Pain on the outside of your lower leg or ankle when walking often points to a problem with the peroneus longus muscle or its associated tendons. This article explores the anatomy and function of the peroneus longus, common causes of pain during walking, how to recognize symptoms, and steps for relief and prevention.
Understanding the Peroneus Longus Muscle
The peroneus longus, also known as the fibularis longus, is a muscle located along the outer side of your lower leg. It originates from the head and upper portion of the fibula, which is the smaller of the two bones in your lower leg. From there, its tendon travels down behind the outer ankle bone (lateral malleolus) and extends underneath the foot, attaching to the first metatarsal bone and the medial cuneiform bone on the inner side of the foot.
This muscle plays an important role in foot and ankle movement, primarily contributing to eversion, which is the action of turning the sole of the foot outwards. It also assists with plantarflexion, the movement that points the foot downwards. During walking, the peroneus longus is involved in maintaining ankle stability, particularly on uneven surfaces, and helps in the propulsion phase of the gait cycle by assisting with effective push-off. It also helps support the arches of the foot.
Common Causes of Pain While Walking
Pain in the peroneus longus muscle often arises from excessive stress or injury to its tendon. A frequent reason is overuse or repetitive strain, which can lead to inflammation or small tears within the tendon fibers. Activities involving repeated ankle movements, such as long walks, running, or certain sports, often contribute to this injury.
Peroneal tendinopathy, a condition of tendon inflammation or degeneration, often stems from overuse or improper foot mechanics. Ankle sprains, particularly inversion sprains where the ankle rolls inwards, can also stretch or injure the peroneus longus tendon, leading to pain. Additionally, wearing ill-fitting footwear that lacks adequate arch support or stability can place undue stress on the muscle and its tendons. Rapid increases in walking distance, speed, or changes in terrain can overload the muscle, causing discomfort. Certain foot structures, like high arches, or gait abnormalities may also predispose individuals to peroneus longus pain by altering how forces are distributed across the foot and ankle.
Recognizing Symptoms and Initial Relief
Pain associated with the peroneus longus appears along the outer ankle or lower leg. This discomfort often intensifies with physical activity, such as walking, running, or pushing off the foot, and tends to lessen with rest. Other signs include tenderness when touching the area behind the outer ankle bone, and sometimes swelling may be present. Sometimes, individuals experience a clicking or snapping sensation.
Several self-care strategies can provide immediate relief:
Rest the affected foot by reducing activities that aggravate the pain.
Apply ice packs to the painful area for 15 to 20 minutes at a time, several times a day, to help reduce inflammation and pain.
Use a compression bandage around the ankle to help minimize swelling, ensuring it is firm but not overly tight.
Elevate the foot above heart level, especially during rest, to aid in reducing swelling.
Perform gentle stretching exercises for the calf and ankle, if they do not cause increased pain, to provide some relief.
Use over-the-counter pain relief medications, such as non-steroidal anti-inflammatory drugs (NSAIDs), to manage temporary pain and inflammation.
When to Seek Professional Help and Prevention
While self-care offers initial relief, professional medical attention is appropriate in some situations. Seek a doctor’s evaluation if you experience:
Severe pain.
Inability to bear weight on the affected foot.
Pain worsening despite rest and self-care.
Persistent pain lasting more than a few days.
Significant swelling or any noticeable deformity.
A healthcare professional, such as a doctor or physical therapist, can accurately diagnose the issue through a physical examination and, if necessary, recommend imaging tests like X-rays, MRI, or ultrasound.
Professional Interventions
Professional interventions may include physical therapy, focusing on strengthening, stretching, and improving ankle stability and balance. Custom orthotics, which are inserts placed inside shoes, can provide support and help correct biomechanical issues that contribute to the pain. In rare cases, injections or surgical procedures might be considered, though conservative treatments are typically the first approach.
Prevention
To prevent recurrence, gradually increase the intensity and duration of physical activities, allowing the body to adapt. Wearing supportive, well-fitting shoes appropriate for the activity and incorporating warm-up and cool-down routines before and after exercise help protect the peroneus longus. Maintaining general leg and ankle strength and flexibility supports the muscle and its tendons.