Peroneal Tendonitis and Tenosynovitis


Peroneal Tendon Anatomy

The two major tendons that run along the outside of your ankle are called the peroneal (or peroneus) tendons. They are known individually as the peroneus longus tendon and the peroneus brevis tendon. The superior peroneal retinaculum and inferior peroneal retinaculum ligaments run over top of the 2 peroneus tendons holding them close to the heel bone.

A common cause of peroneal tendonitis is the stretching of the tendons during an inversion sprain or rolling over on your ankle.

The peroneal tendons are important tendons because they prevent the foot from rolling and causing a lateral (inversion) ankle sprain. The peroneus longus tendon and the peroneus brevis tendon are slightly weaker than the muscles and tendons on the inside of the ankle and are more prone to injury.

Tearing or dislocation may occur in one or both of these tendons. This leads to pain, swelling, sensitivity and a sense of instability on the outside of the ankle. They can also pop out of the supporting ligaments that hold them in place (a dislocation). Once this occurs, continuous or recurrent dislocation and tearing is inevitable without immediate attention and repair. Stitching and at the worst, tendon replacement may be required for patients suffering from torn or dislocated peroneal tendon(s).


Peroneal Tendonitis and Tenosynovitis

Peroneal tendonitis (also spelled tendinitis) is the inflammation and irritation of one or both of the peroneal tendons. Like all forms of tendonitis, peroneal tendonitis is a condition that may flare up and subside over a period of time.

Peroneal tendonitis (tendinitis) is inflammation of the peroneal tendons located on the outside of the ankle.

Peroneal tendinitis is usually caused by repetitive use of the tendons, but can also be caused by trauma such as a rolled or sprained ankle. Little tears in the peroneus longus tendon and the peroneus brevis tendon irritate the tendon fibers resulting in pain and inflammation.

Peroneal tenosynovitis is swelling and inflammation of the peroneal tendons' sheaths (or coverings) which prevents the tendons from gliding smoothly within the shealths causing pain. It can be experienced at the same time of peronial tendonitis, and has similar symptoms. It often results in trouble moving the ankle and will feel sore to the touch. In rare cases, tenosynovitis can be caused by infection, so it is always recommended to check with your doctor to rule this out as a cause.


Symptoms of Peroneal Tendinitis/Tenosynovitis

  • Pain and/or swelling along the tendon and possibly up the leg along the fibularis longus muscle during or after activity.
  • A burning sensation along the tendon.
  • Pain either first thing in the morning or at night.
  • Stiffness in the foot and trouble stretching the area.

Who is at Risk?

People who play racquet sports are at risk of experiencing peroneal tendonitis
  • People who play sports or do activates that involve repetitive ankle movements.
  • People who participate in activities such as running on uneven surfaces, racket sports, basketball, hiking, or skiing.
  • People with high arches in their foot.
  • People in aging populations, because our tendons lose elasticity and become brittle.
 

Peroneal Tendonitis Conservative Treatment Options

Allowing your peroneus longus tendon and the peroneus brevis tendon to rest is always recommended following a tear or dislocation. Having said that, however, some careful movement is required to prevent the joint from freezing and losing range of motion. Avoid all activities that may have caused the injury or irritation and begin cold compression treatments as soon as possible. The peroneal tendons are difficult to rest completely as they are essential tendons for walking and daily activities. During your recovery, you will probably have to modify and/or eliminate any activities that cause pain or discomfort in your ankle until the pain and inflammation settle.

The trick with any tendon injury is getting your tendon back in the best possible condition you can. This means getting it to heal quick to minimize scar tissue growth, and this is what our T•Shellz Wraps® are designed for! Even with optimum healing, there is always less elasticity in a previously injured tendon. This will cause your peroneal tendon to hurt during regular movement and exercise. However, if you heal your injury efficiently and quickly, your chance of re-injury later on is much lower than average.

Although steroid injections may provide temporary relief from the pain of a tendon injury they should generally be undertaken with caution as they weaken the tendon and may lead to a complete rupture. If you do opt for an injection, doctors usually recommend that you do not participate in strenuous activities for several weeks to reduce the risk of a rupture.


