When a muscle is overstretched, asked to contract hard against a sudden load, or overused, injury can occur to the muscle, the area where the tendon attaches to the muscle or the tendon itself. Small tears in the muscle fibers or the fibers of the tendon that connect the muscle belly to nearby bone are called a strain. A peroneus brevis tendon strain involves the tendon that connects the peroneus brevis muscle to the foot. The peroneus brevis originates on the lower lateral portion of the fibula on the outer lower leg. It travels down the leg and loops behind the lateral malleolus (outer ankle bone) and inserts on the fifth metatarsal (the long bone that connects to the pinky toe).

This muscle helps to move the foot outward and upward, a motion called eversion. It also assists the peroneus longus muscle in plantarflexing the foot or pointing the foot downward. It also plays an important role in stabilizing the outer ankle and preventing ankle sprains. The tendon is responsible for transmitting force between the muscle and the bone. Tendons are inelastic, meaning they do not stretch easily. They are quite strong but can be injured. Tendon injuries can happen when a sudden high load is placed across the tendon or if it is overstretched or overworked. Running on uneven terrain or rolling your ankle inward can cause a peroneus brevis strain. When caused by overuse and left untreated, a strain can turn into tendonitis.

WHAT DOES A PERONEUS BREVIS TENDON STRAIN FEEL LIKE?

If you decide to work with a physical therapist to help correct your ankle issues, your entire treatment plan could consist of around 8-20+ different physical therapy sessions that will each last 60-90 minutes. Once you complete your customized physical therapy treatment plan, you will be able to continue to do the prescribed stretches and exercises utilized during your PT sessions yet in the comfort of your own home.

PHYSICAL THERAPISTS CAN HELP YOU RECOVER

While mild peroneus brevis tendon strains often recover on their own within a couple of weeks, you may choose to see a physical therapist to address a more severe strain or if the symptoms of a mild strain interfere with your activities. The goals and interventions for rehabilitation of a peroneus brevis tendon strain can be broken down into three stages:

Early/acute phase (first 5-7 days):

• Protect the peroneus brevis tendon to allow healing to begin
• Use bracing, taping, immobilization or assistive devices as needed to normalize your walk and minimize painful motions
• Consider ice, ultrasound or other modalities to manage inflammation and promote healing
• Passive range of motion that is pain-free may be used to prevent stiffness, maintain range of motion and reduce pain
• Exercising nearby but uninjured areas of the body is helpful

Middle/subacute phase (7-21 days or so after injury)

• Introduce active range of motion
• Wean off assistive devices, bracing, taping, etc
• Begin submaximal exercise to lightly load the muscle and promote good fiber alignment in the tendon
• Begin very light stretching as needed
• Apply gentle soft tissue mobilization to promote healing, reduce pain and mobilize edema

Late/chronic phase (21 days to many months)

• Begin loading the muscle more intensively while monitoring for signs of acute regression including lasting soreness or inflammation
• Increase the load on resistance training
• Increase stretching and mobility
• Incorporate more dynamic weight-bearing exercises
• Begin exercises to improve tendon stiffness to help prevent future injuries
• Perform work and sport-specific drills to prepare for return to activity

DON’T GO IT ALONE