From the Research
Peroneal tendinopathy is primarily caused by overuse and repetitive stress on the peroneal tendons, which run along the outside of the ankle, as supported by the most recent and highest quality study available 1. This condition commonly affects athletes, particularly runners, and individuals who participate in activities requiring repetitive ankle movements. Some key factors that contribute to the development of peroneal tendinopathy include:
- Sudden increases in training intensity or volume
- Improper footwear
- Running on uneven surfaces
- Poor biomechanics such as excessive foot pronation Anatomical factors like high arches (cavus foot) or ankle instability from previous sprains can also predispose individuals to this condition. Direct trauma to the lateral ankle can trigger tendinopathy, and the underlying pathophysiology involves microtrauma to the tendon fibers that, when accumulated faster than the body can repair, leads to inflammation and degeneration of the tendon tissue, as discussed in 2 and 3. This results in pain, swelling, and sometimes audible clicking along the outside of the ankle, particularly during activities that involve ankle movement. Early recognition and addressing the causative factors are essential for effective management and prevention of chronic tendon damage, with treatment options including nonsteroidal anti-inflammatory drugs, physical therapy, and immobilization, as outlined in 4 and 5.
The most recent study 1 provides the best evidence for the causes of peroneal tendinopathy, and its findings should be prioritized in clinical practice. While other studies, such as 2, 3, and 5, provide additional information on the treatment and management of tendinopathy, they do not directly address the causes of peroneal tendinopathy. Therefore, the most accurate and up-to-date information on the causes of peroneal tendinopathy is provided by the study published in 2020 1.