Ryan Hannigan InjuryOn August 27, after nearly a month on the DL with ankle peroneal tendonitis, Red Sox catcher Ryan Hanigan began a rehabilitation assignment with Double-A Portland. It’s good news heading into September — the time of year championship-caliber teams start to get healthy and go on a run. But what exactly is peroneal tendonitis and what can you learn from Hanigan’s injury? Joseph DeAngelis, MD, Orthopedic Surgeon in the Division of Sports Medicine and Shoulder Surgery at Beth Israel Deaconess Medical Center, says this somewhat rare but aggravating injury can frustrate even the most dedicated athletes.

“Peroneal tendonitis is a frustrating injury because the peroneal tendons play an important role in athletics and every-day mobility,” says DeAngelis. “They support the outside of the ankle and give your foot power and stability when you push off. When they’re inflamed, every step hurts.”

DeAngelis adds that other symptoms of peroneal tendonitis include:

  • An aching pain on the outside of the ankle that decreases with rest.
  • Swelling or soreness behind the ankle bone on the outside of the ankle.
  • Pain and weakness when actively moving the foot in an outward direction, stretching the foot inward or when pointing it down.
  • Pain when pushing off the ball of the foot during walking, running or when walking on irregular surfaces that turn the foot outward.

Although peroneal tendinitis is less common than other forms of tendon pain, it can sometimes be more challenging for athletes to deal with. Even just pinpointing the exact source of the pain can be difficult. That’s because you actually have two peroneal tendons: the peroneus longus and the peroneus brevis. The two run parallel to each other, connecting the outside of your foot to the muscles in your lower leg. These tendons work together to help stabilize your ankle and to help roll your foot outwards. In other words, these tendons are a key part to being able to walk and run.

Says DeAngelis: “Athletes rely on their tendons to transmit force from the muscles to the bones. With overuse, the tendons can become inflamed. As you can imagine, you won’t be able to perform at a high level until that pain and inflammation are gone.”

The best treatment for peroneal tendonitis is rest, regular stretching and strength and balance exercises to restore regular functioning of the tendon. It can also help to work with a physical therapist to create a progressive treatment plan that is targeted to your specific needs.

What you do at home can improve your recovery, too. “Rest and ice help to relieve the pain and inflammation,” says DeAngelis. “In the end, rehabilitation is about making sure an injury doesn’t come back. With stretching and strengthening, you are setting the stage for a better, healthy future.”

The Red Sox are hoping for a healthy future too. And with summer winding down and the playoff race heating up, the timing couldn’t be better.