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Debunking Peroneal Tendon Myths
Avoid Commonly Made Mistakes
Answering What Works and What Doesn't
Does Exercise and Stretching Help?
Does Massage Help?
Bands, Straps, Wraps and Gadgets
Medicine - what to take and what to avoid
One Key Understanding:
Don't use compression socks or wraps. You need immobilization to protect your ankle.
Crutches or a cast from your doctor are great for keeping your ankle immobile during the first part of your healing process.
After you stop using these, you can use tape to continue to help protect your ankle as you heal.
MYTH: Wearing a Soft Brace or Sock Will Help
REALITY: Squeezing Your Peroneal Tendons Will Make it Worse
There are a million companies selling socks and wraps for you to wear all the time.
Companies like Amazon sell them because they can, not because they help.
What does Amazon know about treating injuries?
Nothing.
If they can sell it, they sell it, and that's it.
If you have a bad injury to the tendon, or the ligament bands that hold the tendon in place, then you really need a good cast that immobilizes the ankle.
Or you can use crutches so you stop using your ankle for a short period.
It needs protection from the normal movement, because the structure that once held the tendon in place is broken, and the tendon can now move about and rub against the bone in the ankle.
In reality, ankle compression wraps and socks just make Peroneal Tendon injuries worse.
They fail to immobilize the injury when it should be.
Compression wraps and bands press your already injured tendons against other bone and tissue increasing the wear and tear as you move.
Compression bands and wraps are a bad idea, no matter how badly Amazon wants to sell you one.
MYTH: Massage Will Heal the Peroneal Tendons
REALITY: Massage Can Make Peroneal Tendon Injury Much Worse
This myth suggests that massage will relax the muscles around the tendon.
They also say it will promote blood flow.
Blood flow is good.
But you need to be careful how you get blood flow to an injury.
Directly rubbing against an injured and inflamed tendon will increase the irritation.
If you have torn ligament bands that normally hold your tendons in place then massage will move the tendons around.
This will rub them against the bones in your ankle and foot.
It's likely to increase inflammation in the tendons and the surrounding tissues.
You really need to let the injured tissue rest.
That is what will get Peroneal Tendonitis to start healing.
Cold Compression can reduce the pain and inflammation.
Early on you may need a brace to immobilize the ankle.
Taping the injury will help protect it once you stop using the brace.
And yes, blood flow will help it heal.
But try a therapy like Ultrasound or BFST instead of massage to stimulate blood flow without having to stress the injured tissues.
Massaging an injury will only create more inflammation and keep the injury/reinjury cycle going.
MYTH: Cortisone Shots Will Heal Me
REALITY: Cortisone Shots Can Cause Serious Damage
Cortisone injections are designed to temporarily relieve pain and swelling, however, they come with a variety of risks and side effects.
These include skin discoloration, allergic reaction, infection, and nerve damage.
They're also associated with tendon rupture.
Cortisone shots are not designed to heal Peroneal Tendons.
They simply mask the pain and can cause you to feel a false sense that you are healed, leading to a higher likelihood of re-injury.
If the cortisone shot is not administered properly, there's a chance that it won't have any effect.
Some people are also unable to metabolize cortisone, meaning it would not provide them with any relief.
Cortisone contributes to the thinning of tissue and an increase in the likelihood of a rupture in your Peroneal Tendons!
REALITY: Surgery May Not Apply to Your Injury and Should Always Be the LAST RESORT
Surgery is not truly required to heal most soft tissue injuries.
But in the case of injuries to the ligament bands in the ankle it often does make sense.
However, it's important to know what part of the ankle is actually injured.
This is where proper diagnosis is important.
If you only have a tear in the Peroneal Tendon and no other injuries then you can very likely heal this condition without surgery.
But, if you have a torn retinaculum, the ligament band that holds the tendons in place, then surgery may be needed.
This is because these bands may not heal on their own or may take a year or more to heal.