If you have an achilles tendon injury, rest is recommended, however, some careful movement is required to prevent the joint from freezing and losing range of motion. See your doctor or physical therapist for stretches that will not cause further injury to your achilles. Avoid activities that cause pain or may have caused the injury and begin cold compression treatments as soon as possible.

The trick with any Achilles tendon injury is getting your achilles back in the best possible condition you can quickly. This means getting the tendon to heal quick to minimize scar tissue growth - something our T•Shellz Wraps® are intended for. Even with optimum healing, there is always less elasticity in a previously injured tendon. This will cause your Achilles tendon to hurt during regular movement and exercise. However, if you heal your injury efficiently and quickly, your chance of re-injury later on is much lower than average.

The Achilles tendon is a difficult tendon to rest completely as it is an essential tendon for walking and daily activities. Fortunately, there are tools that can help boost blood circulation to the Achilles region, strengthening the ability of the body to heal soft tissue. We feel this can help you get back to a life without pain and risk of further injury. The use of a T•Shellz Wrap® (Circulatory Boost) increases elasticity of soft tissue while promoting blood flow (vasodilation) at the treatment site.

Although steroid injections may provide temporary relief from the pain of an achilles injury they should generally be undertaken with caution as they weaken the tendon and may lead to a complete rupture. If you do opt for an injection, doctors usually recommend that you do not participate in strenuous activities for several weeks to reduce the risk of a rupture.

Conservative Treatment Step 1: Reduce The Initial Inflammation

Inflammation is the body's natural response to an immediate achilles injury and is a normal part of the healing process - helping to reduce tissue infection in the early stages of injury. Swelling, pain, heat sensation, redness, and loss of function are the main symptoms experienced.

The combination of rest, topical pain relief cream and minor amounts of cold is the gold standard in medicine for minimizing tissue damage and reducing inflammation after injury or activity. It serves as a critical bridge into the next phase of the healing process.

Scar tissue on Achilles tendon

Conservative Treatment Step 2: Enhance Blood Flow to the Injured Soft Tissue

Once the inflammation in your Achilles tendon has been reduced, nourishing and strengthening the tissue in the Achilles tendon and surrounding area is recommended.

When you have a tendon injury, there is not much blood flow in your injured tendon, especially if it is in the watershed zone, which it probably is. Inflammation and reduced movement (lack of activity or on-going immobility) reduces the flow of blood to an area that is already receiving very little blood flow. If you are moving your injured Achilles around you run a risk of increasing the severity of the injury. If there has been some healing, you could re-injure your tendon all over again.

MendMeShop Achilles TShellz Wrap for elasticity of Achilles tendon collagen fibres.
Achilles Tendinosis Running Injury

Even though the concept is simple, improving blood flow to injured tissues can be difficult. When the injury is ankle related, the challenges are even greater. Traditional methods require your muscle to move to promote blood flow (exercise), but that same motion that promotes blood flow can at times lead to making your pain and condition worse.

  • Have you reinjured your achilles by returning to work too quickly?
  • How many times in the past have you aggravated your lower leg just trying to perform basic tasks around the home?
  • Is your debilitated heel/achilles preventing you from work or activities you love to do?

Most people we deal with tell us these scenarios have happened to them many times in the past. Perhaps it has already happened to you.

Promoting blood flow within a muscle or soft tissue injury to help the body heal itself is a concept that has been utilized for centuries. This is where the focus has to be if you are seeking long-term improvement.

Oxygen and nutrients, carried within the blood, are critical for the body to heal itself. Without proper blood flow, recovering from an injury or condition will be delayed...sometimes for a very long period of time.

The real challenge is how do you promote blood flow to the tendon without causing further injury? This goal is further complicated by the fact the achilles (and muscles controlling the ankle joint) are involved in the majority of the physical movements we perform each day.

 tshellz bloodflow stimulation

It is through the blood the body carries the nutrients and oxygen that injured tissues rely on for recovery.. It is well known that increased blood flow helps your body accelerate the healing process.

