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How do you treat peroneal tendonitis?

Tendon pain from overuse is a very common problem in sports activity. It happens when 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 simply how much activity is taken on and just how frequently it is done. It is important that the tendon has time to adjust to those loads or the cumulative load could exceed that. That's the second part, just how adapted the tendon would be to those loads. Understanding these concepts is important in being familiar with and dealing with tendonitis.

By way of example, peroneal tendonitis which is an excessive use injury occurring on the outside of the ankle joint. The collective load in this tendon is greater when activity levels are too high or increased too quickly and not enough time is given for the tendon to adapt to those higher loads. The cumulative load is also increased by the biomechanics of the feet. For instance, if the supination resistance of the foot is low then the peroneal muscles on the outside of the lower limb will need to work harder. That could put an increased force on the peroneal tendons after which in addition to training errors that load could possibly exceed what the tendon can take and it develops tendonitis.

Based upon these principles, peroneal tendonitis is treated by lessening that collective load. That will mean exercising volumes and frequency have to be decreased somewhat to permit the tendon to adapt to the loads. The strain in this condition can also be reduced with foot orthotics that evert the foot, which means the peroneal muscles does not need to work so hard. Then the tendon really needs to be given a chance to get used to the loads. This implies that training amount and frequency has to be slowing increased, with lots of rest between training loads to get the tendon to adapt to those stresses.