Have you started running, or recently increased the number of kilometres you are running and now have pain on the outside of your ankle?

It could well be peroneal tendonosis, commonly located just behind the outside bone (lateral malleolus) of the ankle and includes both the peroneal brevis and peroneal longus tendons.

Our Gold Coast Physiotherapist Ben Mack recently presented with the exact same problem and has been able to continue running whilst managing the condition. What does that involve you ask? Well, here are the main aspects the we have used on him to help control and manage the condition:

  • Make sure you have the right footwear and good heel support. Ensure you are not over inverting the foot, requiring excessive contraction of the peroneals (everters) throughout mid-stance during the running gait. 
  • Trial some taping of the peroneal muscles to deload the tendons and the cross over of each tendon at the back of the ankle. 
  • Icing. This actually works in this instance and is very helpful when just using a piece of ice to micro-massage over the affected area for ~20minutes at night. 
  • Eccentric strengthening exercise. This is probably the most important but technique and quality of the movement is crucial! Because the peroneals are plantar flexors and everters the foot needs to start out in a pointed but turned outward to the side position. Resistance then needs to be applied by way of a resistance band which is pulled against the foot and then slowly allow the foot to bend upward inwards toward the other foot (letting the resistance band win!!). This movement needs to take place over 30-45 seconds! Repeat only 3-4 times and of course, PAIN FREE!

The Physiotherapists may also trial dry needling or ultrasound for this condition as both have been found to work very effectively. 

Management of workload is obviously also very helpful and crucial in this instance when still running with the condition.

So, we hope this is helpful to all the runners out there particularly with the Gold Coast Marathon fast approaching! Good luck and happy training. If you have any questions or concerns please give one of our Physiotherapists a call or make a booking on 55911816. 

PhysioFlex Team

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