Make sure you understand which part of your ankle is injured and ask your doctor if it will heal on its own.
Also ask them how long it would take to heal on its own.
You can reduce the inflammation in your ankle with cold therapy and rest.
You can speed up the healing of the tendon with ultrasound therapies like BFST.
If you do undergo surgery, you can still use BFST® and ColdCure® products beforehand to help prepare your body, and after the procedure to accelerate your recovery.
Always get a second opinion before signing up for Peroneal Tendon surgery.
MYTH: TENS Machines Stimulate Blood Flow and Help Heal Your Peroneal Tendon
REALITY: TENS Machines Can Cause Serious Damage
A TENS machine does not stimulate blood flow.
TENS is an acronym that means Transcutaneous Electrical Nerve Stimulation.
What a TENS machine is designed to do, is overstimulate the nerves to relieve pain - it only deadens the nerves.
While you want to reduce pain from your injury, using a TENS machine for Peroneal Tendonitis is not recommended.
Having your muscles pulse and flex uncontrolled will cause further tissue damage and slow down healing.
It is an important part of injury recovery, to feel the pain, and respect the pain.
Pain is going to tell you when you're potentially causing further damage.
Never mask the pain heading into any activity.
MYTH: Physiotherapy Helps Heal Your Peroneal Tendons
REALITY: You Need To Advocate For Yourself. Pain = Re-Injury
The purpose of physiotherapy is to help with strengthening the muscles surrounding your injury once the healing process is underway.
Starting physiotherapy before your injury has had a chance to start healing and stabilize, will only cause further damage and more pain.
After being inactive for an extended period of time, you get muscle atrophy (weakened muscles).
As your injury heals, physiotherapy can be an excellent resource to help you rebuild that lost muscle.
Just remember, your physiotherapist cannot feel what you feel.
If you feel pain during physio or afterwards advocate for yourself.
Physio should not hurt.
You need to work within your pain limits.
If an exercise hurts, you need to stop that exercise because you're not ready yet.
As you heal you will be able to do more, but do not push yourself because this will only cause re-injury.
This is true throughout your entire recovery process.
Always respect the pain.
Stretching can help the muscles attached to the Peroneal Tendon relax and not be as tight.
But this won't really help your Peroneal Tendonitis because it does not address the root problem.
At this point you have a tendon that is irritated and damaged.
Stretching may not add to the problem but it won't heal the damage to the tendon and it won't reduce the inflammation.
Relaxing the muscles attached to the tendon will not heal the tendon either.
It's not a range of motion problem.
Fixing tightness in the area won't reduce the inflammation.
It is not a key to healing but go ahead and stretch if you enjoy stretching.
If you find that stretching increases your pain then stop and come back to it later.
MYTH: Orthotic Insoles Will Fix Peroneal Tendon Injuries
REALITY: Custom Orthotic Insoles Don't Treat the Cause of Peroneal Tendonitis
Some companies offering Custom Orthotics claim that their insoles will keep your foot from rolling to one side when it strikes the ground.
Some say this will fix Peroneal Tendonitis by removing excess stretch in the tendon.
The most dangerous thing about orthotics is that you're messing with your body's design.
You've gone your whole life without an injury in your Peroneal Tendon, so your design has worked well for a long time.
Don't give up on that.
You have an injury to fix, not a design issue.
It happens so, so often, that people get orthotics to help one condition, only to develop another.
Orthotics don't remove stress from your body, they move the stress from one part to another.
Over a period of time that extra stress in your ankle, heel, leg or hip can lead to injuries there.
It happens all the time.
Be very careful before choosing orthotics, because you're messing with your body's natural design.
Peroneal Tendonitis is an injury.
Heal the injury properly, and it will be gone for good.
MYTH: Exercising, Despite the Pain, Will Help Me Heal Faster
REALITY: Working Through the Pain is Dangerous
This myth suggests that you need to get blood flow to the injured tendon with exercise.
