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Peroneal Tendonitis is an rare issue with the tendons on the lateral side of the rearfoot. The problem usually happens in athletes in which the stresses on those tissues are so higher. There are 2 peroneal muscles on the of the leg whose tendons move across the outside of the ankle joint with one tendon attaching on the outside of the foot at the bottom of the fifth metatarsal. The other tendon passes under the foot to attach to an spot near the center of the arch of the foot. The peroneal muscles have many different functions, but a major one is to stop the ankle rolling laterally and winding up having a ankle sprain. Since they work hard at that task, the load on the tendons could be too much for the tendon to tolerate and they end up with a peroneal tendinopathy.

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Normally the tendonitis commences with pain either over or just below the outside ankle bone with or without some swelling. In some the inflammation develops later. With ongoing exercise the symptoms gets more persistent and progressively worse. A typical feature in those with peroneal tendonitis is a decreased supination resistance. This means it is easy for the ankle to supinate or roll outwards. This leads to the peroneal muscles to be really active, so if you then combine it with higher level of sporting activity, then the tendon is at higher risk for an overuse injury.

The treatment of peroneal tendonitis almost always starts with lowering the stress by reducing physical activity levels as well as the use of shoe wedging or foot orthotic to pronate or tip the feet inwards so the muscle does not have to function as hard. Ice and anti-inflammatory drugs will also help lessen the discomfort and inflammation. Over the medium to long term raising stress by the way of exercise needs to be put on the tendon in order that it can adapt to the stresses placed on it. In some circumstances, surgery is advised.

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