Pertinent Pearls for Peroneal Tendonitis

At the American Society of Podiatric Surgeons’ Annual Conference, Melissa Lockwood, DPM, DABPM, FACPM, FASPS, addressed the audience to discuss peroneal tendonitis. Podiatry Today had the chance to speak with her about some of the most important points surrounding her lecture.

Q: What do you feel is one of the biggest challenges DPMs face when it comes to treating peroneal tendonitis?

Dr. Lockwood feels clinicians may sometimes mistake peroneal tendonitis for a lateral collateral ankle sprain. Subsequently, she feels they may then not order physical therapy or orthotic therapy to optimally manage the biomechanics.

“(It is important to) appropriately isolate each of the two muscles to ascertain which one (many times both) is affected, and at what level (insertion, posterior fibula, muscle belly, etc),” she adds.

Q: What one evaluation or management step do you feel DPMs can take in their practices to improve outcomes with peroneal tendonitis?

Accurately imaging the tendons, either in-office with ultrasound (with appropriate training), or having a short trigger for ordering an MRI to fully evaluate the extent of the tendonitis is key, says Dr. Lockwood.

“Too often we hesitate because of the paperwork involved in ordering utilizing this important imaging modality,” she explains.

Q: Are there any practice management pearls related to this condition that might enhance success for both the patient and the practice even further?

“Like so many other musculoskeletal conditions that we treat, peroneal tendonitis is ultimately a mechanical issue,” she says. “Therefore, appropriate use of in-house modalities like physical therapy, laser therapy, DME (boot, compression sleeve, and orthotics) utilization are all critical in the ultimate healing of these sometimes chronic conditions.”