Peroneal Tendonitis and Tenosynovitis
The two major tendons that run along the outside of your ankle are called the peroneal or peroneus tendons. They are known individually as the peroneus longus tendon and the peroneus brevis tendon. The peroneal tendons are important tendons because they prevent the foot from rolling and causing a lateral (inversion) ankle sprain. The superior peroneal retinaculum and inferior peroneal retinaculum ligaments run over top of the 2 peroneus tendons holding them close to the calcaneus (heel bone).
Peroneal Tendonitis, Tears, and Tenosynovitis
Tearing may occur in one or both of these tendons. This leads to pain, swelling, sensitivity and a sense of instability behind the outside of the ankle. They can also pop out of the supporting ligaments that hold them in place which is called a dislocation. Once this occurs, continuous or recurrent dislocation and tearing may occur without immediate attention and repair. Stitching and at the worst, tendon replacement may be required for patients suffering from torn or dislocated peroneal tendon(s).
Peroneal tendonitis (also spelled tendinitis) is the inflammation and irritation of one or both of the peroneal tendons. Like all forms of tendonitis, peroneal tendonitis is a condition that may flare up and subside over a period of time.
Peroneal tendinitis is usually caused by repetitive use of the tendons, but can also be caused by trauma such as a rolled or sprained ankle. Little tears in the peroneus longus tendon and the peroneus brevis tendon irritate the tendon fibers resulting in pain and inflammation.
Peroneal tenosynovitis is swelling and inflammation of the peroneal tendons' sheaths (or coverings) which prevents the tendons from gliding smoothly within the sheaths causing pain. It can be experienced at the same time of peroneal tendonitis, and has similar symptoms. It often results in trouble moving the ankle and will feel sore to the touch. In rare cases, tenosynovitis can be caused by infection, so it is always recommended to check with your doctor to rule this out as a cause.
Tearing of the peroneus longus tendon and/or the peroneus brevis tendon can occur. This leads to pain, swelling, sensitivity and a sense of instability in the ankle. The tendon(s) can also pop out of the supporting ligaments that hold them in place (superior peroneal retinaculum and inferior peroneal retinaculum ligaments) which is known as dislocation.
Symptoms of Peroneal Tendinitis/Tenosynovitis
- Pain and/or swelling along the tendon and possibly up the leg along the fibularis longus muscle during or after activity.
- A burning sensation along the tendon.
- Pain either first thing in the morning or at night.
- Stiffness in the foot and trouble stretching the area.
Who is at Risk?
- People who play sports or do activates that involve repetitive ankle movements.
- People who participate in activities such as running on uneven surfaces, racket sports, basketball, hiking, or skiing.
- People with high arches in their foot.
- People in aging populations, because our tendons lose elasticity and become brittle.
Treatment - What You Can Do!
Allowing your peroneus longus tendon and the peroneus brevis tendon to rest is always recommended following a tear or dislocation. Avoid all activities that may have caused the injury or irritation and begin cold compression treatments as soon as possible. The peroneal tendons are difficult to rest completely as they are essential tendons for walking and daily activities. During your recovery, you will probably have to modify and/or eliminate any activities that cause pain or discomfort in your ankle until the pain and inflammation settle.
The trick with healing a peroneal injury is getting it to heal with minimal scar tissue formation and with as much realignment of the tendon fibres as possible - something ultrasound therapy is great at! Even with optimum healing, there is always less elasticity in previously injured peroneal tendons. This will cause the tendons to hurt during daily activities and exercise. However, if you heal your peroneal tendons efficiently and quickly, your chance of re-injury later on is much lower than average.
Fortunately, there are healing tools that can help treat your peroneal tendons and speed up the healing process so you can get back to a life without pain and risk of further injury. Therapeutic ultrasound will treat scar tissue and reduce inflammation while Blood Flow Stimulation Therapy (BFST®) promotes blood flow to heal your tendons faster and more completely than any other methods available.
Cold Compression Therapy
Doctors recommend using cold compression as soon as possible following an acute peroneal tendon injury, like a sprain, and after any re-injury. This will reduce pain and swelling and minimize tissue damage that occurs with soft tissue injuries like tendon tears and tendinitis.
The Ankle/Achilles Freezie Wrap® allows you to treat your peroneal tendonitis in an effective and convenient way.
Cold Compression Therapy works by interrupting and slowing nerve and cell function in the injured area and reducing swelling that can block blood vessels. This is important because once blood vessels are blocked or damaged, they can no longer carry oxygenated blood through the peroneal tendons and tissue cells begin to break-down.