This is why the T•Shellz Wrap®is such an important tool. The whole purpose of the wrap is to provide localized heat while also significantly increasing blood flow to tissue in the treatment area. The result of this is as follows:

  • Blood vessels within the treatment area relax and naturally expand (this is termed "vasodilation") permitting more blood flow to reach the very tissues you are trying to heal.
  • When tissue temperature increases, the tissues increase both in length and flexiblity. Elongated and flexible tissue is less likely to strain and tear, so your risk of further injury and/or reinjury is reduced when this occurs. Less injury during recovery means 1) your recovery will be streamlined and not sidelined due to recurring injury, and 2) less re-injury will mean less scar tissue should grow in the area.
  • Enhanced blood flow benefits tissue in a number of ways: 1) It is likely to clear the area of toxins and excess fluid build up more quickly, thereby reducing inflammation and 2) Scar tissue can form in areas that are starved for blood flow - an enhanced blood flow is more likely to reduce such occurrences.

Increased Blood Circulation = Increased Healing Capability


T•Shellz Wraps® contain a unique Carbon Fiber Energy Pad which is flexible and will shape to conform to your body. This Energy Pad emits a uniform wave of perfectly safe energy over its entire surface. This energy is absorbed by soft tissue in the treatment area, opening blood vessels, resulting in an increase in blood flow. Increased blood circulation is what your body needs to accelerate the healing of soft tissue and this is why we recommend the T•Shellz Wrap®.

The Achilles T•Shellz Wrap® is an FDA Registered Medical Device and is suitable for use in therapeutic clinics and FROM HOME. It is completely safe for people and patients to use for themselves.

The technology found in a T•Shellz Wrap® has been used for decades in the worlds of professional and amateur sports - a contributing factor as to why athletes seem to recover from injuries so quickly.

Have you ever wondered by an athlete can return to activity after 3 to 6 weeks following a foot injury - while your average person takes much longer to return back to normal? The secret isn't really that much of a secret - it involves consistent treatments (meaning multiple times a day) using a treatment like the T•Shellz Wrap® to stimulate blood flow to the injured tissues. Most athletes have the luxury of using in-house facilities many times per day.

How many us can afford the time and money to visit a clinic multiple times a day? Very few indeed. This is how you can gain some of the advantages that athletes enjoy in their injury recovery - by using a device like the T•Shellz Wrap® two or three times a day on a consistent basis.


Consistent Treatments = Consistent And Long Term Improvement



What Else Makes the Achilles T•Shellz Wrap® So Special?

We believe the T•Shellz Wrap® to be one of the most effective home treatments to increase localized blood flow to soft tissue in and around the treatment area.

We can promise that you will receive a product that is designed to be safe and does what it is supposed to do... reduce pain (as stated in "Therapeutic Heat and Cold", 4th edition. - Ed. Justus F. Lehmann, M.D., Williams, and Wilkin) temporarily increase length & flexibility of soft tissue (as stated in "Therapeutic Heat and Cold", 4th edition. - Ed. Justus F. Lehmann, M.D., Williams, and Wilkin) and aid your body in recovering from tendon, muscle and other soft tissue injuries via enhanced blood flow.

The unit plugs into a standard wall outlet to get its power. The nice thing about the power supply is that the same unit can be used in North America and overseas as well. It has the capability to operate between 110v and 230v.

The T•Shellz Wrap® has a special signal controller that can be set for 3 different power levels of application (3=High, 2=Medium, 1=Low). The cord is long enough that you can sit or lie comfortably and watch TV, read or surf the net while you're using it.

Treatments are max 30 minutes in duration and the device can be worn over clothing. This allows you to use the device at work, at home, or really anywhere you have access to an electrical outlet.

achilles T•Shellz Wrap

Conservative Treatment Step 3: Recognize That Healing is a Process

With dedication, the right tools, and the right information - you will achieve your goal of a sustainable recovery. A combination approach of cold compression, heat treatments, and functional movements will make it happen much more quickly.

