Peroneal Tendonitis (tendonosis, tendinopathy) is a common overuse injury I see in runners. It is an irritation of a group of tendons that stabilize the ankle and “kick” the foot out to the side (pronation / everson) during toe-off. Patients usually come to my office complaining of pain on the outside of their ankle, behind the the pointy bone on the side of the ankle (the lateral maleolus) or on the outside of their foot.
The main causes of peroneal tendonitis are similar to shin splints. The peroneal muscles “kick” the foot out to the side, and support the ankle and arch. When the other muscles that stabilize the ankle, arch, knee and hip aren’t doing their jobs, the peroneal muscles have to pick up the slack. When they’re overworked, their tendons can get irritated. The muscles, themselves, can also develop trigger points, which can also cause pain in the outside of your ankle.
When you come into our office, we’ll take a look at your gait and test for muscle imbalances and restricted range of motion. Usually, I find that people have weak hip abductors / stabilizers, and an imbalace between peroneals and posterior tibialis / long toe flexors. The soleus muscle (a deep calf muscle) is also involved sometimes.
Now, for the good news! Orthopedic electro-acupuncture and dry needling are two of the best tools to quickly restore strength and function, and improve overall sensorimotor integration in your lower extremity. What’s more is that tuina mobilizations and gua sha can help break up fascial adhesions and other issues that may be leading to sub-maximal performance. This means that you can expect more strength, flexibility and stability.