But this is not the right way to do it.
Blood flow can help speed up healing.
But you have to be careful how you get the blood flow.
Peroneal Tendonitis happens because a tendon became damaged from an injury to the ankle.
Now that the tendon is extremely irritated and swollen it only takes a little bit of movement to keep the cycle going.
Exercise in the early stage of healing just adds to the irritation and swelling in the tendon.
The other version of this myth is that you need to fix a muscle imbalance or strengthen a weak muscle to heal.
But fixing muscle imbalance will not treat the root problem of the inflammation of the Peroneal Tendon.
The main problem is that the ankle is used all the time so the tendon never gets to heal.
Adding exercise at the early stage of the healing process is just adding more movement to damaged tissue and irritating it even more.
Let the tendon rest and use cold therapy to reduce the inflammation and the healing process will accelerate.
You may need to brace the ankle so it can't move during the early part of the healing process.
After you stop using the brace or if you choose not to use a brace you should use tape to protect your tendons from reinjury.
You are still healing for months after the pain is gone and it seems like you are back to normal.
There is a reason you see professional athletes taped up all the time. It works.
Tape the area right where it hurts to protect it from further injury so you don't have setbacks.
Wait until you are well into the healing process, and the pain is gone, to do any exercises.
And when you do decide to exercise, if you feel pain or swelling starting to come back, then stop immediately.
Give it more time.
You need to accept that for a short while, reducing your activity is important to letting your Peroneal Tendon injury get over the hump in terms of healing.
You cannot keep doing the same level of activity you were doing before becoming injured.
You need to let your Peroneal Tendons rest.
If you are driving through the pain, you are just making your situation worse.
This can't be stressed enough about Peroneal Tendonitis because your initial injury has turned into a cycle.
Rest is critical. Give your tendon a break.
You can gradually work your way back up to your regular activities, but this will take some time.
MYTH: Painkillers Are a Quick & Easy Solution at Any Time
REALITY: Only Take Painkillers During Times of Rest
Painkillers should never be used during times of physical activity.
This is because painkillers completely block the pain signal, making you totally unaware that you're doing more damage to the injured area.
Painkillers mask the pain, tricking you into thinking you're better and able to push yourself physically, when this will only result in further injury.
Make sure you restrict painkillers to times when your body is at rest. An ideal time to take painkillers is before bed.
Using painkillers when you're active means risking complete rupture of your tissue, and this means surgery and an even longer recovery.
While painkillers are effective at relieving pain and inflammation, they are not designed to address the root cause.
In situations where the underlying injury is osteoarthritis or tendonitis, some meds can help if used at the right times.
For more information about which meds help and when, give us a call, our treatment advisors will give you some excellent free advice.
You need more than painkillers, though, if you really want to heal.
While using a heating pad on an injury can feel good due to the warmth, they do not provide any healing benefits.
Many sites online are marketing heating pads in place of proper treatments like BFST®.
The reality is that BFST® can heal soft tissue injuries, and heating pads can't.
BFST® stimulates healthy blood flow in the area of your injury, deep below the skin.
This increase in blood flow works to speed up the healing process.
Heating pads can't do this.
Heating pads simply bring blood to the surface of your skin, making it hot to the touch.
Unfortunately, many people buying inexpensive Chinese heating pads from American companies, like you see all over the internet, end up getting burned, not healed.
There are thousands of complaints filed with FDA every year from people who get skin burns or burnt furniture and house fires from defective heating pads that were sold as solutions to their injuries.
And unfortunately, those only represent a small portion of the people actually getting hurt.
In the first 6 months of 2023, the FDA received almost 300 reports of injury and fires, just as a result of heating pads sold for healing people.
These were company names you may know, like Sunbeam, Conair, Mighty Bliss, Walgreens, Softheat, CVS, Healthsmart, Dunlap, Yeamon, and Drive.
Many of these were sold through Amazon.
ALL of them were sold as heating pads to help people heal.