In our experience, soft tissue repair rates via conservative home treatment methods using a dedicated, comprehensive approach have surprised many of our clients, but will differ from person to person. In nearly all cases, however, it is very important to stop whatever you were doing that created the injury in the first place (ie. running, jumping, climbing stairs).


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The Achilles T•Shellz Wrap® - A Healthy Achilles For The Long Term

The best option we came across in our research to accomplish effective blood flow to soft tissue in the achilles area at home is the Achilles T•Shellz Wrap®. Use of this device results in an increase of blood flow within the treatment area - all in a non-invasive manner.

Have you seen what happens when you add water to a flower wilted from drought? In essence, your injured achilles is much like a "wilted" flower; your body wants to heal its injury, but needs lots of nutrients to do it. Blood brings life to your tissue by delivering healing nutrients and oxygen that are vital for their growth and survival. In addition, the blood carries away toxins and waste cleaning the area and healing it faster. Without a good supply of blood, your achilles simply won't heal properly.

Using a T•Shellz Wrap® will not expose you to the risk of causing further harm to soft tissue like you can when using rigorous exercise. The Achilles T•Shellz Wrap® accomplishes the goal of enhanced blood flow without the need for intensive exercise and as such reduces your risk of re-injury.

achilles T•Shellz Wrap

Conservative Treatment Tools Our Clients Have Used to Help
Limit Achilles Damage & Boost The Body's Soft Tissue Repair Process at Home:

  • A Cold Compress or Ice Pack to reduce inflammation wherever there is pain and/or swelling (as soon as possible).
  • An Achilles TShellz Wrap to increase blood-flow to the treatment area (Circulatory Boost).
  • MendMeShop Arnica Pain Cream for temporary relief of pain due to sore muscles and joints.
  • An Exercise & Stretching Plan to prevent muscle atrophy and shortened tendons in the leg. A proper plan will increase elasticity and strengthen the muscles and tendons in the ankle, calf, knee, and upper leg.

Conservative treatment tools just like these have been used successfully by thousands of soft tissue injury sufferers - just like you.




T•Shellz Wrap® = Enhanced Blood Flow in the Treatment Area

We believe the use of T•Shellz Wraps® for boosting blood flow to soft tissue in the area of application is one of the most under-utilized home treatment options available on the market today. We have client after client that have tried many options out there and have been amazed at how effective and fast the TShellz Wrap treatment can relieve pain and increase blood flow in the treatment area.

*With regular use of the Achilles TShellz Wrap:

  • Your pain will be reduced*.
  • Due to increased blood flow, soft tissue in the treatment area will be expected to recover at an accelerated rate with reduced potential for re-injury.
  • Tissue in the treated area should experience a larger range of motion and increased extensibility of collagen tissue* due to the heat effect on soft tissue. This should translate into a reduced rate of re-injury occurrence as soft tissue is known to lengthen and become more flexible when exposed to warm temperature. (*Chapter 9 of "Therapeutic Heat and Cold", 4th edition. (amazon.com link - Ed. Justus F. Lehmann, M.D., Williams, and Wilkin)

*Know that every personal soft tissue injury is unique and the TShellz Wrap may not work for everyone. This is why we offer a 60-day money back return on all our TShellz Wrap devices.


Learn More About Achilles Injuries & Treatments

I want to learn more about Achilles Surgery & Post-Surgery Recovery

I want to learn more about Circulation Boost

I want to learn more about Ice & Heat: Which Is Better For The Achilles?

I want to learn more about Stretching for the Achilles

I want to learn more about Achilles Injury Treatments


During your recovery, you will probably have to modify and/or eliminate any activities that cause pain or discomfort at the location of your soft tissue injury until the pain and inflammation settle. Always consult your doctor and/or Physical Therapist before using any of our outstanding products, to make sure they are right for you and your condition.


 
 

Please be aware that this information is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider before using any of our outstanding products to make sure they're right for you and your condition or if you have any questions regarding a medical condition. Always see your doctor for a proper diagnosis as there are often many injuries and conditions (some very serious) that could be the cause of your pain.


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