Peroneal Tendon Pain Treatment Process

TREATMENT PROCESS

This is my current treatment process for patients with Peroneal tendonitis or tendon tears, please watch the video for full details.

1st Visit - Evaluate your condition, review x-rays, and perform a walking evaluation to determine the cause of your condition. Start working to reduce inflammation, reduce tightness, and reduce stress through your Peroneal tendons.
2nd Visit - Will evaluate the initial treatments and if indicated perform an ultrasound examination to evaluate the thickness of the Peroneal tendons to help guide further treatments.
Shockwave and Amnio Injection - Most of my patients benefit from a series of 3-6 sessions of shockwave therapy to improve blood flow and recovery of the Peroneal tendon. After these sessions, patients go through a course of 6 weeks of physical therapy. At times to help speed up the healing an Amniotic injection is beneficial.
Orthotics - Orthotics are useful to stabilize the heel position, help with posture, and reduce excess movement of the foot which can increase stress in the area of the tendon.
Physical Therapy - After these sessions of shockwave patients go through a course of 6 weeks of physical therapy.
Daily Rituals: Towel stretch before getting out of bed (30-second stretch 3 times), foam rolling (10 minutes 2x a day), icing or contrast baths (10 minutes 2x a day), anti-inflammatory for 2 weeks at a therapeutic dose (if not doing shockwave), stable shoes and rigid insert, Oofos sandals in the house, and avoid going barefoot.
Cortisone Injection - At times cortisone is indicated in the peroneal tendon.
Walking Boot - At times a walking boot can be used to rest the injured tendon.
Brace - At times I recommend an off-loading brace to reduce pressure on the injured tendon and move the pressure to the lower leg region.

RESOURCES

Shockwave (EPAT) - Information about shockwave therapy.
Orthotics - Explanation of how and why orthotics help foot pain.
Icing and Contrast Bath Instructions - Here is information on how to ice your foot.
Oofos - Recovery sandals to wear at home for more support.
Shoe Recommendations - Here is my shoe recommendation.
Foam Rolling Exercises - Instructional video for foam rolling.
Aerospring Brace - This is a carbon fiber brace that can offload the plantar fascia.