Peroneal Tendonitis From Too Much Road Walking

by Paul
(England, UK)



I have Peroneal Tendonitis from too much road walking.

See specialist in 2 months, long wait for healthcare in england, uk.

Apart from icing as much as I can what else can I try ?

Self massage ?

Rest ?

Heel lifts ??

Might a night or day splint help ?

I am swimming for cardio.

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Joshua Answers:

Hi Paul.

Road walking as exercise, a sport, just getting too and fro?

So you have Peroneal Tendonitis, and assumably pain and such.

I'm going to ask for more information, and then answer your question. More information will later be able to help me better answer your question.


Questions:

1. Age.

2. Activity level.

3. How long have you had Peroneal Tendonitis Symptoms?

4. Why do you think it's Peroneal Tendonitis, as opposed to anything else?

5. What have you done for it so far?

6. What has worked, what hasn't?


Answers:

1. Rest. Won't save you.

2. Heel Lifts. NO! The muscles is already too short. Shortening it may temporarily relieve pain, but it sets you up for more of the same, and worse.

3. A night splint could very well help a lot. I'm not a fan of day splints.

4. Icing. YES! Specifically, get an ice cube or some such and dig in there to where it hurts, and ice massage all over in there.

5. Self Massage. YES! With fingers, knuckles, elbows, whatever, and/or ice cube, get in there
rub around, press, squeeze, pin and stretch, etc.

#4 and #5 right at this moment are your best bets for getting out of pain quickly and effectively.

Frequently and repeatedly.

6. Make sure you have read and understand the Tendonitis, Process of Inflammation, and Pain Causing Dynamic pages.




Joshua Tucker, B.A., C.M.T.
The Tendonitis Expert
www.TendonitisExpert.com














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Jul 20, 2009
Rating
starstarstarstarstar 		PART 2 - Peroneal Tendonitis From Too Much Road Walking
by: Anonymous

I am 42, 6 foot, 200 pounds

After a few years of no exercise went head on into power walking, 5 days a week, 4 miles, on roads, poor shoes!!!.....no wonder !!

About 4 months ago after 3 months of walking saw doctor for soreness and tightness and sometimes stabbing pain in lateral ankle, below ankle bone and under foot...he said peroneal....suggested rest.....naproxen....and has referred me to specialist ..but that could be two months ago....I have had this pain for 4 months now ......advice on internet seems to be rest, ice, heel lifts ?....am I ok to walk gently on this ?....what sort of night brace ..the ones they use plantar faciatis ?

I am doing ankle alphabet circles to keep ankle mobile ?

Will go crazy if I cant do some sort of cardio. Is it ok to keep swimming?

And how about ankle circles and basic movement range exercises ?

I am sure it must be tendonitis, as I can easily stand on tip toe without pain

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Joshua Answers:

High five on the starting walking. Awesome. Just doing that on a daily basis is incredibly good for everybody.

1. Ankle circles and basic ROM exercises. Great.

2. Keep swimming, yes. Unless that directly makes it hurt more. Even so....

3. Self care for you is:

A. Ice Massage. The spot around the ankle, you'll find it and feel it.

B. Massage repeatedly throughout day. Just a few seconds, hit it with massage. Repeatedly squeeze the sponge and move things around.

Frequently and repeatedly throughout the day.


If you do this intensely for a few days, you will notice big results. If you keep at it till the pain is gone, that will make you happy.

If you keep at it for a week or so after the pain is gone, you will be even happier, because pain won't come back for a long(er) time.

If you feel a twinge in the future, repeat. This will keep problem knocked down before it rears it's head again.


Do you have any history of sprained ankle/ankle injury?


Yes, you're ok to walk gently on it. The main problem is the pain enhancing chemical produced by Inflammation.

Ice to knock down the Inflammation process.

Do the icing and massage for a few days, and let me know how it goes.

And it can't hurt to add in Bone Broth as the best Tendon Supplements and/or increase your protein intake.

Magnesium for Tendonitis is always a good idea too.

Keep me updated!

Ask more questions, get more answers.

Joshua
Jul 20, 2009
Rating
starstarstarstarstar 		PART 3 - Peroneal Tendonitis From Too Much Road Walking
by: Anonymous

Ok Joshua

Its midnight here in England so tomorrow will be my first day of icing.

I have frozen some dinky cups..yogs fpobau call em dixie cups and also have frozen some corn into bags for a more general before and after deal

Shall I keep taking the anti inflammatory meds?....seems pointless as they don't do much.

How about calf stretches ?

So as long as I dont enter the world power racewalking I am ok to do some gentle walking on grass, some light cycling...no hills... and my swimming.

Can I use a gentle lubricant like biofreeze....I dont rate that product itself.. for the massage and you mean massage the area of the peroneal tendon under the ankle AND the calf area where it leads from ?

Just any sort of movement ?

Have to say I am afraid of digging around the peroneal ankle area !!

Will call in tomorrow night to let you know how things are doing

Will icing increase the soreness at first?

