I’ve self diagnosed myself with peroneal tendonitis. It started several weeks ago and I have a dull aching pain along the outside of my foot and behind my ankle bone. It doesn’t hurt when I’m running, no swelling, and doesn’t cause a limp when running or walking but I do have a dull ache after running for most of the day. I currently run in custom orthotics and like I said it doesn’t hurt when I run but after I run it feels worse when wearing my custom orthotics. I switched out my custom orthotics with some green superfeet in my work shoes and it feels better with the superfeet. I’ve been icing it after running and biking, foam rolling my peroneal longus muscle, and taking anti-inflammatories. I do have a doctors appointment scheduled in 3 weeks I just couldn’t take off work for 3 weeks because this is a very busy time of year. Has anybody dealt with this injury before? Any suggestions?
I had something similar…lots of PT and then lots of stretching before and after run. Very happy with results. Give it some time.
Yes and it took forever. I thought it was a stress fracture. I found that swimming specifically kicking (a lot of moment on that arm) aggravated it the most. Had pretty good success with Graston (?) /ART and foam roller. Good luck on the rehab.
grastons, art, acupuncture, heat, and cissus. google each individually if you are unclear. good luck.
Was anybody able to run through it or did you have to stop running altogether?
Was anybody able to run through it or did you have to stop running altogether?
Stop. it won’t heal otherwise. As above, it took a number of weeks to fully heal. I think I recall my PT saying it’s an area that does not get a lot of blood flow, so it’s just a slow healer
I had it and stopped running for 12 weeks. It hurt a little all the time and did not seems to be getting better much at all. I said screw it and started running and it slowly healed over the next year, running all the time Not suggesting you try this but that is what worked for me.
As you continue, consider that especially in our sport, pain is often referred from elsewhere in the body. You may very well have a slightly impinged nerve in your lumbar spine that’s causing your foot pain. Most of our aero positions aren’t the healthiest by chiropractic standards. Remember that all nerves begin in the spine. A foot nerve travels a long way before it gets to the foot. Any imbalance, impingement, rubbing, etc… anywhere along it’s route can cause pinpoint pain in a very specific area of your foot that has the identical symptoms as what you’ve self diagnosed. Orthotics, zero drop shoes, overuse, bike position adjustments, fatigue, etc… can all cause micro adjustments in the spine that refer pain elsewhere. Just something to consider.
That’s what knocked me out of the Boston Marathon this year. For me it came on completely out of the blue, in the middle of a 15k race. Over the course of one mile it went from me first noticing it, to having to stop. I then could not run at all for a month and not even 2 days in a row for 6 weeks. I just babied it coming back and by 2 months I was able to run regularly, 3-5 days in a row
The key for me was to stop running and let the inflammation go down and then go away and then stay away for a while. I swam a lot
Was anybody able to run through it or did you have to stop running altogether?
Stop running. NOW. And give it time. Lots and lots of heat. And everything else I mentioned before. I was hit with this last summer, took less than 3 weeks off leading up to a half marathon. Was able to run pain free during that race and every day after.
I’ve had a severe bout of this. Finally cured with a good physio and doing exercises to fix ‘duck foot’. I sleep with that leg flopped out to the side and had all sorts of hip/glute weakness and imbalance. Stretching, rolling, rest and then some rehab exercises fixed me. One exercise in particular that helped was to put a band around above the knee (other end attached to something solid), bend your knee so the foot is level with it, and then rotate that knee inward such that the foot rotates out and forward. Also try clamshells, and a lying side leg raise with a foot rotation at the top of the raised position, and ‘waiter bows’ for leg stability and lower leg activation. In Ottawa we have a great functional mobility coach in John Zahab at Continuum, his classes (when I behave myself and go) are really helpful to my lazy runner muscles.
Good luck!
Going through this, mine diagnosed with an MRI. No running for two months. Bike and swim all I wanted (low level swimmer, so about 5k a week). Finally healed to the point that I am introducing 2 milers before swim sessions on TM, to get back to running before I add intensity or mileage. Good news, swimming is getting better…
It will get exponentially worse, if you keep running on it. Search the forum, surgery is a real option, of you don’t let it heal.
Good luck 
Sami
Had a bad case last year.
Cure: Couple sessions of dry needling, and no running at all for prob 4 to six weeks for me.
What shoes are you running in? Are they Stability shoes?
Many times I see this problem with runners due to over support. Many running shoes have arch support or pronation control built in. If you add too much support on top of the built in support, you can over support your foot. This would explain why the Superfeet felt better, less arch than your custom orthotics.
Too much arch support will roll your foot out (underpronate or supinate) and force your peroneal muscles to work overtime to pull the foot back in. Depending on your current shoe, a simple shoe change can make a dramatic difference. With the use of custom orthotics, rarely is anything other than a neutral/cushioned shoe needed.
Hope that helps.
Chris
“With the use of custom orthotics, rarely is anything other than a neutral/cushioned shoe needed.”
man, i could not disagree more. assuming you pull out the sock liner, you have or should have a flat surface in the shoe that allows the custom orthotic to support the foot perfectly. if there is too much arch support that’s the fault of the person making the orthotic. but if you take a shoe like a brooks adrenaline or a hoka, that’s a nice flat surface for the orthotic. there’s no arch support in any shoe after you pull out the sock liner.
however, there is orthotic support in a shoe. or not. if you carve out the area in the arch, or if you have no way to support the medial side of the orthotic (e.g., a midsole cradling the upper) then the orthotic will retain its shape but it will cave in as the shoe caves in. it’s like those houses that fall, whole, into the sea when the cliffside erodes. i think you need to be careful when you just talk about a “neutral” shoe. if you call a hoka neutral because it has no special medial side gimmick, like dual density EVA or a plastic plug on the medial side, fine, that neutral shoe works great for orthotics, because it is an extremely stable shoe (lateral/medial) without gimmicky features on the medial side.
but if nike frees and saucony kinvaras are neutral shoes and in my opinion these are disastrous candidates for orthotics, because there’s no foundational support for the orthotic.
