What causes pain on the outside of the foot?



Pain on the outside of the foot, from the heel to the toes, is quite common in active people and can have different causes, with the majority being due to overuse. Traumatic injuries to the foot such as ankle sprains, stress fractures and dislocation can cause significant pain and swelling, but the most common cause of pain on the outside of the foot, or lateral foot pain, that I see in my clinics is Peroneal Tendinitis, or Tendinopathy.

What are the Peroneal tendons?

The Peroneus Previs and Peroneus Longus tendons run down the outside of the ankle and foot, with the Brevis tendon attaching to the 5th Metatarsal bone, and the Peroneus Longus running under the foot and attaching to the 1st Metatarsal bone on the other side of the foot. Both tendons stabilise the foot and are active when the foot rolls out, acting to prevent ankle sprain type injuries where the foot rolls out too much, everting the foot or rolling it back in towards pronation. If you do a lot of walking or running on uneven terrain, or if you play multidirectional sports such as tennis, (Padel tennis anyone?) then those tendons are working very hard and can become overloaded over time. They are also vulnerable to a shoe that is too tight, compressing them against the bone.

What is the pain like?

Pain is usually described as an ache along the outside of the foot, often in the region of the 5th Metatarsal, and it is sometimes worse after exercise, towards the end of the day or on getting up the next morning.

It is important to rule out a stress fracture which is a common cause of pain on the outside of the foot, so it is important to get a proper diagnosis from a suitably qualified health professional.

How can it be treated?

In mild cases, rest, wearing a supportive trainer type shoe with a heel drop and reducing activities which aggravate the tendon should settle it within a couple of weeks. If pain is not improving or getting worse, then it is time to get help.

How can we help at Active Podiatry?

In the case of lateral foot pain, we will: –

  • Assess strength and function in the injured foot
  • Carry out a diagnostic ultrasound scan to identify the injury
  • Refer you for extra tests such as Xray or MRI as needed
  • Treat pain and inflammation with Laser therapy to promote recovery
  • Give you a structured rehabilitation plan to strengthen the injured muscle/tendon
  • Give advice on footwear and supply orthotic insoles where needed

Getting an early diagnosis if you have lateral foot pain is essential to avoid delayed recovery and ensure you are on the right treatment plan for your injury.

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