Peroneal tendinopathy

[Gearoidmuar]

If you're stretching, STOP.
I had a year-long problem in area of upper tendon about 30y ago. Was active runner/cyclist at the time. I became lame. Everyone had me stretching. I'd limp after 400yd walking. EVENTUALLY I went to an expert masseur who'd worked with Pro footballers in England.
I'll fix you in three weeks, said he. I, being a doctor, was sceptical. I stopped stretching and he massaged the hell out of it. In three weeks it was perfect. I never stretched since and It's been fine for 30y.
The modern scientific evidence is that at best, stretching is harmless but that it is useless.
My daughter has run in the Olympics in the Marathon and doesn't stretch. Very few of her fellow elite runners do.

[NATURAL ANKLING]

Hi,
I don't stretch at all and shun those who do so on every park bench and doorstep..........posers

But you do need professional examination first before you just launch into any static home exercises.

I would be a cripple without my daily workout, physiotherapy.

[goddardsharon482]

If you're stretching, STOP.
I had a year-long problem in area of upper tendon about 30y ago. Was active runner/cyclist at the time. I became lame. Everyone had me stretching. I'd limp after 400yd walking. EVENTUALLY I went to an expert masseur who'd worked with Pro footballers in England.
I'll fix you in three weeks, said he. I, being a doctor, was sceptical. I stopped stretching and he massaged the hell out of it. In three weeks it was perfect. I never stretched since and It's been fine for 30y.
The modern scientific evidence is that at best, stretching is harmless but that it is useless.
My daughter has run in the Olympics in the Marathon and doesn't stretch. Very few of her fellow elite runners do.

It's funny, I have been coming to a similar conclusion. My current troubles involve tendons at the sides of my ankles. I have been told to stretch, straight legged for the calf and bent legged for the soleus. But I don't feel that either are making any impression on the areas giving me trouble. Occasionally I feel the straight legged version is helpful for if my calves are tight.

I think massaging the area directly makes much more of an impact. However I think I have overdone it a few times, I could do with my own expert masseur. I doubt I will be better in 3 weeks (I wish!) .

[martin113]

Interested to hear your case Goddardsharon482. I was diagnosed with peroneal tendinitis in July by a local sports physio. My GP said I had plantafasciaitis but the physio went straight to the correct diagnosis as the pain is all on the outside of the right foot and around the outside of the right ankle. Mine came on over many months and I am bemused about how it happened. The physio's theory is that it may have been due to over tightening the ratchet on my road shoe, the ratchet sits right on top of where the tendon joins the 5th metatarsal. I was doing about 80 miles a week January to June, riding twice a week and I do like to tighten my shoes so it is a plausible explanation. A good podiatrist that I saw says it may have been caused by my heal being turned inwards so that I am walking on the outside of the right foot. I now have orthotics to correct that. I also used to do country walks and the pain was worst after long walks, certainly not after cycling.

I now can't walk more than a 100 yards or so without being in pain. I have had to use a mobility scooter or crutches. I have had to give up cycling though I get around town by riding flat pedals with my foot half on and half off but I wouldn't want to do any serious miles like that. I spend a large amount of time on the sofa resting the foot, can't get serious work done on my allotment and in three months I can't say I have seen any improvement. GPs and the physio just tell me it takes a lot of time. Basically I am really disabled and life is extremely difficult and I just get told to be patient and wait. The physio said don't do stretches as it will aggravate the condition.

Could you update us on how you are doing as you haven't posted since August? I would be interested to hear how it has gone further down the line.

[goddardsharon482]

Hi Martin113,
Sounds like you're having a horrible time of it! Have they given you an estimated time frame for your recovery?

I am lucky in that I have not been in much pain overall. I would get the occasional stabbing pain followed by weird sensations of weakness, and my ankle puffing up making it difficult to walk. These vague symptoms held up the diagnosis until in one physio session I was very sore at the peroneal tendon site, but only when the physio massaged it.

I think as time passed my recovery was further hindered by muscle weakness setting in. I am finally making a bit of progress, responding well to heel raises. I am up to 10 raises, just one set on alternate days.

I think my physio has dumped me! She kept trying to make me do loads of exercises, but having had so many bad experiences prior to seeing her (most of my previous efforts to increase activity had just resulted in me off work, unable to walk) I was very scared to do everything she asked of me. So now I'm just muddling through, hoping for my current run of progress to continue!

Tendonitis can come on very gradually as you describe, a 'build up of wear and tear'. I also had foot alignment issues, and am using an insole to correct that now.

I have heard that rest is a bad thing for tendonitis. But it must depend massively on the degree of injury to the tendon, stage of recovery etc. It could need an operation. My physio did one test on me which she says shows I don't need an operation on mine. With me lying on my side on a bed, injured foot on the top, she put her hand on the outside of my foot and pushed down, making me resist and try to push her hand up. The fact that I could do this apparently showed there was no significant injury to the tendon, just minor wear and tear.

Regarding being unable to walk: one thing I found good to do, even when I was at my worst, is to always try and do a small walk every day, even if it's just 5 mins on crutches. But obviously if it's agony probably better not!

Sorry for the long post, but I hope some of this is of use to you. I know it's miserable being unable to walk! Best of luck with it.
Sharon

[goddardsharon482]

Just a quick update for anyone interested in Peroneal tendinopathy (can we change the thread title?).

The main continuing symptom is a chronic, low grade inflammation, no pain. My forefoot puffs up as well now, in addition to the original site over the peroneal tendon (above the ankle joint).

