Table of Contents
- Introduction
- Signs and Symptoms
- Causes
- Treatment
- Preventive Measures
- Prolotherapy
- Case Studies
- Conclusion
- Frequently Asked Questions
- References
Introduction
In this article, you will find out everything you need to know about peroneus brevis tendon injury and the most effective ways to treat it, including an advanced treatment called Prolotherapy.
Peroneus brevis tendon injury is a condition in which you develop longitudinal splits or tears in your peroneus brevis tendon. It is typically a chronic condition that develops over time due to repetitive damage to your tendon. This condition usually results from overuse of muscle that results in a tear of the tendon. Ankle sprains and repetitive subluxation cause the tendon to slip out of its normal groove and contribute to peroneal tendon injuries.
Peroneus brevis muscle arises from the outer surface of the fibula (outer bone of the lower leg), below the peroneus longus tendon. The muscle ends in a tendon that is inserted in your hindfoot below the lateral malleolus. Function of this muscle is to evert the foot and move it away from your leg. Peroneus brevis tendon is present directly beyond the fibula and is more prone to injury.
The peroneus brevis tendon injury is common in people over 40 years of age. It is more common in athletes who play sports that involve a lot of ankle movements. People who have tight tendons and high arches in their feet are also prone to develop this condition.
In this article, you will find appropriate information about the causes and symptoms of peroneal tendon injuries and the measures that you can take to prevent this condition.
Signs and Symptoms
You will feel pain and swelling on the outside of the ankle whether your condition is acute or chronic. Acute injuries cause redness and weakness of movements and chronic injuries lead to lateral ankle instability. Some other symptoms of this condition include:
- Pain: You will experience foot pain or lower leg pain if you have peroneal tendon subluxation or tendon rupture. The peroneus muscle is supplied by the peroneal nerve. This nerve also supplies the skin on the lower lateral side of the leg all the way to the lateral side of the foot. When the tendon is damaged, it irritates the nerve and causes pain along the distribution of the nerve.
- Swelling: Swelling is another sign that you will see if you have tendon injury(1). Tearing of fibers in the tendon also leads to rupture of blood vessels. This causes the blood to move from blood vessels out into the surrounding tissues. Swelling usually occurs at the ankle on the lateral side of your lower leg.
- Instability: You will feel instability when you stand on your foot with peroneus brevis tendon tears. The peroneus brevis is one of the main peroneal muscles involved in the inversion and eversion of the foot. It is also involved in maintaining the stability of your ankle. When this tendon is damaged, these movements will not take place properly and the joint will become unstable.
- Popping sound: If you hear a sudden popping(2) sound during an ankle sprain, and afterward, you are unable to perform normal movements at the ankle joint, there is a chance that your peroneus brevis tendon is damaged.
Causes of Tendon Injuries
Peroneal tendon inflammation (tendinitis) can develop with repetitive overuse of the tendons or it may happen suddenly due to an ankle injury. The tendons or the lubricated tendon sheaths around them can swell, making it hard for them to move smoothly. Some other causes include:
Overuse is the most common cause of peroneus brevis tendon injury(3). A sudden increase in training levels or poor training techniques put an additional strain on your peroneus brevis tendon. Sudden repetitive movements at the ankle cause the tendon to rub against the bone and the friction thus produced can lead to tearing of fibers or dislocation of your tendon.
You are more likely to develop this condition if you have damaged your ankle or suffered from an ankle sprain. The peroneus brevis along with the peroneus longus is commonly injured during a lateral ankle sprain and the tendon of the peroneus brevis muscle is the most commonly dislocated tendon.
Running on uneven surfaces also increases your risk of developing this condition. The peroneal muscles normally adjust foot position when you stand on an uneven surface. Running on such a surface puts additional stress on your tendon resulting in damage to the tendon.
Damage to ligaments supporting the ankle joint also increases the chance of peroneus brevis tendon damage. The lateral ankle ligaments include the anterior tibio-fibular ligament (ATFL) and the calcaneofibular ligament (CFL). These ligaments are damaged during an ankle sprain. This puts an additional strain on the peroneus brevis tendon to maintain joint stability and therefore leads to tendon damage.
If your injury has occurred suddenly, then you may either have a simple tendon tear or you may have an avulsion strain (fracture). An avulsion strain occurs when the tendon tears and also pulls a small piece of the bone with it. It most commonly occurs along the fifth metatarsal bone.
Treatment of Peroneus Brevis Tendon Injury
The immediate treatment of the tendon injury (tendinopathy) includes proper first aid to avoid further damage and speed up the healing process. Further treatment options include:
R.I.C.E Method
Stop doing any kind of movement for at least 2 days after injury because it can make the damage worse and delay your recovery. Apply the ice pack for about 15 to 20 minutes every 2 to 3 hours for 2 days(4). Compression of the affected area is also effective in reducing swelling. You can also use elastic bandages, casts, and splints to support your ankle. Elevating your foot above the heart improves blood flow and provides pain relief.
Physical Therapy
The first step in recovery is to modify the position and limit activities to reduce pressure on the tendon and reduce pain. Your physiotherapist will play an important role and provide specific recommendations. Massage by a physiotherapist promotes muscle relaxation and improves blood supply.
Immobilization
For severe tendon damage or an avulsion strain, a plaster cast may be used to immobilize the ankle while it heals. This reduces the range of motion and allows natural healing. Mild injuries may only require an ankle brace for protection.
Orthotics
Congenital abnormalities in the foot shape can cause tendonitis. Wearing inserts in your shoes often helps correct the condition. Consult a podiatrist for proper management. Using incorrect insoles may worsen the condition.
Medical Treatment
This involves the use of painkillers to relieve pain, including NSAIDs such as ibuprofen and naproxen(5). Cortisone or other steroid injections are also effective in reducing pain and swelling.
