Peroneal tendonitis is a condition that would be generally tough to treat
Peroneal tendinopathy is an uncommon issue with the tendons on the lateral side of the rearfoot. The condition typically happens in athletes in which the loads on these structures are therefore greater. There are 2 peroneal muscles on the lateral side of the leg whose tendons move round the outside of the ankle joint with one tendon attaching on the outside of the foot at the base of the fifth metatarsal. The other tendon goes underneath the foot to attach to an spot near the middle of the arch of the foot. The muscles have several different actions, but a main one is to prevent the rearfoot rolling laterally and winding up having a ankle sprain. Since they work hard during that action, the burden on the tendons can be too much for the tissue to take and they end up having a peroneal tendonitis.
Typically the condition starts off with discomfort either over or just beneath the outside ankle bone with or without some inflammation. In some the swelling develops later. With ongoing activity the pains becomes more persistent and gradually worse. A common finding in those with peroneal tendinopathy is a decreased supination resistance. Because of this it is easy for the rearfoot to supinate or roll outwards. This leads to the peroneal tendons to be very active, so if you then combine it with higher level of sports activity, then the tendon is at high risk for an overuse injury.
The management of Peroneal Tendonitis in most cases begins with minimizing the strain by reducing exercise levels and the use of footwear wedging or foot orthotic to pronate or tip the feet inwards so the muscle does not have to work as hard. Ice and anti-inflammatory drugs will also help reduce the discomfort and inflammation. Over the medium to long term raising stress by the way of exercise needs to be placed on the tendon in order that it can adapt to the stresses placed on it. In a few situations, surgery is often needed.