Peroneal Tendonitis

hey guys dr christie ennis today we are going to go over how to get rid of this pain that's down the outside of that leg and into that foot sometimes what causes it what do you do so these muscles are known as your peroneal muscles sometimes also known as your fibular muscles i had a nutrition professor in college who said when we can't think of anything new in medicine to do or to call we just rename things so used to be peroneal now you might hear them as fibular muscles same darn thing okay there's actually three of them but it's only two that tend to be an issue the longest and the brevis and ready for blow your mind here the longest is the longer one and the brevis is the shorter one so depending on which muscle is actually an issue you can either get pain if you feel a little knobby bone part of the leg it either starts kind of there sometimes down a little in the middle the brevis actually attaches to this bone on the outside of the foot so a lot of times people will get pain there and they'll think it's a stress fracture when it's really coming from this tendon and then the longest since it's the longer one it actually goes both go behind the ankle and then it actually comes around the bottom of the foot it attaches to the base of this big toe so sometimes people think they have plantar fasciitis because they're getting foot pain when it's actually coming from this tendon now a couple ways to figure out geez is that what the problem is all right here we go another mind-blowing fact here if you touch it and it hurts it's probably coming from that muscle or that tendon the most common way to injure this though is that actually if you actually sprain your ankle right you're kind of rolling that ankle in or rolling it out either way not only do you tend to damage the the ligaments but also the muscles themselves tend to get strained and people kind of often forget that these muscles job these muscles job poor english but the job of these muscles is to help stabilize that foot right so now you've lost some stability by straining or spraining those ligaments now these muscles aren't doing their job as well either if there happens to be weakness here you're also not going to get that great stability in the ankle okay so ankle sprain number one number two is believe it or not walking or running on the road because the road is kind of angled so you're constantly putting stress these muscles point the toes down or point the foot down yeah i have terrible motion here and then also turn out the foot twitchy that's what they do right so you can think about that if there is that angle how much stress you're putting on there all right so think about those things in your head as we're going through treatment because now you can probably figure out oh my gosh yeah that probably is where this issue is coming from that being said if you do this and you do it immediately and you go oh my gosh right you've just been walking you've been running and you notice a sharp pain be aware that that may be an actual full tear okay and that's going to require a little bit of different treatment than what we're going over today and you might want to go get that checked out if it's something that's come on for a while and it's kind of gradually gotten aggravated more likely to be that tendinitis okay so that's what we're going to talk about how to fix today now that we know the cause oh i missed a cause weak hip muscles actually on these outside hip muscles because the hip controls right that knee rolling in and out think about what that means for the foot so if these are weak and that foot rolls in easy to get strain there too i'll show you some exercises for that very first thing though that we want to do i know this is the worst thing ever but it's actually let it rest a little bit nobody wants to hear that i know but if you really just did this injury it's pissed off excuse my language it is angry okay and you do need to let it rest a little sometimes some kinesio tape where you're going from here and around can help soothe that a little bit and i'll link a video for you so you can see what that looks like but after a day or two if it's starting to feel a little bit better one of the things that i tend to do is get a little bit of soft tissue work in there and so i'm using the derma edge to just get right alongside and these muscles because i have a very bad ankle that i shattered tend to be a problem for me you can do it with a foot neutral you don't have to turn it in okay and actually i'm going to advise you not to turn it in you don't want to stretch a muscle or a tendon that's just been strained you need to let that heal first okay so once you do that and you do feel like you should feel as you're doing this that you're kind of going like ah that does feel a little bit better that's your guidance for how long you're doing this okay then you're actually going to get into some of those areas that may be a little naughty now that we're getting some scar tissue forming in there so you're going to take your knuckle which i don't find overly comfortable so i tend to use the edge of the derma edge i'm going to straighten my leg out and for me oh that's the spot right there so i'm going to dig in and as i do that i'm going to point my foot down excuse me and turn it in okay it may not feel awesome you can even try up and down if that feels a little bit better the goal is to try to get some movement with this that actually helps to break those up a little whoopsies a little bit easier okay once you've done that now we need to address that strength and i always do strength before you throw in any type of orthotic in the chute right if you have a high arch or a foot that rolls in obviously that can cause some issue too and an orthotic might be the way to go but if you have hip weakness remember i said that also can be a problem so we want to make sure that we strengthen that hip before you just stick an orthotic in the shoe that might help self-correct that a little bit so one of my favorites see it's hard to get up sometimes one of my favorites i have dubbed the sassy teenager if i'm going to work on this hip this outside hip strengthening and if you want to work on balance and proprioception a little at the same time a double whammy this is a great exercise so you're actually going to drop the opposite hip and then using that right one you're gonna pull up so i'm holding on but if you can without your foot going crazy right up and down and you'll feel this pretty quickly so 10 to 15 reps roughly okay the other thing that people tend to forget and this often happens with an ankle sprain itself regardless of whether these muscles are a problem is that the ankle joints themselves tend to start to get stiff and locked up okay so when that happens then you can't bend into that ankle very well and then because of that your poor foot is like well i still have to get through this this gait cycle so it

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