If 300 people actually reported to FDA, then you can expect that thousands who didn't report were also injured.
Get BFST® for healing.
BFST® technology far surpasses the heating pad in terms of therapeutic benefits.
BFST wraps are 100% safe and heavily vetted by over 300,000 users and several regulatory bodies including FDA.
MYTH: I Need To Elevate My Injury Higher Than My Heart to Bring Down Swelling
REALITY: Any Injury That Isn't Bleeding Does Not Need To Be Raised Above The Heart
Bleeding should slow down if you raise an injury higher than your heart; however, this isn't necessary for Peroneal Tendon injury.
Elevating the leg could have a slight impact on swelling as fluid drains back out of the elevated leg.
But you can do much more with cold therapy.
And once you have the swelling down you want to get blood flow to the Peroneal Tendons and having it elevated would interfere with this.
You don't need to lay around with your ankle elevated to heal.
Simply resting the injury is sufficient.
MYTH: Once the Pain Stops, Treatment is No Longer Necessary
REALITY: Treatment Should Continue Long After the Pain Stops
One of the biggest mistakes you can make during recovery is stopping treatment before your injury has finished healing.
The healing process does not end once the pain stops.
The healing process takes much longer than most people realize.
(You can click here for the full story on how injuries heals.)
The key thing to remember is that long after the pain stops, your tissue is still healing.
This means you need to continue doing BFST® treatments in order to complete the healing process.
Doing regular BFST® treatments for several months after the pain is gone is extremely beneficial.
Do a BFST® treatment prior to any physical activity to warm up your circulatory system and to help avoid re-injury.
MYTH: RICE is the Best Formula to Follow
REALITY: RCCE® is the Best Formula to Follow
Most people think that RICE - Rest, Ice, Compression & Elevation - is the formula to follow when treating inflammation, swelling and pain.
The truth is that ice can actually freeze your skin and numb your nerves, causing 'cold burns' and even permanent damage to your underlying tissue.
Rest is absolutely a good thing.
The proper solution is RCCE® - Rest, Cold, Compression & Elevation.
For Peroneal Tendonitis the compression should be gentle and constant for 20 to 30 minutes at a time.
You can use elevation at first to help bring down the swelling but you do not have to keep your leg elevated.
You need blood flow to the Peroneal Tendon as well so once you have the swelling reduced go ahead and stop elevating the leg.
Where ice is concerned, we don't want to apply ice - we want to apply cold that is just around freezing.
Yes, you want cold - and lots of it - but not so cold that it is below the freezing point of water.
ColdCure® technology was developed specifically to address the need for a cold compression device that does not freeze the skin and underlying tissue.
ColdCure® gel packs pose no threat of cold burns.
This makes them much safer to use than other products that use ice, which can cause the skin to freeze, leading to permanent damage.
ColdCure gel packs are completely safe to use for extended treatment durations, meaning faster relief of pain and swelling.
ColdCure® technology is a huge improvement on regular ice packs.
What You Should do when you have a Peroneal Tendon Injury?
For a little while - not forever - it is really helpful to give your Peroneal Tendons a rest.
If the injury is severe enough then you may need to immobilize the ankle to give it time to heal.
Make sure you get a proper diagnosis and understand what part of the ankle is injured.
If you have torn one of the ligament bands, called a retinaculum, that holds the tendons in place your doctor may recommend surgery to repair the band.
These bands are very slow to heal on their own, so surgery could make sense in this instance.
A brace and crutches are a good idea.
They are recommended for a couple of weeks after an injury and maybe a month or more if you have a retinaculum band injury that requires surgery.
It a Peroneal Tendon is injured, and not the bands, you can treat it as you would any soft tissue injury.
Lot's of rest.
Cold compression.
Protect it from reinjury.
And if you want to speed up healing you can use a diathermic treatment like BFST.
In many cases, resting your Peroneal Tendons for a few weeks will give it time to heal to a point that your body gets ahead of the healing / reinjury cycle.
