So you decide to run your first 5K and get out there and start training. Now you are noticing pain near your outside ankle bone (which is actually the end of your fibula—the long, thin bone in your lower leg). What could it be? Muscle aches? A break in the bone? Or could it be peroneal tendon pain?
Why Your Ankle Hurts
You may have never heard of peroneal tendons before you began looking up reasons for your ankle pain, but they perform a crucial operation: they help turn your foot outward at the ankle. This complex joint is able to move in all directions, giving you amazing mobility. The movement happens because of tendons that connect your bones to various muscles and pull your foot in different directions.
When you suddenly increase running distance or intensity without conditioning your body first, the peroneal tendons may be stressed more than they can handle. The problem could also occur if you have a foot structure or gait that causes your ankle to lean outward with each step (supinate). Previous ankle sprains may also put you at risk for these problems.
Whatever the cause, when tendons are overstretched and weakened over time, the tissue fibers may become thick and enlarged. This is called peroneal tendinosis, and if inflammation occurs from the injury, it is called tendinitis. If the elasticity of the tendons is compromised, they can tear, and if the sheaths that hold them in place are damaged, they can pop out of position, which is called subluxation. All of these problems typically result in pain just behind the outer ankle bone.
When Peroneal Tendon Surgery Is Needed
Most of the time, problems with these tendons can be treated successfully without surgery. Therapy includes resting by limiting walking on the foot and possibly using a boot or ankle brace. You may need to stay off the foot for several weeks, and full healing may take up to a year. Steroid treatment is not recommended as it can make the problem worse, and although some practitioners are working with platelet-rich-plasma treatment, there is no real evidence that it helps with peroneal tendon problems.
Once the pain is gone, you may be able to resume training, but do so gradually. Sometimes an orthotic can be designed to lessen the stress on the tendons while you walk and run.
If you try conservative treatments for many months, but the pain does not go away or gets worse, or the tendons keep slipping out of position and make your foot unstable, you may be a candidate for surgery. This can take one of several forms: increasing the depth of the groove the tendons run through, cleaning out and repairing a frayed or torn tendon, or attaching tendons together. Recovery will involve no weight-bearing for many weeks, and likely include a round of physical therapy to recondition the tendons after they have healed.
Peroneal Tendon Treatment Specialists in the Greater Phoenix Area
If you think tendinitis might be the reason for your sore ankles, you can’t do better than to come to Advanced Foot & Ankle Specialists of Arizona. Our experienced podiatrists are also expert surgeons who understand your feet and how to fix them. We will evaluate your pain and decide on the best treatment course, and if that involves eventual surgery, you can trust our experience to get you the best results.
Call and set up an appointment at our office in Chandler, AZ by dialing (480) 963-9000, or in Gilbert at (480) 981-1800, or fill out the form on our website to contact us.