Ask a PT
156 Posts Posted - 03/03/2008 : 17:28:29 Show Profile Reply with Quote Our user asked: "tennis player...right leg, outside just below the fibula, very tender can not associate the pain to any specific event...I have been icing it wth some relief...not sure what stretches or strengthening exercises to do...what is the best treatment? is there a type of support I can use on the leg?"
Ask a PT Response: "You are correct in that the peroneal tendons (longus & brevis) wrap around the outside of the ankle (lateral malleolus/fibula). Tenderness at this region of the lateral mallelous could be attributed to inflammation of these tendons. The peroneal muscles function to evert (bring foot out) and plantarflex (bring foot down) at the ankle. Pain is usually experienced when an individual performs these movements if the peroneals are involved. Performing movement in the opposite directions usually doesn't elicit pain. However, passive range of motion and a stretch into the opposite directions could elicit some pain. Strength testing of the peroneal muscles could also elicit pain and display weakness of the peroneal muscles. The article on CyberPT talks more about injury to the peroneals and has some video examples of some of the exercises a PT could prescribe for such an injury: http://www.cyberpt.com/cptcondtrt9perlngAnk.asp - http://www.cyberpt.com/cptcondtrt9perlngAnk.asp . A PT will usually progress to theraband exercises for strengthening after isometric strengthening. Single leg exercises on surfaces such as foam rollers, airrex pads or BAPS boards could be utilized later in the treatment plan as well. An Ankle Support Orthoses (ASO) may be recommended as well for a patient who has to be on his/her feet for an extended period of time or has to perform higher level activity. A PT will also examine the feet, footwear and mechanics to determine if orthotics may be required as well. If you are able to, it may be beneficial for you to consult with a PT to determine if you really do have a problem at your peroneals or if something else may be going on. Good luck and thanks for using CyberPT."
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