Without cold compression therapy cellular break-down and tissue damage continues as the cells do not get the oxygen they need to survive. By limiting the amount of damage, you also limit the amount of healing that needs to occur. This is a very important step to heal your peroneus longus and the peroneus brevis tendons faster and with less pain!
The deep cooling effect provided by the Ankle/Achilles Freezie Wrap® slows cell metabolism thereby reducing cellular break-down and tissue damage. Furthermore, because the cold wraps serve to numb the nerves, the wraps also reduce pain! The Ankle/Achilles Freezie Wrap® uses a supercharged cooling gel pack with a medical-grade neoprene compression cover to keep the cold directly off your skin preventing cryoburn while delivering cold right where you need it - around your sore ankle.
Ultrasound therapy is the most effective and pain-free way to reduce inflammation, soften scar tissue and promote faster healing of your peroneal tendons.
During the healing process, scar tissue builds on your peroneus longus and the peroneus brevis tendons and can attach the tendons together, the inner layers of the tendons to the surrounding sheaths they glide through, or the surrounding ligaments that hold them close to the calcaneus to the tendons themselves. This limits the flexibility and movement of the tendons and other tissue in your foot and increases the amount of pain you will experience. Fortunately, you can treat your scar tissue with therapeutic ultrasound to improve the elasticity and flexibility of your peroneal tendons.
Not only does ultrasound reduce inflammation, soften scar tissue and speed up the healing process, it also helps to prevent long term complications. Pain, lack of mobility, tendinosis, or a complete peroneal tendon tear are some of the more common long term complications that can occur when tendinitis (tendonitis) goes untreated. By treating your peroneal tendons with ultrasound, scar tissue becomes softer and the tissue becomes stronger reducing the risk of chronic problems in the future.
For those who suffer from long term tendon tears or strains, ultrasound can help. Ultrasound therapy can help to break up scar and fibrous tissue that has built up over time on the peroneus longus and the peroneus brevis tendons and restore elasticity to the tissue and flexibility in your ankle joint.
Ultrasound can also be used to administer therapeutic medicines into the body. This is a process known as phonophoresis. Ultrasound with phonophoresis is rapidly becoming more popular than ultrasound therapy alone.
Using the MendMeShop® Lavender Infusion Gel during your ultrasound therapy gives you 2 therapies in 1. You get the benefit of the regenerating sound waves from the ultrasound device itself AND the added bonus of the therapeutic ingredients inside the gel being delivered into the tissue where it is most effective.
Lavender Infusion Ultrasound Gel contains the natural essential oils of Bulgarian lavender, peppermint, eucalyptus, and menthol and is exclusively available from MendMeShop®. These ingredients reduce inflammation, relieve pain and improve blood circulation to your peroneal tendons. 1 bottle of MendMeShop® Lavender Infusion Ultrasound Gel comes FREE with every MendMeShop® Ultrasound System so you get unbeatable ultrasound therapy for your injured ankle ligaments and tendons.
MendMeShop® ultrasound therapy with phonophoresis is safe, convenient, and easy and generally requires between 5 - 10 minutes per treatment. It is based on a form of deep tissue therapy, which is generated through high frequency sound waves (that we can not hear). These waves send vibrations deep into your body and slightly increase the temperature of your soft tissue cells. The waves are delivered through a hand held transducer and conductive gel that are used together in a slow, circular motion on your skin over the injured ankle.
Blood Flow Stimulation Therapy
Once the peroneal tendinitis inflammation has been reduced, nourishing and strengthening the tissue in the tendon and surrounding area is recommended.
Using Blood Flow Stimulation Therapy, or BFST®, will speed your recovery and heal your peroneus longus and the peroneus brevis tendons more completely preparing them for strengthening exercises. BFST® increases the amount of blood that flows naturally to your ankle to nourish your peroneal tendons and ligaments, improving elasticity and accelerating the healing process.
By treating your ankle with Blood Flow Stimulation Therapy you can increase your body's blood supply to your peroneus longus and the peroneus brevis tendons and increase your body's natural healing power. In addition, the fresh blood flow whisks away dead cells and toxins that have built up from tendonitis and tissue damage leaving the area clean and able to heal faster. Our Ankle/Achilles Inferno Wrap® provides effective, non-invasive, non-addictive pain relief and healing with no side effects.
With these 3 easy therapies you will notice incredible improvement in your peroneus longus and the peroneus brevis tendons. You will reduce your pain and strengthen your tendons to get yourself back on your feet again. The more diligent you are with your treatment and rehabilitation, the faster you will see successful results!