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Saturday, January 10, 2015

Peroneal Tendinitis: General Mechanical Treatment Thoughts

Hi, Dr. Blake--
I saw you in October 2014 for peroneal tendonitis incurred during tennis play.  You recommended bracing (I bought the ASO ankle brace; like you said, very good brace), activity modification (I'm back on the tennis court, but conservative with my movement), ice (I ice after tennis/cycling), thera band exercises (I'm doing) and stretching (I'm doing with a PT).  I am clearly doing better than when I saw you.  However, today is 3 months post-injury, and I am not yet 100% (am I expecting too much for a 66-year old guy?) and I feel some occasional soreness in my ankle. 
First question:  Do you feel my progress is reasonable?
Second question:  You watched me walk, and you said I walked on the outsides of my feet, perhaps contributing to my risk for this injury.  I wear an over-the-counter Birkenstock orthotic.  Do you feel that an orthotic that addressed my walking on the outsides of my feet would help me?
Thanks for your feedback!

Dr Blake's response:

     Thanks for the followup. Yes, everything sounds reasonable, even if you were 33!! The goal is to gradually increase your activity while keeping the pain level between 0-2, with an occasional twinge. The real good mechanical things you can do are:
1. gradually get stronger and stronger with the peroneal tendons
2. every evening do your balancing exercises (first goal 2 minutes with eyes closed)
3. continue wearing the protective brace for 2 months longer than you think you need to.
4. Make sure that your shoes are not broken down to the outside (due a monthly check by standing them on a flat surface and looking at the back of the heel).
5. Get orthotics adjusted/made to center you. I would be happy to revisit that area. 

Hope this helps. Rich

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.