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How to Treat Peroneal Tendonitis with Seattle Podiatrist Larry Huppin
Hi, today i’m going to talk about peroneal tendonitis. so to start with, let’s look at the anatomy a little bit. The peroneal tendons are two tendons that start as muscles up on the leg, travel down around the outside of your ankle and then attach to the outside of the foot right here. That’s one of them called the peroneus brevis, the other one is called the peroneus longus and it crosses under the arch of the foot. So the peroneus brevis attaches right here, peroneus longus goes down and attaches at the base of this.
First metatarsal bone, right? So the main purpose, I’m going to talk as if they’re one tendon or one muscle today, but the main purpose of those muscles is to help pull you this way. So often they will be irritated in situations when they’re having to work too hard. For example, people with unstable ankles that are often spraining their ankle, those muscles have to work extra hard to pull you this way. Eventually you tug on that tendon enough it becomes inflamed. Now,.
This is a problem that really should be treated professionally. it’s better to have it treated professionally rather than treat it yourself because if the tendon is allowed to go on, or the tendonitis allowed to go on, and it doesn’t heal, you can develop something called tendonosis, which is a thickening or scarring of the tendon. It’s treatable but it’s much more difficult to treat so the earlier you treat this problem the better. When we look at treating this problem, the first thing we want to do is take tension.
Off of the peroneal tendons. imagine that the tendon is this rubber band here. if it’s extremely tight, we’re gonna try and get it loose for a few weeks so that there’s less tension on it and the tissue can heal. We’ll often use an ankle brace or even a walking boot, like this, for a week or so and really let it calm down. From there we would put you into an ankle brace or teach you taping techniques, that you can use to take tension off of it.
During that time then, we also get you on a strengthening program. there are some very specific exercises that have been shown in studies to be the most effective for this area. We also might use an orthotic device inside your shoe, either a prefabricated one or a custom one. Unlike many of the problems we treat where we want the orthotic to conform very tightly to the arch of the foot, in this situation we actually want the foot to pronate or flatten out a little bit, because that helps take tension off of the area.
Also, we’ll often use some of these sandals that you could use, these flip flops or slippers or sandals you can get that have pretty good arch support, and they’ll act to help transfer pressure off the side of the foot and get it over to the inside of the foot, take pressure off the area where that peroneus brevis tendon attaches. Finally, if you want to try treating this yourself, please go to our website, click on the Self Care tab and then go to tendonitisperoneal and you’ll find some home treatment hints.