It's important to realize that once the fluid, swelling and pain go away, your underlying injury may not be healed completely so take it easy and go back to regular life gradually once the pain and swelling are gone.
If you want to be more proactive about healing the problem, you can For more information on Proactive Treatments, you can click this link.
Rest & Use Conservative Treatments
If you want your Peroneal Tendon injury to go away as quickly as possible, you need to rest the affected ankle.
Avoid any physical activities that could cause further injury to your tendon.
Do your best to avoid the activity that caused the injury and any activity that hurts is likely causing additional injury.
Do regular ColdCure® treatments to control the pain and swelling in your ankle.
The compression during each treatment helps gently move reduce the inflammation of the Peroneal Tendons.
You can also focus on healing your underlying tendon injury with regular BFST® treatments.
This combination will work to finally get rid of your Peroneal Tendonitis.
Around the 4-6 week mark you can start doing some light stretching and strengthening exercises.
Slowly work your way back to your regular level of activity.
Continue doing BFST® treatments long after the pain and swelling disappear to maintain the healing you've done.
Do a ColdCure® treatment if you experience any flare-ups of pain and swelling and after any significant activity.
Dealing With Pain
Painkillers are BAD, Not Good
Painkillers mask the pain, causing you to continue to stress and injure your tendon.
This will only make your condition worse.
It is understandable that people need relief from the pain, so if you have to take painkillers, restrict them to times when you are off your feet.
You can use painkillers to help you sleep.
Using them when you are active is a recipe for permanent damage.
Your choice of pain killers is important.
You can give us a call to discuss which ones are best.
The ColdCure® Ankle Wrap is designed to relieve the pain associated with Peroneal Tendonitis.
This safe and effective pain reliever is also great at bringing down swelling and inflammation.
The ColdCure® Ankle Wrap is incredibly soothing and provides support and protection for your sore, swollen tendon.
The painkilling element is incredibly powerful and it works instantly - there's no 20 minute wait like with pills.
Peroneal Tendon Strains and Tears can be extremely painful and debilitating.
Painkillers such as ASA or acetaminophen are often used to treat the pain but these drugs do nothing to treat the actual condition.
In fact, most painkillers are known blood thinners that can have other side effects.
Cortisone injections are used in extreme cases but these too are intended to address the pain.
They do not promote healing of the injury itself and they put you at a very high risk of further injury.
Blood Flow is Essential for Healing
There's no doubt about it, for healing most tissue injuries in the body, blood flow is the most critical element in rapid recovery.
The blood flow brings the building blocks for new cell growth.
It carries away the waste and damaged tissue.
It brings antibodies to protect against infection.
Your blood flow supplies the cells in your body with everything it needs and removes much of what needs to be taken away.
While your heart ensures a sufficient supply to your body as a whole, in the individual parts of your body there are a lot of factors that determine how much that area receives.
Motion in local tissue can play a significant factor in blood supply.
But when you are injured, that motion is less and so is that trigger to bring blood to the area.
People often don't understand that motion is enough and that doesn't mean putting a heavy load on your joint.
When you dangle your leg - not lift it - and swing it gently back and forth with limited range of motion, that's enough to stimulate circulation. Adding the weight of your body or doing stressful exercise doesn't improve the flow significantly more than unloaded motion.
The motion plus the added loads can end up resulting in reinjury.
Find light gentle motions that you can do with no pain at all and do those several times each day.
Just move the body part without any strain, you don't need to add more load.
Diathermy is a medical process to promote blood flow in tissue that is at rest.
Diathermy is a process by which energy is sent deep into the body to stimulate blood flow in tissue far below the skin.
An example of diathermy are the ultrasound treatments that people get when they go to physiotherapy.
The challenge with ultrasound is that all diathermic treatments are only effective for up to 4 hours.
But people go to the physio clinic once every couple of days, so they are only getting occasional treatments when their body needs several each day.
