Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with chronic/subacute lateral left ankle pain localized along the peroneal tendon course. Pain is exacerbated by activity, specifically eversion and dorsiflexion. No history of acute trauma or ankle instability. Reports morning stiffness and localized tenderness posterior to the lateral malleolus.
Clinical Examination Findings
Inspection of the left ankle reveals no gross deformity or edema. Palpation demonstrates focal tenderness along the peroneal tendons posterior and inferior to the lateral malleolus. Pain is reproduced with resisted eversion and passive inversion of the left foot. Ankle range of motion is within normal limits but painful at end-range eversion. Neurovascular status is intact distally.
Treatment Protocol
Initiate conservative management including activity modification, non-steroidal anti-inflammatory drugs (NSAIDs), and physical therapy focusing on peroneal strengthening and proprioceptive training. Consider orthotic intervention or a lateral heel wedge to offload the peroneal tendons. If refractory, consider corticosteroid injection (with caution) or imaging (MRI) to rule out longitudinal split tears.