Pain on the outside of your foot? It could be due to peroneal tendonitis.

pain on the outside of the foot

A common foot injury often misdiagnosed as a complex ankle sprain is called peroneal tendonitis.  The peroneal tendons are two in number, and run together under the outside of the ankle joint, where they stay together for a couple inches until they reach the middle part of the side of the foot.  It is here that one stays on the side of the foot, attaching to the bone prominent on the outside of the foot.  The other longer tendon runs underneath the foot to attach near the other side.  These tendons are known as everters, because they help the foot to roll to the outside, or evert.  This motion is very important during the normal walking cycle, and helps to balance the more powerful muscles on the other side of the foot that draw it inward.

The peroneal tendons can become injured during simple ankle sprains, as the twisting force that tears ankle ligaments can stretch and injure the peroneal tendons running near the ligaments.  However, the peroneal tendons can also become injured without having a specific sprain.  Walking on uneven surfaces, simple excessive climbing, using unstable shoes, and even compensating for arch pain can lead to peroneal tendonitis.  Because the symptoms, which may include pain around and under the outside of the ankle, are similar to the pain of an ankle sprain, it is often misdiagnosed as an ankle sprain. The typical pattern of pain also includes sharp or achy pain to the side of the foot, where the majority of the time the pain is at it’s strongest.  Bearing weight on the injured foot, twisting it inward, and moving on uneven ground like lawns or gravel can aggravate the pain.  There is rarely ever swelling or bruising visible on the side of the foot, and there is never a cracking or popping sensation (unless the tendons are moving over the ankle bone or a fracture has occurred on the side of the foot- both of which are different conditions).

Fortunately, the treatment of peroneal tendonitis is not too different from that of an ankle sprain, so if there is a misdiagnosis at least the recovery process is similar.  In general, peroneal tendonitis needs rest, ice, anti-inflammatory medications, and ankle brace support.  Cases that don’t respond to these measures need physical therapy to help with healing and strengthen the tissue.  The difference in treatment from an ankle sprain lies in that if physical therapy is needed to improve the recovery, a misdiagnosis could lead to imprecise therapy and a poor result.  In addition to the above treatment, severe cases of peroneal tendonitis may require immobilization of the leg or surgery to repair the tissue damage.  It is not uncommon for partial tears of the tendon to accompany the tendonitis, and often these need to be surgically repaired if the pain is not resolving with non-surgical treatment.

Do I Need To See A Doctor For My Anke Sprain?

sprained ankle

Ankle sprains are one of the most common injuries that occur in the body.  Athletes playing sports make up part of the millions of people each year who sprain their ankle, as well as people simply walking on uneven ground, stepping into a hole, slipping on ice, or awkwardly stepping off of a curb.  Ankle sprains can run the range from simple to severe, with some sprains feeling fine after a few days to others with pain lasting well over a month.  Ankle sprains are one of the most under treated types of foot and ankle injuries, and these seemingly simple injuries can often have long term effects on the health, function, and stability of the ankle as a whole.

An ankle can be injured when it rolls either inward or outward.  The ankle is bound together on either side by strong straps of tissue called ligaments.  The ligaments on the inner side of the ankle are particularly strong, and rarely get injured.  The ligaments on the outer side of the ankle are considerably weaker, and therefore it is easier for the foot to roll inward under the ankle during an injury, which then cause the outer ligaments to either stretch or tear.  There are three total ligaments on the outer side of the ankle, and the severity of the sprained is defined by how many ligaments were injured, and whether there was simply a stretching of the tissue or an outright tear.  Whether stretched or torn, an ankle sprain can pave the way for future sprains to more easily occur because of the looseness of the tissue that follows such injuries.  While tears are certainly more unstably, stretch injuries can also lead to ‘loose ankles’ that have a higher chance of re-injury, and even an elevated chance of that injury causing a fracture in the ankle.  Unfortunately, even simple sprains can also have additional injures dealt to the foot by the force of the sprain injury, which may go unrecognized or mixed in with the pain of the sprain itself.  These can include muscle strains in the leg or foot, sprains of smaller joints in the foot, microscopic fractures in bone, nerve stretching injuries, and tendon strains.  It is not uncommon for these additional injuries to be missed even in an emergency room, where sprain care is basic and concentrated on making sure a fracture is not present.  These additional injuries may be subtle at first or simply painful with the sprain, but over time can gradually lead to secondary areas of pain, further foot or ankle instability, arthritis, weakness, or loss of some sensation (if a nerve was damaged).

Because of the long term implications of ankle sprains and their associated secondary injuries, it is recommended sprains be evaluated by a physician, with a strong preference towards a foot and ankle specialist well trained to recognize all the subtle elements that make up these injuries.  Early appropriate treatment can be vital to ensuring the ankle passes through the injury period intact and healthy.  Examples of early intervention includes stable ankle bracing, early therapy and mobility exercises, as well as a guided return back to activity.  this level of treatment can make a world of difference between an ankle that stays healthy and strong, and one that becomes chronically weak.  As the after-effects of a sprain may take years to fully appear, the notion of being ‘tough’ and ignoring the sprain in the hope it will simply heal on its own is unwise, especially when professional care for these injuries is so easily available.