Peroneus longus pain

[Fate]

Does anyone have experience with injuries to the peroneus longus?

About two weeks ago I started to get some aching pain in my right leg, a bit too high to be in the ankle, a bit too low to be in the calf, on the back and slight outside of the leg. The pain never really bothered me during workouts so I kept going hoping it would go away on its own like most aches do.

Last weekend, I ran by longest run in 10 months, going 8.2 miles (I have done 10k several times with no problems) and experienced a bit of pain in that leg and then a twinge in my knee that felt like my ITBS coming back (at that point I stopped running). This week, the aching has been much worse, including some sharper pain when walking.

My research leads me to think it's a problem with my peroneus longus. Doing the stretch I've found for that muscle/tendon (which is it? I see it listed as both) makes the area very sensative to the touch, and coming out of the stretch is somewhat painful. I also experience a "popping/cracking" feeling when I dorsiflex the ankle, though this is not painful.

Any ideas? I have been going with ice massages, stretching, limiting impact in my workouts (no running or jumping), and ibuprofen (which I hate taking). Is this the right strategy? How long will this take to heal? Should I be worried about my ITBS flaring up become of subconsciously compensating for this?

Thanks for any and all insights you may have.

[piper]

Fate- Your treatment sounds right on. Since it has been going on for a long time, you may want to try alternating heat with ice (8 min ice, 2 min heat, 6 min ice, 2 min heat, 4 min ice, 2 min heat). Since stretching is causing you so much discomfort, I would back off on that. And, yes, you should be concerned that an injury in one area can cause problems some where else. Just like a weakness or imbalance somewhere else can lead to injury. Some other things to consider: what shoes are you wearing, how are your running mechanics, and how are your crossfit workouts? I'm impressed by your research. Let me know about your shoes, mechanics and work-outs.

[saml]

Hi Fate - have you looked at your running technique? Are you running Pose or heel striking? I would strongly recommend getting your technique evaluated by a Pose coach (as endorsed by CFE). If you are having peroneal pain this would suggest that you are running with too much tension in the calves/lower legs, possibly by trying to force a ball of the foot landing, or pushing off with the toes. Your other post about pain when jumping rope would also support this. When doing this exercise try to focus on a soft landing, with relaxed calves and ankles, don't actively push away from the ground, and carry this feeling over into your running. The rehab steps you are taking will help, but the problem is likely to recurr unless you address the underlying technique issues.

[Fate]

Hi saml and piper, thanks for the input.

@piper - I wear a minimalist running shoe, I can't recall the brand name off the top of my head, but it is one recommended by CFE. I have been wearing them for over a year with no problems. I considered replacing them, but the soles do not show any wear, probably due to the low mileage of CFE training.

I have been running POSE-ish since I hurt myself in September 08. I have not seen a certified POSE instructor, because I just didn't have the money for a CFE cert and I have been unable to find a POSE certified coach in my area. From what I know, I would say that my weaknesses are that my foot lands a bit ahead of my center of mass. I do have a tendency to push off with the calves, but I have been working on it. After setting my 5k PR in November, my calves were sore for days, but since then I have not had those problems on any runs (up to 10k @ a good pace). Also, it appears to me that my feet are slightly angled as I run (I'm sorry I don't know whether its pronation, supination, youth-of-the-nation, or otherwise).

Crossfit workouts are good. I do very well in most workouts compared to others at my gym and have seen big improvements in benchmarks (FGB ~270 - 324, Fran ~7:00 -> 4:27). My biggest weakness is overhead strength, but I tend to excel at anything based around a squat, situp, or hip extension.

[piper]

Wow Fate, I wish I had a solution for you, but I don't. I keep going back to mechanics, and it would be good to watch you run. Any way to get someone to video you from the side and front? And then we could slow it down and get a frame by frame look (and figure out if you've got youth-of-the-nation ). Besides that, you may have to resort to seeing a doctor.

[jonyoon]

Fate, I just got diagnosed with an inflammation of the Peroneus longus and Peroneus brevis tendons. The Peroneus longus wraps out from the bottom of the foot on the outside and goes up around the ankle. There is another tendon on the opposite side that goes down the inside of the foot, basically acting as a stirrup. That entire area gets jacked up for a variety of reasons:

1.) Too much too soon.
2.) Physical weight (a person who weighs 125 lbs will have less of a problem than someone who is over 200 lbs. The bigger you are, the more stress the tendons will get).
3.) Improper running form.
4.) Improper running shoes.

Also, you don't exactly know what your own foot bones look like. The X-Ray on mine showed a small protrusion of extra bone from the 5th metatarsal, which was rubbing on the two tendons on the outside of the foot. No amount of POSE would have helped with this (if anything, it aggravated the problem by pushing that extra bit of bone against the tendons), so I actually need to have my foot mildly realigned through taping and possibly orthodics for some time until the bones re-align properly and I can go back to running without support.

Go to a podiatrist and have it checked.