Treating Peroneal Tendonitis With Compression

Is treating peroneal tendonitis with compression a good option? Can it help or is it a waste of time?

Pain in the peroneal tendons is often mistakenly identified as Achilles tendonitis. However, understanding how to identify it correctly and treat it can make a huge difference to how well these tendons heal.

In this article, we’ll discuss peroneal tendonitis and whether or not compression is a good form of treatment for it.

We’ll also recommend some products that could help if you’re undergoing treatment for the condition, whether with a doctor or at home.

What Is Peroneal Tendonitis?

Peroneal tendonitis occurs when friction between one or both of the peroneal tendons and the ankle bone leads to inflamation.

These two tendons run along the outside of your ankle and sit on top of each other, behind the ankle bone. In some cases, the tendons rub against each other, which leads to inflammation.

Both tendons connect the fibularis muscles in the outside of your leg to your ankle and foot.

They then split in the ankle, with the peroneus brevis tendon attaching to the bone just below your fifth toe on the outside.

The peroneus longus tendon runs underneath your foot and attaches to the first metatarsal bone. This tendon plays an important role in supporting and stabilizing your transverse arch when you walk or run.

Both tendons help to stabilize the ankle joint, move the foot outwards, and protect the ankles from sprains.

Causes of Peroneal Tendonitis

Peroneal tendonitis can develop gradually through repetitive ankle motion—like running or cycling—which leads to overuse of the tendons. It can also be caused by an acute injury to the ankle, like a sprain.

With that being said, there are a number of contributing factors that can lead to you developing the condition.

An increase in your training or training with bad form can increase the load on your tendons. This can lead to inflammation in and around the soft tissue of your ankle.

You may have an increased risk of developing the condition if you supinate and have high arches.

As you go through your gait cycle, your body weight is shifted to the outside edge of your foot. This puts excessive pressure on the tendons as they rub against the bone, especially if they overstretch, and leads to inflammation.

If you’re not wearing shoes that provide adequate support for feet and you supinate, it can worsen the condition.

Muscle imbalances, tight calf muscles, or weak hip muscles can increase the load placed on the fibularis muscles. This then puts the peroneal tendons under excessive pressure and causes the tendons to become inflamed.

Spraining your ankle a few times can cause a loss of stability in the ankle joint, increasing your risk for developing the condition.

Runners who tend to follow the same route which has them running on a sloped surface may be at an increased risk of developing peroneal tendonitis.

This is due to excessive friction between the tendon and the bone, which occurs as your foot rolls outwards when you land on the sloped surface.

Symptoms of Peroneal Tendonitis

You will notice either a sharp or an aching sensation behind your ankle bone, along the length of the tendons, or on the outside of your foot.

It will hurt when you try to point your foot to the left or the right, the tendons will be tender to the touch, and the pain may radiate into the arch of your foot.

You’ll also notice swelling on top of your foot on the outer edge, behind, and around the outside ankle bone.

As you go about your daily activities, you may notice that the pain increases and that your ankle feels weak or unstable when you walk.

Who Is Prone to Get Peroneal Tendonitis?

You’re more likely to develop peroneal tendonitis if you participate in activities that involve repetitive ankle movements, like running or cycling.

Peroneal tendonitis is more likely to occur in runners who run along slopes, as your foot rolls outwards. This increases the friction between the bone and the tendons causing inflammation.

You may be at a higher risk of developing peroneal tendonitis if you:

  • Have high arches
  • Have muscle imbalances in the lower legs
  • Don’t stretch before an activity
  • Had multiple ankle sprains before
  • Have tight calves or weak hip muscles
  • Don’t complete your rehabilitation following an ankle injury
  • Are obese or overwight
  • Underpronate/supinate

How Do You Prevent It?

There are a few steps you can take to avoid developing peroneal tendonitis.

Make sure that you wear shoes for peroneal tendonitis that properly support your foot and ankle. Consider putting an orthotic or insert device in your shoes if you overpronate or supinate. This will help reduce lateral movement of the foot, reducing strain on the tendons.

When you warm up before an activity, make sure that you spend some extra time stretching your calves and peroneal muscles.

Include strength exercises into your workouts that work the outer calf muscles— fibularis muscles—and your hip muscles.

Increase your training load gradually, as this will allow your muscles and tendons enough time to adapt to the new level of intensity.

Give your body time to rest between each workout and if you do experience pain, don’t try to push through it.

It may be tempting to take time off during your off-season, but you should maintain a level of activity. Not only will it help you maintain your fitness, but it will prevent excessive loads being placed on the tendons when you return to your workouts.

If you’ve sprained or injured your ankle, then give it the time it needs to heal properly. By returning to activity too early, you can cause further damage, which can cause you to develop the condition.

Provide a bit more support and stability for your ankles by using a brace during activities, especially if you’ve got weak ankles or have sprained them multiple times.