Surgical Treatment
If the condition is not improving with conservative treatment, surgical intervention is required. X-rays and MRI are done to locate and assess tendon damage. The orthopaedic surgeon repairs the tendon by sewing the torn parts. Recovery typically takes 4 months.
Preventive Measures
- Exercise regularly to maintain flexibility and promote tendon strength(6).
- Report ankle pain promptly to prevent worsening tendon damage.
- Maintain a healthy body weight to reduce strain on the peroneal tendons.
- Wear appropriate footwear and use braces if needed for repetitive ankle movements.
Prolotherapy
In recent years, Prolotherapy has built its reputation for clinically proven ability to treat Peroneus Brevis Tendon Injury. It provides pain relief, reduces inflammation, and promotes tendon regeneration.
Prolotherapy involves injecting a natural regenerative solution with tiny needles, stimulating collagen production to repair tendon damage. By treating the root cause of Peroneus Brevis Tendon Injury, prolotherapy can offer a permanent fix and prevent symptoms from returning.
Case Studies
Case Study 1: A 45-year-old runner with lateral ankle pain due to a peroneus brevis tendon tear underwent Prolotherapy. After 3 months, the patient reported full recovery and return to running.
Case Study 2: A 38-year-old recreational football player with chronic ankle instability and peroneus brevis tendinopathy showed marked improvement in pain and function after a series of Prolotherapy sessions over 12 weeks.
Conclusion
Peroneal tendon disorder affects daily activities and gait. Recovery takes time, and following medical advice is critical. Untreated injuries may lead to tendon tears and associated nerve damage, requiring surgery. Prompt recognition of symptoms and proactive management are essential for recovery.
Frequently Asked Questions
What does peroneus brevis tendon pain feel like?
Discomfort is felt on the lateral side of the ankle, often with swelling. Pain usually worsens with activity and improves with rest.
How long does it take to heal?
Healing depends on injury severity. Mild injuries may heal in 8–12 weeks, while full recovery can take up to a year.
Can walking worsen the injury?
Yes, rest is essential. Avoid activities that exacerbate the tendonitis until symptoms subside.
How do I know if my tendon is torn?
Sudden pain with a popping sound, tenderness, and inability to walk may indicate a tear.
What happens if a torn tendon is untreated?
Minor tears can worsen, leading to ruptures and impaired mobility, often requiring surgery.
Can shoes cause peroneus brevis tendonitis?
Improper footwear, especially with high arches, can strain the tendon and worsen tendonitis.
Contact ProHealth Clinic
Don’t let Peroneus Brevis Tendon Injury control your life any longer. Join the thousands of patients who have found lasting relief through prolotherapy at ProHealth Clinic.
Phone: +441234380345
Email: info@prohealthclinic.co.uk
Our Clinic Locations:
London: 104 Harley Street, Marylebone, W1G 7JD
Manchester: The Hadley Clinic, 64 Bridge Street, M3 3BN
Bedford: The Village Medical Centre, Kingswood Way, MK40 4GH
All clinics offer the same award-winning prolotherapy treatment with convenient appointment times, including evenings and weekends.
Author Bio
Having performed over 10,000 procedures, Mr Eaton is one of the UK’s leading practitioners in the field of treating Peroneus Brevis Tendon Injury, with patients travelling to see him from across the UK, Europe, and the Middle East.
With over 12 years of clinical experience, Oliver is dedicated to helping patients understand their symptoms associated with Peroneus Brevis Tendon Injury and providing effective treatment options to alleviate them.
He qualified in Prolozone Therapy and Prolotherapy in America with the American Academy of Ozonotherapy. He continued on to complete further qualifications at the Royal Society of Medicine, Charing Cross Hospital in London, Keele University’s Anatomy & Surgical Training Centre, and the medical department of Heidelberg University in Germany.
Over the years he has had the privilege of treating many elite-level athletes, including both Olympic and Commonwealth medallists.
Linkedin profile: https://www.linkedin.com/in/oliver-eaton-4338225b/
References
- Selvanetti, A., Cipolla, M., & Puddu, G. (1997). Overuse tendon injuries: Basic science and classification. Operative Techniques in Sports Medicine, 5(3), 110–117. https://doi.org/10.1016/s1060-1872(97)80031-7
- Spindler, K. P., & Wright, R. W. (2008). Anterior Cruciate Ligament Tear. New England Journal of Medicine, 359(20), 2135–2142. https://doi.org/10.1056/nejmcp0804745
- Niek van Dijk, C., Scholten, P. E., & Kort, N. P. (1997). Tendoscopy (tendon sheath endoscopy) for overuse tendon injuries. Operative Techniques in Sports Medicine, 5(3), 170–178. https://doi.org/10.1016/s1060-1872(97)80039-1
- van den Bekerom, M. P. J., Struijs, P. A. A., Blankevoort, L., Welling, L., van Dijk, C. N., & Kerkhoffs, G. M. M. J. (2012b). What Is the Evidence for Rest, Ice, Compression, and Elevation Therapy in the Treatment of Ankle Sprains in Adults? Journal of Athletic Training, 47(4), 435–443. https://doi.org/10.4085/1062-6050-47.4.14
- Hertel, J. (1997). The role of nonsteroidal anti-inflammatory drugs in the treatment of acute soft tissue injuries. Journal of Athletic Training, 32(4), 350–358. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1320354/
- Buchanan, C. I., & Marsh, R. L. (2002). Effects of exercise on the biomechanical, biochemical and structural properties of tendons. Comparative Biochemistry and Physiology Part A: Molecular & Integrative Physiology, 133(4), 1101–1107. https://doi.org/10.1016/s1095-6433(02)00139-3