I've continued with heal raises, I was up to 20 single raises (one set, alternate days). Then I tried going back to dancing and it started to decline. So I'm giving that up (again), reducing the heel raises for a week or so to see how it recovers.

To manage the inflammation I tried going full dose on Ibuprofen, but got diarrhoea after 2 days, so stopped that (although for the ankle it had felt promising). Have tried the Ibuprofen gel, but that still affects my stomach, so that's not a sustainable treatment for any significant length of time. Now using a Curcumin supplement, it does help but is not as effective as Ibuprofen. Also a TENS machine brings the swelling down, but only has a temporary effect.

I think my plan for the next few months is to keep up with the heel raises, increasing the number very gradually and slowly. In a couple of weeks from now try more regular sessions on the cross-trainer and taking my bike out for short rides locally.

I got myself a private MRI in January, it showed nothing of interest, no tendon tears. But tendinopathy is typically the result of micro-tears too small for the scanner to resolve. I just wanted to check, as I couldn't believe that this problem that has been hounding me soooo long was down to something 'minor', lol!

[Vorpal]

Just a quick update for anyone interested in Peroneal tendinopathy (can we change the thread title?).

I've changed it, but for future reference, you can change a title by going back to your original post and clicking on the edit (little pencil) button in the upper right of the post. Just change the subject field. You can't change the title on anyone elses posts, but you can change in on yours. I could change them all, but anyone who hits reply should now have the new title.

To manage the inflammation I tried going full dose on Ibuprofen, but got diarrhoea after 2 days, so stopped that (although for the ankle it had felt promising). Have tried the Ibuprofen gel, but that still affects my stomach, so that's not a sustainable treatment for any significant length of time. Now using a Curcumin supplement, it does help but is not as effective as Ibuprofen. Also a TENS machine brings the swelling down, but only has a temporary effect.

Ibuprofen is not good to take long term, anyway. It is not good for the kidneys, and may have other (as you have found) side effects. Your GP should be able to prescribe something more effective than a curcumin supplement and safer long term than ibuprofen.

Ideally, someone with chronic pain should have a pain management plan, or at least a lengthy conversation the with GP about how to manage the pain on an ongoing basis, and when it is especially bothersome.

[Vorpal]

I now can't walk more than a 100 yards or so without being in pain. I have had to use a mobility scooter or crutches. I have had to give up cycling though I get around town by riding flat pedals with my foot half on and half off but I wouldn't want to do any serious miles like that. I spend a large amount of time on the sofa resting the foot, can't get serious work done on my allotment and in three months I can't say I have seen any improvement. GPs and the physio just tell me it takes a lot of time. Basically I am really disabled and life is extremely difficult and I just get told to be patient and wait. The physio said don't do stretches as it will aggravate the condition.

That sounds really awful. Do you have some exercises, or something to help improve the condition?

[NATURAL ANKLING]

Hi ,
If it’s keeping you awake , Painful to walk et cetera, you need to go back to see the GP.
I have several problems I deal with on a daily basis.
I spend at least 20 minutes every day doing physiotherapy exercises.
Trying to get out on the bike At least three times a week equals 8 to 10 hours.
Physiotherapy Helps so is the bike.
If I stop either I’m in problem, If I do nothing for about a week can’t sleep from the constant pain in the leg.
I was on ibuprofens for several years, didn’t get any better, but stopped completely , Ached for a week .
With physiotherapy that’s recommended by a physiotherapist, if you saw one day skip one or two days and then restart.
Are the heel lifts Circular heel drops as well, both feet on the step drop-down using 1 foot rays using the other foot I repeat 15 times.
Rest for five minutes and repeat with other foot.
I’ll try not to take any painkillers whatsoever but now and again when I can’t sleep once a month I take a dose Of naproxen 250 to 500 mg and this normally clears up the problem completely.
I pro Bruthenfriend can give you the runs .
I have a painful shoulder at the moment which stops me getting to sleep can’t raise arm above 90° without pain, did this mid-November and still in pain now seen physiotherapist several times Tuesday but they are sick.
I will have to look up the meaning of your new diagnosis, at least you know what is not.
Good luck.

Text dictated by speech, auto grammar Correction is working overtime.

[goddardsharon482]

I've changed it, but for future reference, you can change a title by going back to your original post and clicking on the edit (little pencil) button in the upper right of the post.

Ideally, someone with chronic pain should have a pain management plan, or at least a lengthy conversation the with GP about how to manage the pain on an ongoing basis, and when it is especially bothersome.

Thanks Vorpal.

I'm not actually in pain, which I think has caused a lot of confusion regarding the diagnosis. It is chronic inflammation (feels sometimes cold/fuzzy/weak/numb). So doesn't sound as serious as pain.

But if I ignore it and try to resume normal activities, the inflammation gets worse until the point I cannot walk. And the same was happening when the physio was trying to get me doing lots of exercises. She could not seem to grasp that if I did as she asked, I would not be able to walk, and thus work.

So I have worked on a much lower intensity version of PT at home. Just heel raises at the moment, drops are on the list of things that make this inflammation worse at the moment.

[NATURAL ANKLING]

Hi,
Because you don’t appear to be suffering pain but swelling, probably been difficult to diagnose correctly.
Sounds like you need to do things carefully and measured to recover.
Physiotherapy is in there somewhere so take care to follow best advice.
Apparently full recovery is possible in for the very active people, now you have a diagnosis will be able to arm yourself with correct footwear et cetera.
https://www.medicalnewstoday.com/articles/318349.php