Ankle

Peroneal Tendinopathy

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Peroneal Tendinopathy, Peroneal Tendonitis, Peroneal Tendinitis

  • Symptoms
  1. Chronic lateral ankle pain (retrofibular), popping and swelling
  2. Ankle instability
  • Signs
  1. Pain and swelling posterior to the lateral malleolus
  2. Provocative maneuvers
    1. Foot eversion against resistance
    2. Foot dorsiflexion against resistance
  • Differential Diagnosis
  1. Ankle Sprain
  2. Fibular Fracture
  3. Peroneal Subluxation
  4. Os perineum syndrome (plantar lateral Foot Pain)
  5. Rheumatoid Arthritis (consider if lack of Trauma)
  • Management
  1. RICE-M initially
  2. Rehabilitation Exercises
    1. Ankle range of motion
    2. Peroneal strengthening (Eversion strengthening)
    3. Proprioception Exercises
  3. Shoe Orthotic
  4. Lateral heel wedge
  • Management
  • Orthopedic referral for possible surgical repair
  1. Failed therapy above
  2. Persistent or recurrent peroneal tendon instability
  3. Peroneal tendon rupture
  • References
  1. Sammarco (1994) Orthop Clin North Am 25(1): 135-45
  2. Simpson (2009) Am Fam Physician 80(10): 1107-13 [PubMed]