Peroneal tendonitis can ruin a great exercise routine! If you’ve been having trouble with your peroneal tendon, it can be tempting to stop exercising to avoid the pain and inflammation.
But there’s good news. There are still plenty of ways to stay in shape with peroneal tendonitis—it’s just a matter of finding the right thing for you.
Here’s what you need to know about the condition and a list of exercises you can do safely.
What is Peroneal Tendonitis?
Peroneal tendonitis is when the peroneal tendon—the tendon that runs down the outside of the ankle—becomes inflamed and painful.
The tricky thing is that there are two peroneal tendons. Just below your ankle, they separate, and each attaches to different parts of the foot.
However, this means that peroneal tendonitis can present with pain in the foot itself, as well as in the ankle. It can sometimes be mistaken for plantar fasciitis, so it’s important to be careful when diagnosing yourself so you can treat it correctly.
Causes of Peroneal Tendonitis
Peroneal tendonitis isn’t the most common running injury, but there’s always a chance of developing it. Understanding the causes can help you to avoid it in the first place… Or stop it from happening again once it’s healed.
- Overuse: repetitive overloading of the peroneal tendons
- Changing of routine: a sudden increase in distance, intensity, or frequency
- Foot biomechanics: poor foot and/or ankle biomechanics
- Muscle weakness: weak muscles in the foot, ankle, glutes, hips, or core
- Tight calves: cause excess strain on the surrounding tendons
- High arches: your tendons have to work harder
- Uneven terrain: trails, damaged roads, or sloping terrain
- Supination: more weight on the outer edges of the feet
- Wrong shoes: incorrect arch support, worn-out shoes, or new shoes
Symptoms of Peroneal Tendonitis
It’s important to check your symptoms carefully so you don’t mistake peroneal tendonitis for plantar fasciitis! The biggest difference is that peroneal tendonitis doesn’t present with the classic sharp, shooting pain in the heel in the morning or after rest.
That being said, some symptoms can overlap. Here’s what you might experience if you’re suffering from peroneal tendonitis:
- A sharp or aching pain at the back of the ankle, on the outside of your foot, or running along the tendons up the outside of the leg
- Swelling on the outer ankle and/or at the back of the ankle
- Redness and/or warmth around the peroneal tendons
- A burning or tingling sensation around the tendons
- Pain when you turn your foot to the inside or outside
- Pain that worsens with activity and gets better with rest
In some cases, you may also experience arch pain and an ache just in front of your heel. This happens when the peroneus longus tendon becomes inflamed—this tendon runs underneath your foot and connects to the arch.
If the peroneus brevis tendon is inflamed, it can present with a nagging, aching pain on the outer edge of your foot right below your baby toe.
How Long Does It Take To Heal?
Peroneal tendonitis won’t heal independently, especially if you continue to do physical activity. You’ll need to rest it and treat it to prevent it from getting worse.
Recovery time depends on how bad your peroneal tendonitis is. Mild peroneal tendonitis can take two to four weeks to heal if you apply conservative treatment, while chronic peroneal tendonitis can take anything from 8 weeks to a year.
If your tendons have torn, then you can expect longer recovery times. However, if you catch it early and rest the foot while applying treatments, you can expect it to heal fairly fast. From there, you can take steps to prevent it from happening again.
Can You Exercise With Peroneal Tendonitis?
You can exercise with peroneal exercise, as long as it doesn’t cause worse pain or inflammation in your tendons. It’s wise to avoid high-impact activities when you’re dealing with peroneal tendonitis.
But while you should avoid anything that places stress on the tendons and causes impact, you can choose an exercise that doesn’t place pressure on the tendons or cause pain.
It’s all about finding the right exercise to stay in shape with peroneal tendonitis without risking reinjuring yourself.
When Should You Rest or Exercise?
If you start to feel pain while exercising, but it eases up after a few minutes, you should be okay to keep going. Once your exercise is done, the pain should subside within 24 hours.
If it does, you can continue exercising at the same intensity. However, it’s recommended that you take a rest of 72 hours between each workout to give the tendons time and space to heal.
If your pain continues for longer than 24 hours, this is classified as an overload of the tendon. In this case, you should rest from exercise until you’re completely pain-free.
It may be frustrating to experiment with this until you can find the right thing for you. But it’s best to err on the side of caution—after all, if you continue to exercise through the pain at the same intensity and frequency, you may end up doing worse damage.
Benefits of Exercise for Peroneal Tendonitis
Choosing the right exercises can improve the symptoms of peroneal tendonitis. When you’re doing an exercise that doesn’t cause pain, you might also find some of the following benefits:
- Reduced pain and inflammation in the tendons
- Improved range of motion in the ankle and foot
- Stronger ankles and less chance of injury
- More supple calves, reducing strain in the tendons
- Better circulation in the ankle and foot area
- Faster recovery times
Types of Exercise for Peroneal Tendonitis
Ready to start getting in shape even with peroneal tendonitis? Here are the exercises you can try.
Low-Impact Exercises
While running may be your go-to, let it go for a while in favor of one of these low-impact cardiovascular exercises.