Also, ultrasound is an older, more risky process that can damage subdermal tissue, so it needs to be performed by a technician - you can't do it at home.
The good news is that you have an option to ultrasound.
BFST™ devices from King Brand are diathermic devices that people can buy to treat themselves at home.
With a home diathermic device, you can treat yourself multiple times each day and significantly improve your blood flow and the healing process.
And they're more powerful than ultrasound too.
And safer.
An Ultrasound device is very focused and the effective area can be less than 1 square inch in the underlying tissue.
That's why it needs to be constantly moved around, both to cover the whole injury and to prevent the tissue from burning.
BFST devices have massive coverage areas, treating up to 70 square inches without needing to move it around.
They are typically up to 10x more powerful than ultrasound too - and completely safe.
Blood Flow Stimulation Therapy™ (BFST®) gives your Peroneal Tendons the blood flow it needs to heal quickly and completely. BFST® brings extra oxygen and nutrient-rich blood to the injured area - a requirement for the body to heal itself.
With a King Brand®BFST® Ankle Wrap, blood flow can be stimulated in the area of injury while you are at rest. With improved blood flow and without physical activity and the risk of re-injury, you can recover from your Peroneal Tendon injury or surgery at a surprisingly rapid rate.
Since I have a peroneal tendonitis issue this seemed to be the perfect treatment for my ankle.
After the very first day of treatment, which lasted 20 minutes each, followed by my cold cure pack at the end of day, I felt a difference in the ankle.
I cannot explain it but it felt like the tendon was actually loosening and the swelling on the side of my ankle was less the next morning.
I can use this every day in the comfort of my own home as often as needed.
I would not hesitate to highly recommend the King brand products for an injury.
King Brand® soft tissue rehabilitation medical products are the #1 choice of top Athletic Therapists and Medical Practitioners worldwide.
We provide guaranteed results and customer satisfaction.
Like all King Brand® products, there simply isn't a better performing option.
All King Brand® products come with a 100% satisfaction guarantee.
Try our products and if you're not completely impressed, you can send them back for a full refund.
We know you will love them though because hundreds of thousands of people already use them and rave about the results.
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That is not all.
They have also been registered with Health Canada which means they received twice as much review.
FDA and Health Canada Registration does not mean that we filled out a form to become Registered.
Our medical claims are significant, and because of these claims the various agencies have looked deep into our technology.
We have submitted to FDA our proprietary research and technology to back up the claims that we make.
King Brand has participated in far more than a basic registration process.
All the agencies have come to our facilities for week-long inspections to ensure that the end user is always receiving the safest, most effective medical devices we can offer.
With two different countries of regulators this means our products have twice the oversight, ensuring exceptional quality and performance.
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This enforces medical standards that are established by the International Standards Organization for global manufacturers of medical devices.
This means more on-site, week long, audits every year, ensuring our quality and products meet strict international standards.
Beyond what is required by any regulator, we use only the safest materials in our products.
ISO-10993 regulation ensures that our products are made from higher quality materials than most baby products, including diapers.
This is the highest bio-compatibility safety standard in the world.
This is the highest hospital grade - think Intensive Care and Operating Rooms.
Our materials go through ISO-10993 testing to ensure they are safe for you.
No consumer products are produced to this high standard.
King Brand products are, in fact, hospital grade through and through.
IEC-60601 is the International Standard for Medical Device safety from an electrical standpoint.
In spite of the BFST® being an electrical device, BFST® can be used in hospital emergency rooms and operating rooms without affecting other equipment.
You can use any medical device with a BFST® and neither device will know the other one is there.
This is a very tough standard to meet, but we do it and you benefit.
King Brand products meet over 20 different safety and quality standards that are not required even for medical devices and FDA registration.
If we think there is anything that can be done to make our products safer and more effective, we have done it.
That is the approach to everything we do and that is why our company and products are so highly regarded.