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Joshua Answers:


1. Icing shouldn't increase your soreness.


2. I wouldn't worry about digging around in the Peroneal area, muscle or tendon.

I mean, don't injure yourself by going crazy with too much pressure, but massaging around in there to tolerance is totally safe, and will cause far more benefit than harm.


3. Something like Biofreeze is fine. I prefer not using a lubricant, it creates a little more stretch through the layers.

Lube isn't bad, it's just creates a slightly different effect.


4. Just any sort of movement. Yes, pretty much. With the intent to squeeze and make mobile the dry crunchy sponge of the muscle/tendon.


5. I'd focus on the icing and the self-massage and leave stretching till later. Massaging is, in effect, stretching.


6. Walking easy should be totally fine, and even more strenuous walking should be fine once you start icing. Swimming is fine (ya know, unless it makes it worse).

-Probably- the problem isn't injury, but muscles that are too tight putting too much constant tension on the tendon -and- an inflammation process that causes pain.

Inflammation is usually the worst part of Tendonitis.


7. I'd drop the anti-inflammatories. Icing is far more effective, and without potential side effects. Anti-inflammatory drugs are fine in a pinch, but in my opinion they are -NOT- a treatment for Peroneal Tendonitis, or any other kind of Tendonitis.



8. Let me know how the icing goes!
Jul 21, 2009
Rating
starstarstarstarstar 		PART 4 - Peroneal Tendonitis From Too Much Road Walking
by: Anonymous

Hi Joshua

Its now midday, England London time

I got up at 7am and and have done 3 ice sessions.

First one, a bag of frozen corn for 15 minutes on lateral ankle area to start

Then I spent 5 minutes rubbing pure ice cubes into where the pain is.

Now I am doing another 15 minutes with the frozen corn bag on my ankle

I guess the only way for me to be sure its "just" Tendonitis is an MRI or CT scan?

I would assume a tear or a ripped ligament would leave me in constant pain rather than just the on off burning and then stabbing I get?

If it is maybe a minor tear I guess ice again is a good healer?

I am taking a minor painkiller at the moment for it, tylenol, I hope that's better than the anti inflammatory that I have stopped


But would an anti inflammatory at a low dose PLUS the ice therapy and massage be ok ?

Or will the anti inflammatory effect the Tendonitis healing process ?

And I am better off without it ?

Kind regards


Paul R. wales, near London
Jul 21, 2009
Rating
starstarstarstarstar 		magnesium
by: Anonymous

How much daily as a supplement ?

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Joshua Answers:

Well, that's a really broad question.

The short answer is, start at 100mg/day, and go up 100mg/day until you feel some benefit. No more than 900mg/day.

For a longer conversation on this topic, check out Kerri's site at this page: Magnesium Dosage

Magnesium is incredibly important for health on many levels. And some of us use more than others for a variety of reasons.

And few of us eat enough of the right foods, and even then they may not be of the highest nutritional value.
Jul 21, 2009
Rating
starstarstarstarstar 		PART 5 - Peroneal Tendonitis From Too Much Road Walking
by: The Tendonitis Expert

Joshua Answers:

Hey Paul.

1. Anti-inflammatory plus Ice and Massage won't hurt anything, and it may or may not 'help'.

To me, anti-inflammatories are just pain killers. They don't stop or change the Inflammation process in any significant way, whereas if you ice enough, you can dial it way down and even get it close enough to 'off' to call it 'off'.

Use them if you want, your call. Or just experiment with the icing and see what happens with that, so you'll know for the future.


2. Minor tear or major tear, ICE IS YOUR BEST FRIEND!

Ice knocks down the Inflammation process that creates most if not all of the pain.

I rather doubt that you have a significant rip or tear, and you probably just have irritation and inflammation (granted, I'm an ocean away so don't pretend that that's a diagnosis).

But from what you've said, while you could have a tear, I doubt it.

Once irritation/overuse happens and inflammation sets in, you can hurt just as you describe, even worse, for long periods of time, even without actual injury.

And, 'on and off burning then stabbing' sounds like pain enhancing chemical at work.

Feel free to get an MRI or CT scan if you want, but....I don't know that it's worth the bother.

Your call. You know best how it feels. The trick is, inflammation and pain enhancing chemical can -feel- like a serious injury, even when there is none.

Consider it a learning experience.


3. Awesome job on getting up and getting to the self care! Keep at it for a solid week, as much as you can do.

Also, I would adjust the ice packing to 5 minutes on, 5 off. As often as possible. You want more squeezes of the sponge.

And, if you can get a big bucket of ice water and dip (as described on the How To Reduce Inflammation page) your ankle/lower leg in, while you're eating dinner, watching tv, working at your desk, etc, I highly recommend that.

Plus the Ice Massage for specific work on the tendon/muscle.

Great job! Keep at it! Keep me updated! Ask more questions!


Joshua
Jul 21, 2009
Rating
starstarstarstarstar 		gee thanks
by: Anonymous

I will drop the naproxen anti inflamms and just up the icing, doing shorter on off bursts to get blood moving ?