As you continue, consider that especially in our sport, pain is often referred from elsewhere in the body. You may very well have a slightly impinged nerve in your lumbar spine that’s causing your foot pain. Most of our aero positions aren’t the healthiest by chiropractic standards. Remember that all nerves begin in the spine. A foot nerve travels a long way before it gets to the foot. Any imbalance, impingement, rubbing, etc… anywhere along it’s route can cause pinpoint pain in a very specific area of your foot that has the identical symptoms as what you’ve self diagnosed. Orthotics, zero drop shoes, overuse, bike position adjustments, fatigue, etc… can all cause micro adjustments in the spine that refer pain elsewhere. Just something to consider.
I’ve been dealing with this on and off for about 8 months - misdiagnosed twice, first as achilles bursitis and then as achilles tendonitis.
Finally saw a chiropractor this week with the goal of getting A.R.T. (first time ever to see a chiro). Chiro immediately figured out that my right hip was so jacked up from my bike position that it was quite a bit shorter than my left leg before adjustment. He did normal chiro adjustments, graston, and A.R.T. on my calf. Feel 90% better already as adjusting my hip into the right place stopped pulling on the tendon, which was culminating in major ankle pain.
He had me adjust my bike fit some and get custom inserts for my cycling and running shoes, and get new cleats as he said worn cleats will allow you to roll to the side when you’re pedaling.
I’ve learned that when something hurts - unless it’s obviously due to trauma - it’s almost always due to an imbalance somewhere else. Fix the imbalance and the problem goes away.
ETA: I’ve been running in very stiff custom orthotics. He freaked when he saw them - said even though my high arches normally supinate, the inflexible orthotic is only making that worse as my foot has no option but to roll to the side with them, which is pulling on my peroneals.
Dan,
I do agree with you. I have been making orthotics for 13 years and what your saying has a lot of merit. The point I was trying to make is, if the orthotic is made correctly a neutral shoe should be sufficient. The practitioner making the orthotic should take the shoe choice into consideration. Unfortunately, many do not and bad advice (or lack there of) is responsible for bad choices, bad outcomes and bad perception of what orthotics can do.
As to your comment about there’s no arch support in any shoe after you pull out the sock liner.
This is true and false at the same time. Although the shoe is flat on the bottom, the last curves in at the medial arch side as you can see when you you look into the shoe. The sole and uppers are made to this shape and sewn in. This creates a “wall” that the arch support rests against and the orthotic can actually sit tilted to the outside. Again, the job of the practitioner dispensing the orthotics is to ensure this does not occur and adjust or grind the orthotic to fit the shoe properly. Most stability shoes cut in excessively in this area and cause the orthotic to tilt or have and unnaturally high arch that was not initially designed which can cause underpronation and peroneal tendinitis.
I also agree with you that Nike Free’s and Kinavera are technically not considered neutral shoes. I would consider them minimalist transition shoes or lightweight shoes.
As the post before mine states, some orthotics are made too hard and do not allow natural dynamics of the foot to occur. I almost always recommend firm EVA or cork for maximum control, cushion, comfort and function.
Thanks for the reply Dan, you brought up a few points I did not consider or explain as well I could have.
Best,
Chris
“Although the shoe is flat on the bottom, the last curves in at the medial arch side as you can see when you you look into the shoe.”
this is the issue. this is, to me, what should NOT happen or, to put it another way, it can look like a curve-lasted shoe when peering in from the top, but if it looks like a curve-lasted shoe when viewing the show from the bottom, that’s a problem. if you read this article, just the paragraph or 2 under the heading no arch cutaway, this is the point i’m making here.
in my opinion, orthotic makers as a group do not spend enough time doing what you’re talking about, which is looking at the actual shoe the orthotic is going to be placed into. kudos to you for doing this. i think there’s a revolution in shoe design right now, ongoing, and orthotic makers ought to keep up with the new shoes sold right now, so that they can take advantage of the design of some of these new shoes that allow a much more productive use of an orthotic.
Hi,
I just came back from the podiatrist and was diagnosed with “Peroneal Tendonitis.” I currently run in the Brooks Ghost 5, (SHOE CATEGORY: Neutral, PRONATION: None/Normal CONSTRUCTION TYPE: Strobel, ARCH: Medium, High, MIDSOLE DROP: 12 mm).
According to my podiatrist, I have high arches. When I walk, I land first on my 5th metatarsal head and then the pressure is spread across the top of the foot. The peroneal tendonitis is only evident in my left foot. Also, my left foot widens more when it lands on the ground.
As for cycling shoes I have the Shimano SH-TR31 with eSoles eFit Supportive with the red arch on the left and the orange arch on the right.
After a quick search online, I found that resting, icing, applying an anti-inflammatory cream along with stretching with a roller will help the alleviate the issue. However, I would like to know what kind of new running shoes I should look to purchase so that I can mitigate the peroneal tendonitis.
Thank you
Agreed…if its not improving stop running until you do not feel the dull ache. That is what I did and have not had the issue since.