The peroneal muscles are a band of muscles that run down the outside of the shin. A tendon is the tissue that connects these muscles to the bones in the foot. A peroneal tendinopathy is damage to the small tendons on the outside of the ankle due to excessive strain or an overuse of these muscles.
· Pain on the outside of the ankle
· Swelling, redness or warmth around the tendon
· Pain that increases with activity
· Thickening of the tendon
· Decreased perineal strength
Peroneal tendonopathy generally occurs due to a medial to lateral instability of the ankle joint. Due to this instability the peroneal muscles on the outside of the ankle have to work through a larger range of motion, and have to provide more stability through their strength. This increases degeneration to the tendon over a period of time leading to significant damage resulting in pain. Orthotic insoles help to place the foot in its ideal position -reducing medial to lateral instability and therefore reducing strain on the peroneal tendon.
Custom made orthotic insoles are generally deemed to be preferential to treatment of peroneal tendonopathy then over-the-counter orthotic insoles.