Peroneal Insertional Tendonitis- Symptoms and Treatment

Tendons are strong fibrous tissues which connect the bones to the muscles. They promote our movements as they withstand the tension while we walk, run or jump. We can move easily because hundreds of tough tendons are present in our body. The overuse of a tendon leads to tendon injury and inflammation of the tendon, resulting in pain in that particular area.

Fast recovery is not possible if the tendon is seriously injured in any way. Injured tendons are slow to heal. Individuals engaged in sports activities use their feet vigorously. The condition wherein small tears in the collagen fibers of the tendons lead to severe pain and restricted movement, is referred to as tendonitis.

There are two peroneal tendons which are present in the foot, exactly behind the outer ankle bone. They originate high in the lateral side of the leg. At one end, they are attached to the tibia and fibula (bones between the knee and ankle).

Both these tendons run side-by-side, but one (peroneus brevis, the shorter one) turns towards the outer part of the midfoot, and inserts into the base of the fifth metatarsal (bone between the ankle and the toes).

The other tendon (peroneus longus, the longer one) makes its way through the inner side of the midfoot and inserts into the bottom of the arch. The main function of the peroneal tendons is to stabilize the foot and ankle, and protect them from sprains.

These two tendons help you to stabilize the foot on an uneven and rough ground. They help prevent the lateral rolling of the foot while you walk on a rough surface. Rolling of the foot can otherwise lead to an ankle sprain. Peroneal tendons also help the calf with plantarflexion (taking your foot away from the shin during each cycle of gait). Sports activities which involve repeated movement of the peroneal tendons can lead to peroneal insertional tendonitis.

Peroneal tendonitis usually involves the inflammation of the peroneus brevis tendon. The peroneus longus tendon or even both tendons can get injured due to overuse or excess load. Excessive load, over an extended period of time, can lead to tendon injury. As a result, the person will experience severe pain at the insertion of the tendon at the base of the 5th metatarsal; when peroneus brevis is injured.

The person will experience pain at the bottom of the foot if the peroneus longus is injured. At the beginning, the pain is usually very mild and may go unnoticed. Normally, there won't be any swelling or redness. The person experiences pain usually at the start of an activity, and gradually the pain goes away as the activity progresses. Peroneal tendonitis can be acute or chronic.

An action which involves forceful bending of the foot backwards or an injury to the ankle can lead to acute peroneal tendonitis. Those who play soccer, basketball, or football regularly, are more likely to suffer from this type of tendonitis. Chronic injuries can lead to ankle instability. Subluxation (tendons slip out of their normal position), frequent inversion injuries, and painful snapping across the ankle, are the symptoms associated with chronic injuries.

Massage and peroneal tendonitis exercises are an important part of the treatment that is designed to treat the tendonitis. Poor blood supply to the tendons is responsible for the slow healing of the injured tendons. Injury to a tendon results in the inflammation of the tendon.

Inflammation is the sign which informs us that the body is trying to bring more blood and oxygen into that particular area where they are required. This excess blood and oxygen promotes healing of the tendon. But still, you need to consult your physician immediately, because the tendons tend to heal very slowly.

The physician may prescribe anti-inflammatory drugs to treat the damaged tendon. This will help lower both the swelling and the pain. Along with the medicines, you need to provide complete rest to the leg and the foot, for a long period of time. You may use a brace during any activity.

A physiotherapist can guide you about the exercises required to perform during peroneal tendon injury. For severe injuries that involve completely torn tendons, surgery is often performed to re-establish the connection between the tissue and the bone.

Individuals who are interested in sports activities should perform proper exercises regularly, to prevent peroneal tendon injuries. Exercises ensure strong tendons, and they lower the chances of damage to the tendons. Aging, excess weight, and repeated or vigorous activities, those like sports activities, can gradually weaken the peroneal tendons over time. A balanced diet and regular exercise helps keep the tendons tough and healthy.