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peroneal tendonitis

Posted by chrisc on 4/08/02 at 16:47 (078844)

Dear Drs.,

After suffering with PF since last spring, I seem to have a continuing case of peroneal tendonitis in the same foot, my right foot. I stretch, use orthotics, (custom rigid), ice, take advil, rest as much as possible.
I have a very high arch and lack flexibility.

I am curious about two things.

First, should I seek physical therapy for added relief and to speed healing?

Second, I always seem to develop problems with my right foot, never my left and wonder if maybe I don't have either an anatomical or functional leg length issue to deal with and if so, how do I best go about determining that?

Also, any opinion on hard vs. more forgiving orthotics?

Thanks,

Chris C.

Re: peroneal tendonitis

Dr. Zuckerman on 4/08/02 at 18:57 (078858)

Hi

I would go to a physical therapist. They can determine your range of motion and muscle strength. I have found that a one time injection of a local steriod medication could help you out alot.

In addition your physical therapy can give you ultrasound. whirlpool etc to this area.

Re: peroneal tendonitis

nancy s. on 4/09/02 at 01:23 (078890)

hi, i'm not a doctor -- a patient who started with PF and ended up with achilles, post tib., and peroneal tendonitis on top of it. as dr. z says, i would recommend physical therapy also. i actually had it for six months, my case was so severe, but i do believe it helped. my PT did ultrasound, iontophoresis, and deep massage, finishing with a giant freezing ice-wrap (this last was what enabled me to walk out of the rehab hospital each time!). it wasn't exactly fun, but i was very glad i did it, because i'm sure it was one of the important elements of my healing (i'm about 90% well now.) good luck to you.
nancy

Re: peroneal tendonitis

chrisc on 4/09/02 at 07:10 (078894)

thanks for the feedback. Unfortunately, I may be a bit wary of any injections, as I had three for the PF when it was so stubborn and ultimately I feel that it may have masked pain in the peroneal while I continued to try to conduct my activities. Matter of fact, at one point I was in agony in several areas of my foot, but over time things have calmed down. For a time I was convinced that I had fractured my foot, or had stress fractures.

Any opinion on the leg length discrepancy I had mentioned? i.e., how does one go about making that determination?

Thanks,

Chris C

Re: peroneal tendonitis

BG CPed on 4/10/02 at 20:18 (079143)

You noted that your foot orthotics are rigid and you have a high arch. I have seen many cases of peroneal tendon flare up when/if you have a cavus foot and the orthotic has too much varus correction or the heel and or forefoot post is thicker on the medial (insode arch) side.

It can put tension on and preload the peroneal tendon. I wouls have the person that made them possible reduce some of that correction if it is there. Also make sure you dont have a running shoe that is posted for pronators. If your foot gets tipped outside too much or over corrected by even a few degrees it can cause that problem also. Not saying it is that for sure, but i have seen 2 in the last 3 weeks myself

Re: peroneal tendonitis

Dr. Zuckerman on 4/08/02 at 18:57 (078858)

Hi

I would go to a physical therapist. They can determine your range of motion and muscle strength. I have found that a one time injection of a local steriod medication could help you out alot.

In addition your physical therapy can give you ultrasound. whirlpool etc to this area.

Re: peroneal tendonitis

nancy s. on 4/09/02 at 01:23 (078890)

hi, i'm not a doctor -- a patient who started with PF and ended up with achilles, post tib., and peroneal tendonitis on top of it. as dr. z says, i would recommend physical therapy also. i actually had it for six months, my case was so severe, but i do believe it helped. my PT did ultrasound, iontophoresis, and deep massage, finishing with a giant freezing ice-wrap (this last was what enabled me to walk out of the rehab hospital each time!). it wasn't exactly fun, but i was very glad i did it, because i'm sure it was one of the important elements of my healing (i'm about 90% well now.) good luck to you.
nancy

Re: peroneal tendonitis

chrisc on 4/09/02 at 07:10 (078894)

thanks for the feedback. Unfortunately, I may be a bit wary of any injections, as I had three for the PF when it was so stubborn and ultimately I feel that it may have masked pain in the peroneal while I continued to try to conduct my activities. Matter of fact, at one point I was in agony in several areas of my foot, but over time things have calmed down. For a time I was convinced that I had fractured my foot, or had stress fractures.

Any opinion on the leg length discrepancy I had mentioned? i.e., how does one go about making that determination?

Thanks,

Chris C

Re: peroneal tendonitis

BG CPed on 4/10/02 at 20:18 (079143)

You noted that your foot orthotics are rigid and you have a high arch. I have seen many cases of peroneal tendon flare up when/if you have a cavus foot and the orthotic has too much varus correction or the heel and or forefoot post is thicker on the medial (insode arch) side.

It can put tension on and preload the peroneal tendon. I wouls have the person that made them possible reduce some of that correction if it is there. Also make sure you dont have a running shoe that is posted for pronators. If your foot gets tipped outside too much or over corrected by even a few degrees it can cause that problem also. Not saying it is that for sure, but i have seen 2 in the last 3 weeks myself