Peroneal Tendonitis?
by Cheryl
(Cleveland)
Hello,
First, please let me compliment you on having such an informative website!
The past Winter I was plagued with some health problems (diverticulitis) that kept me bedridden for months. (I didn't take any form of fluoroquinolone, but Augmentin instead) One this lengthy health problem resolved in late Spring, I was left with quite a bit of muscle atrophy due to inactivity. It also doesn't help that I'm in my early 50's, I'm noticing that ailments don't heal as quickly as when I was younger.
I immediately began (big mistake) cleaning my attic, while sitting on both feet cleaning out boxes for hours. I had some stiffness and mild swelling in my ankles, but it dissipated. I also began going on nightly walks to increase my activity level. After arriving home from my second or third walk, within 30 minutes I had developed pain in my ankles, hips and back. Fortunately the pain was gone by the next morning.
Over the coming weeks my left ankle began to cause me pain but I couldn't pinpoint exactly where. (I've never had the repeat episode of hip or back pain again) I had been to the ER twice to no avail, an urgent care clinic in which I was told that I sprained my ankle and given a boot. (No imaging was done) Shortly thereafter I had seen an Orthopedic twice. On the first occasion he took an x-ray of my foot and said that everything looked good, took me out of the boot and gave me some sort of ankle wrap which didn't help. As time progressed, so did the pain.
As for my pain patterns, it seems to come from around the lateral ankle and travel up into the side of my lateral calf. The pain in the lateral calf seems to be the worst. By evening, I have mild swelling around the lateral area of the ankle. Upon my research over the months, my best guess is Peroneal Tendonitis. I haven't been doing anything physical since this pain started and have been in bed 90% of the day with my foot elevated. In the morning, the pain isn't very bad but increases throughout the day with evening being the worst. I assume this is due to having to walk around briefly throughout the day.
With that being said, over the past few weeks, I've noticed the same dull and nagging pain beginning in the right ankle with the same pain pattern. I recently saw a
Podiatrist who examined me, looked at my gait and said that I had a problem with over-pronation. He said it was more severe in the left ankle than the right. I have no problem with ROM. I'm currently waiting on a pair of Orthotics to be made that he feels will correct this mechanical imbalance.
I was in physical therapy for a brief period, but he thought it would be wise to save my visits for after I receive the Orthotics. No MRI was ever done, as my insurance company denied one.
While I understand that it can be complicated offering help without being hands on, would you tend to agree with the Podiatrist? Upon my research, I haven't come across many people that have Peroneal Tendonitis in both ankles and I seem to come across so many failed Peroneal Tendon surgeries that frighten me. While waiting for my Orthotics, I use ice nightly.
Thank you for any insight you may have to offer, it would be much appreciated.
RESPONSEHi Cheryl,
Thanks for the kind words regarding my site; I try. It sounds like you may have peroneal tendonitis as I see a lot of it and in most cases it appears to come from over pronation, in an otherwise healthy individual.
The pain you describe as originating on the outside (lateral) side of the ankle and going up the lateral side of your calf, follows the course of the peroneal tendons.
Since your podiatrist determined that you excessively pronate then I agree with the notion of orthotics. Why not try and alleviate the problem from the source?
Since prescription orthotics can take a few weeks to be made, I am surprised that your doctor did not suggest you try a pair of store bought arch supports. Any thing that reduces the pronation, even ever so slightly with the store orthotics, should relieve some of your discomfort.
treatment for peroneal tendonitis until your orthotics arrive
If icing helps then keep icing, try and limit your activity to necessary tasks until you get your orthotics. Because of your diverticulitis you cannot take nsaids, so you are limited there. If it is more then ten days from now before you expect to receive your orthotics then go out and buy a pair of arch supports, ones which will raise your arch the most. Try and wear them exclusively in sneakers which also tend to have a built in arch which will further reduce your pronation.
Marc Mitnick DPM
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