Posted on April 23, 2021
How do you treat peroneal tendonitis in runners?
Tendon injury from overuse is a very common injury in sports activity. It occurs in the event the cumulative strain on the tendon surpasses what the tendon can take. There is two parts to this: the first is the cumulative load and that means the amount of exercise is undertaken and just how frequently this is done. It is important that the tendon is given time to get accustomed to those loads or the cumulative load might exceed that. That's the second part, just how adapted the tendon would be to those loads. Understanding these principles is crucial in being familiar with and dealing with tendonitis.
As an example, peroneal tendonitis that is an excessive use injury occurring on the outside of the ankle joint. The cumulative load in this tendon is higher when exercise amounts are too high or increased too quickly and not sufficient time is given for the tendon to adapt to those high loads. The cumulative load can also be increased by the biomechanics of the foot. For example, if the supination resistance of the foot is reduced then the peroneal muscles on the outside of the lower limb will be required to work harder. That may put an greater load on the peroneal tendons after which in addition to training errors that load will probably go beyond what the tendon can take and it develops tendonitis.
Based upon these concepts, peroneal tendonitis is treated by reducing that cumulative load. That could mean training volumes and frequency really need to be reduced somewhat to permit the tendon to adapt to the loads. The stress in this disorder will also be decreased with foot orthoses that evert the foot, which means the peroneal muscles will not need to work as hard. Next the tendon ought to be given an opportunity to get used to the loads. This means that exercising volume and frequency has to be slowing increased, with lots of rest between training loads to get the tendon to adjust to those loads.