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Joshua Comments:

Essentially, yes.
Jul 22, 2009
Rating
starstarstarstarstar 		ok , day two
by: Anonymous

Late here.

Been using dixie cups and corn bags today

Feel very sore !!

Tomorrow I will be getting a small bucket from my local side store for ice dipping

How many times for that and how often ?

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Joshua Comments:

Might as well get a big bucket! :)

The How To Reduce Inflammation page has conversation and directions.

There's isn't a section specifically for Peroneal Tendonitis, but you'll notice that in general, the basic Ice Dipping recipe is the same.

And, even though the recipe says '10x', that's just the starting recipe. Feel free to do as many dips as you can, just for 10-20 seconds each.

The more you do on the front end, the faster you will experience less pain and less tendon inflammation.
Jul 27, 2009
Rating
starstarstarstarstar 		HOWDY, Day 5
by: Anonymous

Ouch !!

Still sore after 5 days

Does it get better ?

Is ice going to help a problem that has been around for 5 months.....that is a chronic rather than acute pain ?

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Joshua comments:

Day 5, good, keep at it.

Yes, Tendonitis issues do get better if you keep at it.

Chronic Tendonitis pain, or Acute Tendonitis Pain, the mechanism is the same, it just depends on where you are at in the spectrum.

1. Are you not any better at all?

2. How exactly are you icing?

3. How active are you on your feet? (I don't really believe in rest, but it is good information.)

Jul 27, 2009
Rating
starstarstarstarstar 		Hiya, Still Day 5
by: Anonymous

Still get a mix of stabbing or burning pain, together with numbness.

Seem to get stabbing pain at night.

Not walking any great distance, in fact trying to avoid being on my feet.

Maybe I should?

Can tendonitis be a mixture of different sorts of pain ...stabbing, burning, numbness?

I am not giving up, will keep icing.

I do 5 sessions of dixie cup massage a day and fit in corn bag icing for 15 to 20 minutes when I can


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Joshua Answers:

Hmmmm. Interesting.

1. Describe the numbness. Where, how much, etc.

2. Are you not any better at all, painwise?

3. Depending on how you meant it, I would switch the ice packs to 5 minutes on, and 5 off, if you're going to ice pack.

I really would go for a big giant bucket full of ice and ice water that you can get your let in as high up to the knee as possible.

4. Ice massage, awesome. Keep at it.

5. Are you massaging the area at all? Gently on the painful tendon, then trace up to the muscle and tissue around there, and press and squeeze and pin and stretch it all.

6. Yes, Tendonitis pain can show up as a variety of different flavors. FOr the most part, it's all from the flood of Pain Enhancing Chemical that is setting your neuroreceptors on high alert.

Jul 28, 2009
Rating
starstarstarstarstar 		DAY 6 - Hiya
by: Anonymous

Should I also be massaging the outside calf area which is where the peroneal muscle is, and also the area below the ankle bone which is where the tendon joins the foot ?

The peroneal muscle on outside of lower calf does seem tight to me

Its funny to describe but the pain area changes position slightly from time to time
but with regard to the tendon area its a mixture of occasional stabbing or burning together with a sort of dull numbness

I have been referred to the rhuematology department of my local hospital

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Joshua Comments:

The rhuematology dept, interesting.

Yes, do massage not only the tendon area but also the muscle and surrounding muscle/connective tissue.

TIght muscle puts constant tension on tendon, which keeps an irritated tendon irritated.

Rub in various ways to relax the muscle. This can be static pressure, or cross fiber friction, circle or squeezing over and over like a sponge, etc.
Jul 28, 2009
Rating
starstarstarstarstar 		PART 7 - Peroneal Tendonitis From Too Much Road Walking
by: Anonymous

Rheumatology and othapedics and physical massage specialists all work together here in England.

So...nice agressive massage on peroneal muscles on outer calf...

More gentle ice cup massage and finger massage on pain area on outer ankle where peroneals are located where they attach to foot?

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Joshua Comments:

Exactly!

Static pressure has the nervous system turn down tightness, if you hold it long enough, basically.

Moving massage squeezes the sponge old stuff out new stuff in, and makes tissue stretched and more mobile.

Curious to hear what the rheumatologist has to say.
Jul 29, 2009
Rating
starstarstarstarstar 		PART 8 - Ice it is!
by: Anonymous

The rheumatology appointment could be two months away!!!

So, ice it is!!

From your website and other info it really does seem ice is the best option as anti inflammatories and cortisone just mask the pain.


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Joshua Comments:

In a perfect world, anti-inflammatory drugs like Ibuprofen and cotisone injections would do something mechanically that would allow the body to heal.

Unfortunately, in my experience, A. They don't and B. it's not so much about healing as it is about reversing the dynamic that has been progressing and now hurts.

And, unless there is some variable going on with you that I don't know about yet, results wise, western medicine has nothing to offer that can beat icing and self-massage.


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