to find that these patients have tendonitis of the peroneal tendons and that previous doctors had not bothered to even check for this problem. 

Given the anatomy and important function of these tendons, checking for this seems obvious to me.

Here’s what you should know… there are two peroneal tendons in the human foot:

  • The Peroneus Brevis – (a short one) and
  • The Peroneus Longus – (a long one)

The two tendons start out on the outside of the calf and run behind the ankle bone on the outside of the ankle. The short one attaches to the base of the 5th metatarsal. While the long one runs along the bottom of the foot and attaches to the base of the first metatarsal.

What is the Main Function of the Peroneal Tendons?

The main function of the peroneal tendons are to stabilize the foot and ankle and to protect them from sprains during gait. They extend (plantar flex) and roll out (evert) the foot and ankle. Therefore, a tremendous amount of tension and stress is placed on these tendons complex with every step as it helps support the foot and ankle. 

Problems can arise when there is excessive stress applied to these tendons. Excessive stress can be due to a patient’s foot type (flat feet versus high arches) or other possible lifestyle changes such as weight gain or a physically challenging job or exercise. 

 

Treatment

Treatment for this condition consists of reducing the inflammation and damage of the tendon and eliminating the cause of the stress. In our clinic, we have been using extracorporeal shockwave therapy (EST) in order to provide rapid relief and stimulate healing of the tissue. This treatment is non–invasive, painless, doesn’t require anesthesia, or any kind of injections. There are no NSAID pills ever needed either pre or post treatment. It involves 4-5 sessions, each one week apart. Shockwave therapy works by increasing circulation to the damaged tendon and by releasing growth factors to stimulate tendon repair. 

Additionally, we address the cause of the problem by providing a custom orthotic in order to reduce the stress on the injured tendon. It will help heal the tendon and prevent a recurrence of the problem. 

If you have any further questions about this condition feel free to send us an email. We would love to hear from you.