From the Guidelines
For peroneal tendonitis, the most effective stretching regimen involves holding a static stretch for 10–30 seconds, with a frequency of 2–3 times a week, and a total stretching time of 60 seconds per exercise, as recommended by the 2018 EULAR guidelines 1. To alleviate pain and promote healing, several stretches can be beneficial.
- Calf stretches can be performed by standing facing a wall, placing the affected foot behind with the heel down, and leaning forward until a stretch is felt in the calf; hold for 30 seconds and repeat 3 times.
- Ankle circles can be done by sitting with the leg extended and rotating the foot clockwise and counterclockwise 10 times each direction.
- The towel stretch is also beneficial - sit with legs extended, loop a towel around the forefoot, and gently pull toward you for 30 seconds, repeating 3 times.
- Ankle eversion exercises can be performed by sitting with the foot flat and moving the outside edge of the foot outward against resistance.
- Toe curls can be done by placing a towel on the floor and using the toes to scrunch it toward you. It is essential to perform these stretches 2-3 times daily, but to stop if increased pain is experienced. These exercises work by improving flexibility in the peroneal tendons and surrounding muscles, increasing blood flow to promote healing, and strengthening the supporting structures to prevent recurrence. Combining these stretches with rest, ice, and proper footwear can significantly improve recovery from peroneal tendonitis, as supported by the American Heart Association's 2007 update on resistance exercise 2. However, the 2018 EULAR guidelines provide more specific and detailed recommendations for stretching exercises, making them the preferred reference for guiding treatment 1.
From the Research
Stretches for Peroneal Tendonitis
There are no specific stretches mentioned in the provided studies for peroneal tendonitis. However, the studies discuss the importance of accurate diagnosis and treatment of peroneal tendon injuries and tears.
Causes and Symptoms
- Peroneal tendon injuries are often underdiagnosed and can cause chronic lateral ankle pain 3
- Ankle sprains are common and can lead to chronic ankle pain, with up to 40% of affected individuals experiencing subsequent chronic ankle pain 3
- The development of tendinitis and tendinopathy is often multifactorial and can be caused by intrinsic and extrinsic factors, including mechanical overload and improper form and equipment 4
Treatment Options
- Low-demand patients may benefit from a nonsurgical approach, while high-demand patients may require surgery 3
- Surgical interventions for peroneal tendon tears can include primary repair with tenodesis, primary repair without tenodesis, FDL tendon transfer, FHL tendon transfer, and allograft reconstruction 5
- The current systematic review showed that overall clinical outcomes were positive for the different modalities of surgical intervention for peroneal tendon tears 5
Diagnosis and Treatment
- Recognition of the characteristic symptoms, physical findings, and imaging results of peroneal tendon tears is essential for accurate diagnosis and appropriate treatment 6
- Chronic disorders of the peroneal tendons can be caused by ligamentous instability or predisposing anatomic abnormalities, and it is important for orthopaedic surgeons to optimize the diagnostic and treatment strategies for these entities 7