Can Compression Help With Peroneal Tendonitis?

Yes! Compression can help with the healing process of peroneal tendonitis.

The tendons in your feet heal much slower than any other soft tissues in your body. This is because the tendons don’t have a great blood supply.

Compression will increase the blood flow to the tendons. The nutrient- and oxygen-rich blood helps the tendon to repair and this can help speed up the healing process.

The graduated compression helps to stabilize the blood flow, which prevents blood and fluid from pooling in the legs. This reduces swelling and alleviates pain.

Wear your compression socks or sleeves when you’re going to be doing a workout, as they’ll help support and stabilize the ankle. This will reduce your risk of re-injury or prevent the injury from happening.

Best Overall

1. Feetures Graduated Compression Socks

The Feetures Graduated Compression Socks look good and provide a nice amount of compression. This will help to ease pain from peroneal tendonitis and increase blood flow to speed up healing.

What We Like

These socks are knee-length, which provides compression across the entire lower leg and stimulates blood flow to help speed up healing.

It uses targeted compression, with 15 to 20mmHg at the ankle, which is a common painful spot for peroneal tendonitis. There’s also strong compression in the arch, which can also ache due to peroneal tendonitis.

They also have an anatomical left and right foot design, which places the compression in the perfect place every time.

A seam-free toe and the tight fit also reduce any chance of bunching up and causing friction or blisters.

High-density cushioning keeps you comfortable as you wear these socks. The material is moisture-wicking and anti-odor, which will keep your feet fresh as well.

Why We Like It

These compression socks provide targeted compression right in the areas you need it most. They also come in various sizes and colors.

PROS:

  • Targeted compression and support where you need it most
  • Hugs your foot which helps to prevent blisters
  • Moisture-wicking material keeps your feet dry
  • Knee-high length, which stays in place

CONS:

  • Those with large calf muscles may find that the compression is not so strong at the ankle
 

Top Runner-Up

2. 2XU Compression Socks For Recovery

These compression socks feature a high level of compression which may be uncomfortable for some but will definitely help.

What We Like

These full-length socks have a strong level of compression—25 to 35 mmHg. This is ideal for those who have a high level of pain and need relief.

The graduated compression will help to stimulate blood flow and repair the muscles and tendons faster, reducing inflammation.

They have an anatomical design, featuring a right and a left sock for the best fit and compression in the right places.

For comfort, there are lightly padded zones and special venting panels in the toe allow for good breathability through the sock. A seamless toe also reduces the chance of chafing which could cause blisters.

You should note that the added compression may make it harder to get these socks on and off.

Why We Like It

This sock has a high level of compression which will stimulate blood flow and aid in the healing process. It’s also comfortable and has light cushioning.

PROS:

  • High level of compression 25 to 35 mmHg
  • Venting panels increase breathability
  • Made from durable nylon blend material
  • Light cushioning in all the right places

CONS:

  • May be hard to get on and off
 

Best Ankle Sleeve

3. Zensah Compression Ankle Support

This compression sock is short but covers the exact area where you need compression for pain relief and blood flow.

What We Like

The Zensah Ankle Brace is lightweight but supportive. It’s easy to slide on and off, and it provides targeted compression right in the ankle area where the tendons need the most support.

The minimalist design of the sleeve allows for a full range of motion in the ankle, so you can wear it while doing exercise or your daily activities.

It’s made of a moisture-wicking, fast-drying, breathable material. It also has anti-odor, antimicrobial technology built into it to keep your feet fresh while you’re wearing it.

The compression is enhanced by the 3D Geo Tech ribbing around the ankle. While you’re getting excellent compression, the sock is seamless to reduce the chances of chafing and blisters developing.

Why We Like It

It gives you the compression in the exact area that you need it. It’s also much more breathable than a full-length sock.

PROS:

  • Targeted support in the ankle area
  • Allows for full range of motion
  • Slim-fitting and comfortable
  • Seamless construction reduces skin irritation

CONS:

  • These insoles run slightly small
 

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Petersen, Wolf, et al. “Blood Supply of the Peroneal Tendons: Injection and Immunohistochemical Studies of Cadaver Tendons.” Acta Orthopaedica Scandinavica, vol. 71, no. 2, Jan. 2000, pp. 168–174,
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www.teachmeanatomy.info/lower-limb/misc/foot-arches/
Accessed 4 Feb. 2022.

Walt, Jennifer, and Patrick Massey. “Peroneal Tendon Syndromes.” PubMed, StatPearls Publishing, 2020,
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Ziai, Pejman, et al. “Peroneal Tendinosis as a Predisposing Factor for the Acute Lateral Ankle Sprain in Runners.” Knee Surgery, Sports Traumatology, Arthroscopy, vol. 24, no. 4, 19 Mar. 2015, pp. 1175–1179,
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