Peroneal Tendinopathy
Peroneal Tendinopathy
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Peroneal tendinopathy is a condition that often causes pain around the outside of the ankle or foot which eases with rest and worsens with activity such as walking, running and jumping.
Patient Signs and Symptoms
Patient Signs and Symptoms
Pain, warmth, swelling, instability and weakness in lateral ankle
Pain in lateral foot and/or leg
History of trauma (lateral ankle sprains)
Significant Findings
Significant Findings
Pain on palpation of the tendon when the foot is inverted
Pain on palpation of insertion site
History of recurrent lateral ankle sprains
Peroneal Stability Test
Laterally deviation of the subtalar joint axis/ cavus type foot
Highly pronated foot type (sub-fibular impingement)
Imaging
Imaging
Not indicated at initial assessment unless history of trauma or to suspect osteomyelitis, however x-ray has low sensitivity and specificity for detecting acute osteomyelitis.
Diagnosis made by clinical signs as typically indicates accurate diagnosis.
Imaging maybe used at later date, can be discussed at our MSK Podiatry Virtual Escalation clinic as required on presentation.
Common Causes
Common Causes
Overuse which can lead to small injuries of the tendon fibres which can cause pain.
Repetitive stress and small injuries cause the normal healing response of the soft tissue to slow resulting in injuries occurring within the tendon at a rate faster than the body can heal them.
Weakness within the peroneal muscles places more strain on the tendon.
Differential Diagnosis
Differential Diagnosis
Actual ankle sprain
Fracture Dislocation/subluxation of tendon
Cuboid syndrome
Subtalar joint arthritis
Sural nerve impingement
Injury to the calcaneofibular/anterior talofibular ligaments
First line treatment options
First line treatment options
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