Anyone ever have trouble with the peroneus longus tendon inflaming. I am not sure if my shoes are worn out or what is going on. It isn’t killing me but after a long run I can definitely feel it for a couple days (or at least that is what I think it is). I did a search on the net and pinpointed the spot and I believe that is what it is. I should have kept track better but I am guessing my shoes have b/w 350 and 400 miles on them. If you have had this problem what did you do to fix it?
I had trouble with the peroneus brevis in 2006. Went to an ortho and did a course of anti-inflammatories, a week on prednisone then a few weeks after that on a non-steroidal one, plus a topical creme that was prescribed. Also did PT once to twice a week when I could which made a big difference.
Right around that time I also switched from a stability shoe to a neutral cushioning one. Typical story - had used the same stability shoe for years, new model came out, suddenly developed tendonitis of the peroneus brevis. No problems since switching to the neutral shoe.
I had a longitudinal tear in my peroneus longus that caused chronic inflamation for years. I’d be fine, but I would hit my foot below the ankle on something at just the wrong angle, and it would have me on floor in pain. It also caused significant aching when I would try to run for durations longer than about 45 minutes, or if I ran too frequently.
I had it surgically repaired in 2002 and have had no issues since. One side effect is that apparently the surgery requires the ortho to move a small bundle of nerves. I guess they were slightly damaged, but the skin over that area of my ankle is now permanently numb.
I’d see your doc and possibly have an MRI to see if that’s what it is. Apparently, the first course of action is to rest it for several weeks to see if it heals itself. I opted for the surgery because I’d lived with it so long (through long periods of inactivity), and knew it wasn’t going to heal on its own.
Are you kidding, what havent I injured…
Last year shortly after my much to abrupt (to be fair) transition to newtons I dnf’d a half with what turned out to be P. longus inflammation. had been real touchy for months when running more than 30 min and sore on the bike but totally tolerable, that day abt mile 5 of the run leg I was afraid I tore something, couldnt even walk on the darn thing for a couple days. A round of antiinflamm. and a bunch of ice later I was OK. I ran a 1:34 at miami man three weeks later (with the newtons again)-and it flared up for a couple weeks but that was the end of my season and it didnt come back in '08. Rest/ice, avoid what hurts and get an mri if it doesnt get better on its own. My buddy john tore his from pushing it relentlessly when it hurt and couldnt run for 18 months after surgery so BE CAREFUL! Hope you feel better
I’ve torn both my brevis and longus (trail running). I’ve gotten occasional tendonitis since then…usually from overtraining. Right now they are mad at me for trail running in snow over Christmas break. They felt better after a few days, then I ran on them again and did some hard bike workouts. They are screaming at me now. I’ve got good strength, but ankle feels unstable. My MT is also an AT and told me to do band work/wobble board for strengthening. I’m also going to play around with my othotics. I’ve been running on more neutal shoes lately, which might be part of the problem. Back to the normal tendonitis grind, of ice, ibuprofen, and taking it easy(er). Good luck
VERY common running injury - also common if in worn out shoes. Typically resolves with rest, ice, po NSAIDs, orthotics if needed, etc. If not, seek a more definitive diagnosis (i.e. clinical exam, ultrasound, MRI) and go from there. I repair lots of these.
Thanks for the info re: the bundle of nerves. I injured PL while cycling and I would ice a lot but it was slow to heal. The skin in the area did go numb for a bit (though the pains continued), which was a bit freaky. It is back to normal now, hopefully it is not permanent for others.
PeeWee, and old saying by one of the infamous Picnic Boys: “you have to learn to hurt”.
The great gammy speaks, I guess I need to learn to hurt.
I made an appt. to see a doc for friday but I bet I get the same advice rroof has given. Thanks for the comments.
Dr rroof,
Is this Peroneus tendon injury normally only associated with pain at the ankle (outside of the ankle)? I seem to have stumped my local physicians for the last year, as they all think it is this that is causing my pain, but it is at the outside edge/underside of my foot where the tendon wraps underneath. MRI and X-RAY both proved unremarkable. Nothing seems to be noticable, except the aches and pain to me of course, even the odd sudden twinge whilst just sitting watching TV. Sorry to hijack the thread peewee.
atomic you aint hijacking that is what this forum is for. Your pain sounds just like mine. My wife is an OT and when I described the pain that is what she blurted out so I went on the net and what do you know I believe she is right. I just want to make sure I don’t screw something up royally, I was planning on starting an HIM training plan in Feb.
