Peroneal tendon

Advice please

1 to 20 of 29 messages
22/06/2006 at 14:06
Fo the second time in six weeks my ankle got sore and puffy, so I wentfor some advice.

The physio says I have damage to the peroneal tendon(s), and has zapped my right ankle with magnetic and sound waves.

The plan for the next two weeks to repair the damage does not include running, but does include ice, stretching, and cycling/swimming.

Next batch of training to start on softer flat ground than the local streets.

My ultimate goal is to lose weight, and to complete 26.2 miles next April, starting and finishing uninjured.

Advice please - how do I train for a long road race without repeating the damage to date?
22/06/2006 at 14:47
Hello helegant,

I would suggest that thorough identification of underlying cause. Acute injury is possible, with overtraining likely.

Any issues of poor form and technique should be sorted out.

Cross training and the old saying 'do not run before you walk' is usefull. You have already suggested altering training surface etc.

Supportive trainers of the correct variety are also essential.

kind regards steve d

P.S i guess others will be along with advice on training regime etc to help you along.
22/06/2006 at 16:44
Thank you Steve. I'd agree with overtraining as a 'most likely' cause; there was no noticeable 'event' to cause the problem and the pain developed gradually over the last twenty minutes of (mainly) walking. I didn't really notice the damage until I cooled down - mea culpa - but it was a nice day...

One additional (ignoramus) question. I know bones and muscles get stronger through training. Does the same apply to tendons?

22/06/2006 at 22:27
No, tendons don't get stonger through training. IMHO.
I strapped my peroneal tendonitis into place and continued running.
Probably a bit controversial, but that's what I did and I survived.
22/06/2006 at 23:58
Limper - how did you work out how to do that?
23/06/2006 at 07:41
Helegant,
I strained the Peroneus brevus longus tendons after my first half marathon a few years ago.
The only way I can describe the pain was feeling like I had shards of glass embedded in my feet...
Saw a physio, who recommended accupuncture and stretching exercises, within hours of the accupuncture I could walk normally on my foot, within 10 days back to short runs of 1-2 miles. I did the exercises religously and all has been well since.
If you want to email me I will scan a copy of the exercies that I was given and send them back to you.
Best of luck!

T
23/06/2006 at 16:08
Tb that's very generous of you - would you enable your email please so I can contact you?

Thank you, H.
23/06/2006 at 16:11
P.S Have put three pairs of old running shoes in the dustbin today - lest I should ever be tempted to wear them 'one last time'
23/06/2006 at 16:30
Limper

yes sure you can strap the peroneal tendons along the distal 1/3 aspect as the run superior to the ankle. If the problem is peroneal snapping disorder of partial peroneal subluxation. But that requires a firm diagnosis and only counts for lower grades of this injury. An orthopaedic referal is typical for mri and intervention.

As for tendon strength. Tendon and muscle conditioning are possible as part of general physiological adaptation to increased stress, as with most tissue. Connective tissue excepted to a certain degree.

Helegant

you need a firm diagnosis from a qualified professional, prior to any form of exercise rehab.

kind regards

steven d
podiatrist
23/06/2006 at 16:55
Doesn't the physio count as a qualified professional?
23/06/2006 at 17:37
OK, I've re-read my first post and I think it may be open to misunderstanding.

I visited a sports phtsiotherapist. The "firm diagnosis" (as I understood it) was "strained peroneal tendons" with several contributing causes:

1)tight muscles (hence the stretching exercises) which reduced the ability to absorb impact,
2) running on cambered and uneven pavements,
3)being overweight - more force going through ankle
4)trying to do too much too soon
5) POSSIBLY wearing old shoes (it's faintly possible that I picked up an old pair by mistake as I put retired pairs through the washing machine then keep them for gardening).

The ultrasound and magnetic pulse was supposed to help healing inside teh ankle, and the advice to ice and stretch, and rest for 2 weeks seems reasonable, as does the suggestion to find soft ground when I restart.

However, I'm frustrated that it has taken so much effort to achieve so little that I feel like a fraud, and even that has been too much.

And I'm scared that the same thing will happen again as soon as I restart. I don't know that I trust myself to be able to tell when I'm doing too much, as overuse injuries were a consistent feature of my 2003 FLM preparation. It cost me a fortune in treatment, a lot of lost training time, and left me feeling as my life was one long whinge.

Is there a better way?
23/06/2006 at 17:52
Helegant,
Should be email enabled now, thought it was!!
26/06/2006 at 09:16
ha ha

apologies

mixed a thread up and lost track!

I would stick to a treatment regime provided for you as an individual, that was the main 'jist' of it;-)
26/06/2006 at 11:34
As for a better way

My take on it is to build up very slowly to a firm base and mainatin that base. This is what i have to do, or suffer the consequence.

But this is not what people typically want to hear, we live in a society that wants everything now with little disruption along the way.

This is a general observation that applies to most of us at times.

I continually get people come in and ask for orthotics to cure an injury, literally just like that.

Taking a history it seems that the person has undertaken little specific walking or general ambulation for 9 months, yet they are surprised at ''shin splints'' when running 20 - 30 miles P/Week within a month.

As i have said before take it easy and start at the bottom and work up, the results in the end will be worth it and recovery, when you do get injured, won't be such a problem in terms of reducing fitness to pre injury level etc. Start by walking as part of the recovery. And be aware that peroneal injury can increase the chances of lateral ankle inversion injury.

stevend
26/06/2006 at 19:17
Thank you SD, your advice has the ring of sense about it, and it's probably what I would say to anyone else in the same situation ;-)
18/07/2006 at 19:30
More questions I'm afraid...

Four and a half weeks after the event, the swelling has reduced slightly, and the pain is much reduced / almost absent. However, I had expected to be completely recovered and training again by now.

Does anyone have any idea how long I can expect recovery to take? Someone really worried me today by telling me that tendon damage can take up to a year to heal. Please tell me that's nonsense!
18/07/2006 at 20:01
Steven

we trained together
see if you can work out who i am

:-)

have you been posting on here long?

20/07/2006 at 15:07
Dear Lurker

If i play along, does it mean i have to purchase a pair of expensive orthotics from you?

Steven
20/07/2006 at 23:03
Helegant

You need to address the underlying cause. When you do then you will be able to return to training sooner than you think.

Peroneal tendinitis is caused by repetitive eccentric force on the peroneal tendons, this means the tendons are being forcibly lengthened with each stride. and this usually happens when your natural pronation is being resisted by a strong counter force. Shoes are the most common culprit and peroneal tendonitis is the most common resu;t of someone wearing too stable a shoe for their gait. The second most common cause is fell running or reeptitive sprains on the ankle.

Gait analysis and correct shoes should be in your near future and then reduce speed and mileage dramatically along with ice and stretch, get back onto tarmac or even smooth gras running, then you will get back into it ... good luck
21/07/2006 at 21:13
Helegant
Tendons are what is known as "fibrous tissue," they do not have a blood supply of their own thus the necessary material needed to effect repair are not directly supplied to them at all.

They are able to pinch from surrounding soft tissue as blood passes by, therefore it is important to warm the area and mobilise regularly thus, attracting more blood to the area. (n.b. avoid warming the area if there is any sharp pain present, no problem if the discomfort is of the stiff, achy type).

Tendons can take well over a year to completely heal but can, with care, be "match-fit" within a couple of months.

Persevere with your rehabilitation, patience now will significantly improve the likelihood that you will line up, fighting fit next April.

Impatience may well ruin your plans

Good luck

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