What is the Pain on the Outside of My Foot?

Peter Wishnie, D.P.M.
Owner of Family Foot & Ankle Specialists in Piscataway & Hillsborough, NJ

If you have pain under the ankle bone on the outside of your foot, this pain is most likely due to a condition called, peroneal tendonitis.  This is an inflammation of a tendon in that region. 

This type of tendonitis is very common in athletic patients.  The problem can be sudden (acute) or chronic (ongoing) in nature.  What happens is the foot continually turns inward (inverts) causing a strain along this tendon.  In addition, it can be traumatic.  The most common traumatic event is a severe ankle sprain, which puts a lot of tension on the tendon. 

Other types of peroneal injuries include partial tears of the tendon or a subluxation.  Tears are usually caused by overuse and repetitive stress to the tendon.  This can easily happen if you ignore the pain.  A subluxation is when the tendon moves out of place.  The tendon rolls over the ankle bone.  The cause of this can be due to damage of a ligament that keeps the tendon in place or damage to the outside ankle bone.  The tendon sits under this bone, thus, if the bone is damaged, it is possible the tendon can’t stay in place.

How Do You Know If You Have A Problem With Your Peroneal Tendon?

The symptoms of a peroneal tendon injury include, swelling, pain, and/or warmth in the area. The pain might not be constant and might occur only when you are on your feet for a long period of time.  In addition, it can occur if you turn your foot too quickly or only when you are running or playing a sport.

Also, pain can come about when resting.  A lot of inflammatory pains happen this way.  The tendon becomes inflamed while you are active, but the pain occurs at rest.  The pain should not be ignored and should be treated immediately.  The longer one waits, the longer a chronic problem will exist, which can lead to a tear of the tendon. 

Treatment of Peroneal Tendonitis

Family Foot & Ankle Specialists, podiatrists in Hillsborough and Piscataway, NJ, will treat the acute injury with rest, anti-inflammatory medications, ice and immobilization.  This rarely needs a cast, but a soft bulky bandage is applied.  This calms the pain and the swelling down very quickly.  Once the swelling subsides, custom orthotics (inserts) are sometimes needed to prevent the problem from occurring.  Orthotics are needed if the cause of the problem is biomechanical.  This means due to the way the foot functions during gait. 

If the tendonitis is chronic, then putting the foot in the cast is sometimes necessary.  If the pain is due to a tear or being subluxed, then surgery might be required. 

The key is to realize that your pain in the area is not getting better and to get immediate treatment.  By doing so, you can avoid major problems, and most of all, surgery.