Symptoms

The peroneal muscles (Musculus peroneaus longus and Musculus peroneaus brevis) are located on the outside of the lower leg. The muscle bellies are located in the upper half, from where they run as tendons further behind the outer ankle to under the foot. According to their position, they enable the foot to bend when tensed, as well as to lift the outer edge and spread outwards.

If the above-mentioned muscles are overstressed and subsequently shortened, the tendon is subjected to increased tensile stress, which it cannot withstand in the long term and reacts with an inflammation. Symptomatically, pressure and strain pain is mainly caused in the tendon area behind the outer ankle of the foot. In addition, the classic signs of inflammation such as redness, swelling, overheating and functional impairment occur. Frequently affected by peroneal tendon inflammation are runners with recurring self-exercise combined with insufficient regeneration time. Other causes can be incorrect footwear, incorrect running technique, past injuries such as twisting the foot or muscular imbalance.

Foot malpositions

Foot malpositions can also be the cause of peroneal tendon inflammation. The altered foot position results in an altered gait pattern and a non-physiological permanent pull on the tendon, which can also lead to inflammation after a long period of time. In general, it is important during treatment to filter out the cause and to work on it in addition to symptom-relieving measures in order to achieve long-term success.

Foot malpositions can be influenced passively with insoles or special shoes, but muscle building must be trained particularly actively with specific exercises. The training of certain muscle groups is intended to normalize the gait and foot position, to compensate for muscle imbalances and thus to take the constant pull off the tendon. Passive measures should always be used only as support and not as a complete therapy.

Further measures

As mentioned above, other measures are suitable for healing peroneal tendon inflammation:

Cold applications against inflammation and heat applications to reduce tension in muscle and tissue.
Electrotherapy and ultrasound applications
Applying tape layers to relieve and support the structures, especially when returning to sport.

Ultrasound therapy is a method in therapy that is often used for tendon insertion irritation and inflammation. Usually a medium-sized transducer is covered with ultrasound gel and moved in a circular motion over the peroneal tendon and especially over its origin and attachment. During the therapy, a feeling of warmth may develop, but no pain should occur.

In the hours or the day after the application, a feeling similar to a sore muscle can develop. The high-frequency ultrasound waves penetrate deep into the tissue, where they have an anti-inflammatory and healing effect, and small calcium deposits can be destroyed and removed. In electrotherapy for peroneal tendon inflammation, both direct current and alternating current can be used.

In iontophoresis, direct current can be used to introduce active substances in the form of ointment into the tissue. Diclofenac, for example, is suitable here to inhibit inflammation and relieve pain. Alternating current also has an anti-inflammatory, relaxing and pain-relieving effect.

The application of a tape for peroneal tendon inflammation can effectively support the therapy and reduce the symptoms. Flexible tape should be used for the following possibilities of tape application:

For the first option, a tape about the length of the lower leg is used, the end of which is stuck under the sole of the foot, directly on the base of the peroneal tendon. This is located on the inner edge of the sole of the foot, approximately parallel to the inner ankle.
The tape is then led along the course of the muscle to the outside of the foot, laterally past the outer ankle to the lower leg and stuck along the painful tendon.Pull is only built up under the sole of the foot. The second tape of this attachment option starts on the lateral back of the foot, is attached to the Achilles tendon and ends on the inside of the foot.
For the second possibility of tape laying, the first tape is glued in the same way as for the first possibility. The second tape starts directly below the inner ankle and is then pulled 50% in front of the heel, in the transverse arch under the sole of the foot.
It then runs in front of the outer ankle and ends before the first tape on the front of the shin. The tape should be worn for a maximum of 7 days and serves as a supporting measure. It does not secure the joint in any way and therefore does not replace the suspension of strenuous sports activities until the peroneal tendon inflammation has healed.