Dr rroof,
Is this Peroneus tendon injury normally only associated with pain at the ankle (outside of the ankle)? I seem to have stumped my local physicians for the last year, as they all think it is this that is causing my pain, but it is at the outside edge/underside of my foot where the tendon wraps underneath. MRI and X-RAY both proved unremarkable. Nothing seems to be noticable, except the aches and pain to me of course, even the odd sudden twinge whilst just sitting watching TV. Sorry to hijack the thread peewee.
As you seem to know, there are 2 peroneal tendons (well, a small percent of the population has a vestigal 3rd, the peroneus tertius), the peroneus brevis (the main evertor of the foot) and the peroneus longus that wraps under the cuboid, continuing on to the base of the 1st metatarsal to help stabilize the 1st ray on propulsion.
Most peroneal tendon issues do occur behind the outer ankle bone (lateral malleolus) where the tendons glide in a groove, then angle inferior.
You may be experiencing cuboid tunnel syndrome (you can google that) where the tendon gets bound down in the groove on the inferior surface of the cuboid (or even subluxing cuboid syndrome).
PeeWee, and old saying by one of the infamous Picnic Boys: “you have to learn to hurt”.
Gammy, I think I’ve heard that before somewhere…mighty wise.
Have your physio lookup Cuboid Subluxation.
Can’t pick it up through x-ray etc at the movement is very small but it can cause exactly the pain you describe. Not common in runners, but apparently is common in ballet dancers.
I think the combination of running and swimming for a triathlete may be a contributory factor. Plantar flexion in swimming (especially with fins) being similar to en pointe.
Sorry for the delay in responding, but thank you for your advice. Google searches indicate that may be it is the subluxing cuboid syndrome, so I will bring that up with my physician (an Ironman Triathlete). I had lowered my saddle at the beginning of the year and was wondering if this may have been the cause. However, after reading the google searches, maybe it was the dance classes my wife and I were attending!
Sorry for the delay in responding also, it seems that you may have hit the nail on the head, with regard to the indication and the cause of the injury. I’ll have to give the dance classes a miss for a while. Thank you for your advice.
No problem. Don’t be surprised if your physician doesn’t know much about it. Also, he/she probably won’t be able to offer much help either! One of my least favorite diagnosis since I’m really not able to help much. Low Dye strapping (google that) is usually helpful, as is the cuboid whip maneuver (that a good PT or chiro can usually do - not so much myself). Avoidance of the cause, support and time generally resolves it though. Occasionally I’ll make an orthotic with cuboid pad or even a corticosteroid injection if pain remains severe and interferes with activity.
Probably more from your dance class than cycling 
Good luck!
Thank you for your postings rroof. I just aggravated my p. longus about 8mi into a 10mi run over the weekend. I’ve been trying to stay off it and doing the normal ice routine.
I won’t be running until it feels better, but would you recommend staying away from the bike trainer too? I’m not sure if the p. longus will be further aggravated on the bike. Thanks again.
Thank you for your postings rroof. I just aggravated my p. longus about 8mi into a 10mi run over the weekend. I’ve been trying to stay off it and doing the normal ice routine.
I won’t be running until it feels better, but would you recommend staying away from the bike trainer too? I’m not sure if the p. longus will be further aggravated on the bike. Thanks again.
Biking is tough - easy spinning probably won’t hurt too much since your description doesn’t sound too traumatic, but there is certainly some firing of the lateral peroneals with pushing. If you feel anything when you try (which you surely will), shut it down.
Ok, so I stayed off of the foot for a week - no activity. It started to feel better so I did an easy 3mi. The run felt great, but the tendon was again inflamed the next day with a lot of acute pain in the tendon just below the ankle bone. So I took another week off and then did a light trainer workout - same result, felt fine during activity but painful after. Another week off and no difference - now I’m starting to go crazy from not training so I finally got in to see an orthopedic surgeon today, actually the PA not the Dr.
I wasn’t impressed from the start since he started immediately with blaming my shoes not being right for my foot. This was odd because I didn’t bring my running shoes and I’ve used the same Mizunos for over 4yrs with no issues. Things went from bad to worse as most of the knowledge he cited came from a presentation he saw once about running injuries and then said, “hey, did you know that people are all into running barefoot now?”…uuughh. He told me to run through the injury and take 800mg NSAIDS 3x day, also recommended using a single ice cube to ice the tendon by rubbing it locally after running. I thought this was crazy but then read some running forums today and saw many runners claiming similar treatments.
Will I risk any more damage by trying to run through this?