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In runners if there is pain on the lateral side of the ankle joint and there's no sign of trauma, then the most likely problem is what is known as peroneal tendonitis. The peroneal muscles are on the lateral side of the fibula bone and there tendons pass around the outside of the ankle joint to then go to the outside and the bottom of the foot. The key purpose of these muscles will be to stabilize and support the foot.
If a tendinopathy occurs in the tendons of those peroneal muscles in athletes, then the reason would probably be overuse. That is carrying out too much too soon and the peroneal tendons are not provided to be able to adapt to the increasing loads which are put on them from that too rapid increase in the distances and speeds being run. It is important that following harder long runs that the body will be given adequate relaxation ahead of the next load is applied. If a load is put on too soon ahead of the tendons to have had time to recuperate, then there is a heightened risk for an injury.
The discomfort of peroneal tendonitis commonly only starts of like a modest ache, either just above or below the ankle bone on the lateral side of the ankle. To begin with there is no puffiness, however that will normally come about later as the pain increases when the issue is not attended to.
To take care of peroneal tendonitis, the runner must lower the running to bearable amounts to permit the peroneal tendons to recover. Foot doctors often make use of a lateral wedge to manage peroneal tendonitis in the short term because this decreases the activity with the peroneal muscles, so there will be less force on the tendons. This goes under the heel in the athletic shoes. When the pain in the peroneal tendon starts to subside, then a progressive and slow increase is needed in the kilometers run to encourage the tendon to adjust to the loads will be required. A strengthening program can also be beneficial.