Walking
Walking is a slower, more controlled version of running. It’s also far less high-impact, which means it’s much easier on your tendons than running. Make sure you wear shoes supporting your feet and ankles and walk at a moderate pace.
Swimming
Swimming is an amazing, low-impact exercise that also goes a long way toward improving flexibility and mobility in your ankles. In addition, the pressure of the water on your ankle can relieve pain and reduce inflammation.
The Elliptical
Elliptical machines can work well because you get a great upper and lower body workout while your ankle stays relatively still.
However, you do need to make sure you’re wearing supportive shoes, and if you feel pain, either lower your intensity or swap it out for something else.
Cycling
Cycling is similar to the elliptical because it’s low-impact and fairly easy on your feet. There’s still some ankle movement, so you will need to be careful.
However, if you start slow and work your way up, you can get an amazing cardio workout with very little strain on the feet. Wear supportive shoes.
If you’re cycling on a stationary bike, anchor your feet to the pedals to reduce unnecessary movement.
Arm Ergometer
Also known as an arm cycle, this machine is not common but can provide an excellent workout that completely bypasses your feet.
You can stand or sit while using it, which makes it great for those who have bad tendonitis and need to be off their feet. You might need to do a bit of research on where you can find one.
Weight Lifting
Weightlifting is another great weight-bearing choice. It’s wise to split your weight-lifting days into upper and lower body days so you can give your feet proper rest for at least a few days a week.
Make sure you’re doing every exercise with impeccable form. This will give you the best chance of strengthening your pain points rather than aggravating them.
If you feel pain with a particular exercise, swap it for something that works the same muscle group.
Strengthening Exercises
It’s a great idea to add some foot and ankle strengthening exercises to your daily routines. This will help your feet to heal faster and lower your chances of the same injury happening again.
Heel Raises
Heel raises strengthen the foot and the calves. Stronger calves mean better-supported tendons and stronger foot muscles help to keep the foot in position and prevent tweaks to the tendons.
Stand with your feet hip-width apart. You can stand on flat ground or with the balls of your feet on a step. Mindfully raise your heels by contracting your calf muscles to a count of 2 seconds.
Hold it for a second at the top and then lower your heels in a controlled manner. If your feet are on a step, try not to let your heels dip below the step. Aim for 15 to 20 reps.
Ankle Flexion
This exercise will strengthen your ankles as they flex and extend. It will help keep your foot in position whatever activity you do.
Anchor a resistance band to something in front of you. Sit on the floor and hook the band around the top of your foot so the band is taut. Then, flex your ankle towards you so it pulls on the band.
You should feel the resistance and work against it as you flex. Do 10 to 15 reps on each foot.
Eversion and Inversion
In these exercises, you’ll try to turn the foot inwards or outwards against resistance. The best way to do this is to sit on a chair and anchor a resistance band to something on the side of you.
Wrap it around the middle of your foot. You’ll want to turn your foot either to the outer or inner edge, depending on which side the band is anchored. You need to be working against the resistance. Do 10 to 15 reps both inwards and outwards.
Standing Lateral Leg Lifts
Stand with your feet shoulder-width apart. Tense your core muscles and lift one leg outwards and to the side. Do this slowly so that your stabilizing leg isn’t thrown off balance. Do 10 to 15 reps on both sides.
Stretching Exercises
Keeping your calves and feet well-stretched will help to reduce pain and lower your chances of the same problem happening again.
Towel Stretch
Sit on the floor with your feet straight out, and hold both ends of a towel. Wrap the middle part around the ball of your foot and gently pull it towards you, feeling the stretch in your calf muscle. Hold for 30 to 60 seconds.
Standing Calf Stretch
Stand with one foot a little in front of the other, with your feet about hip-width apart. Lean over by hinging at the hips, bending your back leg but keeping the front leg straight.
Lean forward and grab your front foot underneath the toes. Gently pull them upwards to increase the stretch.
If you can’t reach without bending your knee, lean as far as you can and lift your front toes off the ground. You can also do this next to a wall for support if needed. Do 5 to 8 reps on both sides.
Towel Pickup
Sit in a chair and place a small towel on the floor, just underneath your toes. Scrunch up your toes and pick up the towel, keeping your heel on the floor. Do 10 to 15 reps.
Sitting Plantar Fascia Stretch
You can sit on a chair or the floor for this exercise. Cross one foot over your knee and grab your toes with the opposite hand.
Gently pull your toes back until you can feel the stretch underneath your foot. Hold it in a comfortable position for 20 to 30 seconds.
Tips for Exercising With Peroneal Tendonitis
If you’re going to be doing exercise to stay in shape with peroneal tendonitis, there are a few things to keep in mind.
- Stop exercising if you feel sharp pain in the tendons
- Warm up by stretching the calves, ankles, and feet before exercise
- Make an effort to keep your feet and ankles aligned
- Start slow and increase gradually so your tendons adjust
- Ice and massage your feet after exercise to increase circulation
- Try taping for peroneal tendonitis for extra support
- Don’t be afraid to take time off to allow it to heal!
