Peroneal tendon pain

[two_ravens]

Having some pain in the peroneal tendons on my rear leg (lateral side, above the ankle.) Anyone else have this and find a fix for it? (Or is anyone better at using the search function?) Did a search and found a post by someone who was going to try a bit of outward cant, but couldn't find the results of that.

Pain is worse on heelside carves and in hard/difficult snow conditions, and has just shown up since I bumped up my angles after I started booting out. Tape around the ankle above the malleoli seems to give some relief just for walking (haven't tried that riding yet.)

Thanks for any help! :)

[kjl]

Hi there - Just a few weeks ago I just had a really brutal bout of exactly the opposite (posterior tibial tendonitis - tendon on the medial side, curls around the bottom of the ankle bump, and hurt like a ***** on every walking step - had a quite difficult time walking even 20 feet). I went to the doctor - for me it was caused by a collapsing arch and rotation of the foot around the long axis, big toe down (er... my foot rolled inwards), stretching that tendon out too much. I tried antiinflammatories, but what fixed it in the short term was a tight neoprene kind of brace to hold the tendon against my ankle so it wouldn't snap back and forth, and in the long term, stuffing huge arch supports in my shoes.

I am definitely, definitely not a doctor, but I would guess adding outward cant in your bindings would be a really, really bad idea - the opposite of what you want to do.

This is what I needed: medial wedges (arch support):

And yours is the opposite, so I'd guess you need lateral wedges:

Indeed, http://arthritis-symptom.com/tendonitis/peroneal-tendonitis.htm recommends "A lateral sole wedge is also helpful. A lateral sole wedge is simply a wedge placed under the lateral or outside of the shoe. Lateral sole wedges inhibit the foot from rolling out. They can be placed on orthotics or glued to the outside of the shoe."

Again, I am not a doctor, but I would guess that while adding outward cant would be a bad idea, an inward cant might not help as much as you want since your foot roll is still the same inside your boot since the boot is a hard plastic shell. You probably want to actually stick a lateral wedge inside your liners.

But first what you should do is not snowboard until it goes away (imo), and minimize walking (and only with wedges in your shoes) until it goes away. I basically had to become a couch potato for a week and a half, and then finally one day I woke up and it was 100% fixed.

[two_ravens]

Hey kjl,

Thanks for you thoughts/experiences. I'm not liking the advice on that link too much though - if I'm not in hardboots, I'm barefoot most of the time! Pooh. But you're right, best to let it heal now....... :)

[Dr D]

Kinesio tape and or spidertech

[two_ravens]

Peroneal report:

The last run I took, with the peroneals screaming, I did slow, careful turns trying to figure out exactly what hurt and when/why. It seemed that I was trying to apply pressure on the heelside turns with the inside (medial side) of the rear boot, but - possibly due to warm spring temps and soft boot plastic (riding Raichle 124's) nothing much was getting transmitted to the board. (Soft boots are not a problem at my usual winter riding temps of 15 F to -25 F.) So it seemed that to compensate I was doing all manner of odd things with my foot inside the boot to try to have some effect on the board - including trying to evert my foot, which seemed to be putting tremendous strain on the peroneal tendons.

Gave my footies 6 days off from snowboarding (well - ok - maybe it was really 5 1/2) and used that time to make changes to my boots and bindings. I changed from 3 deg straight heel lift to about 2 deg heel lift and 2 deg outward cant - in order to engage the boot sooner and require less knee/leg travel to edge the board. For the boots, I tightened my BTS springs, added Booster straps, and added padding on the medial side of the boot between the shell and liner. Basically, did everything I could think of to simulate stiffer/taller boots. Then I taped a small piece of foam padding to the top lateral side of my foot to further limit the possibility of everting my foot. Finally did a tape stirrup to hold my foot slightly inverted, plus tape around the ankle just above the malleoli to help support the tendons. (Sorry Dr. D - the fanciest tape I had was tie-dyed colored duct tape, so that's what I used! :))

Went out like that for two very short easy days on Wed & Thurs in relatively soft afternoon snow, and all seemed to be well - just a slight ache after riding. And after falling down for a couple of turns, I figured out how to ride with outward cant and ended with my heelsides feeling very solid (see the new avatar photo - taken Sat. :D)

Then Saturday went out and rode pretty hard from open to close on hard spring snow that didn't quite get around to softening very much. Leg felt fine - no pain and only a slight ache. Sunday went out for a 1/2 day in the same conditions. Did a heelside chatter early on, in a frozen chunky ungroomed spot, and felt immediate severe pain. Rode carefully back to the base and took a break. The pain diminished, so I went back out and rode a couple more hours - and by the time I finished I was feeling no pain or discomfort whatsoever. Two days later I still have no pain, no ache, and only a slight lingering sense of stiffness.

So..... that's my story. Hope it's the end of it. And I realize that I didn't really follow anyone's advice - I just did what my leg seemed to want most, according to my individual situation. Cheers, and thanks for the all the input!

p.s. I also backed off my angles - from 63/60 to 55/52. So now I'm booting out again sometimes, which sucks - but as long as I keep most body parts off the snow I'm usually ok.

[trailertrash]

Do you have a BTS on your boots? I used to get this bad on my front foot (the pain would wake me up at night) then I unlocked my BTS and it is a lot better.

Edit, ok I see that you do have the BTS, is it working correctly?

Can you describe where the pain is a little more?

[two_ravens]

Well, the pain is all gone now, but it was in the tendons, and especially at the tendon/muscle juncture, of the peroneal group - on the lateral side of my rear leg. The most intense area of pain was about one hand width above the point of the lateral maleolus (outside ankle bump) but also felt pain all along the tendons to where they round the corner behind the ankle and head under the foot.

I believe my BTS's are working correctly - Fin installed and set them up for me originally. I have yellow springs, and I had them backed off pretty far - so combined with the Raichle 124's and warm temps - I had a LOT of flex. For me, tightening them up seems to be helping.