On this page

• What Is Fibularis Tendinopathy?
• How Does It Feel?
• How Is It Diagnosed?
• How Can a Physical Therapist Help?
• Can This Injury or Condition Be Prevented?
• What Kind of Physical Therapist Do I Need?

What Is Fibularis Tendinopathy?

How Does It Feel?

If you have fibularis tendinopathy, you might notice:

• Pain at the back of the foot or heel during or after activity, such as:
  • Pushing up off the ball of the foot (a heel raise)
  • Walking, running, or jogging
  • Quick movements
  • Jumping
  • Walking on uneven surfaces or on a hill
• Decreased pain with rest but pain in the morning
• Swelling or tenderness behind the outer ankle bone (lateral malleolus)
• Soreness on the outside of the lower leg
• Pain and weakness when actively moving the foot outward
• A clicking or popping sensation when you move your foot

How Is It Diagnosed?

A physical therapist will diagnose your ankle injury with a thorough evaluation. They will ask about your health, daily activities, and how the injury happened.

A physical therapy evaluation for an ankle injury may include:

• Looking at how you walk, squat, and climb stairs
• Testing the strength of your foot, legs, and core (the muscles of your trunk)
• Measuring the range of motion of your foot, ankle, and other joints
• Assessing the flexibility of your legs
• Testing your balance and movement patterns
• Performing movement and resistance tests to determine what tissues are causing your symptoms
• Discussing your goals, including what activities you want to return to

Your physical therapist may refer you to an orthopedic doctor or podiatrist to rule out other causes with imaging tests. An X-ray can rule out an injury to the bone. An MRI or CT scan can show the health of muscles, tendons, and ligaments. After your diagnosis, your physical therapist will work with you to create a personalized treatment program to begin your recovery.

How Can a Physical Therapist Help?

Physical therapists are doctorate-educated movement experts. They help people with fibularis tendon injuries heal through custom treatment plans. Your physical therapist will design a program based on your evaluation results and personal goals.

Your treatment program may include:

Education. You will learn what caused your injury and how to modify your activities so your tendon can heal. You will also learn ways to prevent reinjury. As your symptoms improve, your physical therapist will guide you on how to gradually resume normal activities.

Hands-on therapy (manual therapy). Mobilizing your joints and soft tissue helps to reduce stiffness and improve movement. Your physical therapist may use these hands-on techniques to help the fibularis tendon heal.

Pain management. Your physical therapist will monitor your progress and pain levels throughout treatment. They may use ice and heat. Additional therapies they may provide to reduce pain include:

• Shock wave therapy (a treatment that uses high-energy sound waves)
• Low-level laser
• Ultrasound
• Iontophoresis (medication delivered through an electric patch)
• Dry needling to help with healing and pain relief.

Footwear and orthotics. Your physical therapist may recommend shoes or inserts to support your foot while it heals. In some cases, they may suggest custom orthotics or shoe inserts. As you get stronger, your footwear needs may change. You may start with inserts and then not need them as your condition resolves. However, in some cases, long-term footwear adjustments could be advised.

Range-of-motion exercises. Tightness in your foot, ankle, or legs can lead to fibularis tendinopathies. Your physical therapist will use hands-on techniques and exercises to restore normal movement.

Strengthening exercises. Targeted resistance exercises promote tendon healing. Building strength in your foot, hip, and core also helps protect your feet and ankles from stress. Your physical therapist will guide you through a gradual strengthening program to help you return to the activities you enjoy.

Functional training. Task-specific exercises can help get you ready to return to your activities. When recovering from a tendon injury, there may be ups and downs in your progress. Sometimes, swelling or inflammation can happen because your body is responding to new stress. This is normal as your tendon adjusts and gets stronger. Your physical therapist will monitor your response to exercises and adjust your program as needed to support steady healing.

Can This Injury or Condition Be Prevented?

Fibularis tendinopathy can often be prevented. These tips can reduce your risk for fibularis tendinopathy:

• Pay attention to pain. If you feel pain on the outside of your foot or ankle after sports, apply ice and allow yourself time to recover. Rest days, along with massaging the area and gentle stretching can help.
• Make changes gradually. Make sure to slowly increase how hard you train, how long you exercise, and the kinds of exercises you do. This helps prevent injuries caused by overuse or doing too much too soon.
• Add strength training. Include exercises for your core, hips, legs, and feet in your regular exercise regimen to improve stability and reduce stress on your ankles.
• Get a gait assessment. A physical therapist can assess your walking or running style and recommend the right shoes or inserts for your needs.

The American Physical Therapy Association encourages regular physical therapy checkups to detect early signs of muscle imbalances, joint stiffness, poor movement habits, or restricted movement. Addressing these issues may help prevent muscle and joint injuries that can develop over time. Physical therapists can design a personalized program tailored to your specific needs and goals to enhance your physical health and lower your risk of injury.

What Kind of Physical Therapist Do I Need?

All physical therapists are prepared through education and experience to treat fibularis tendinopathy. However, you may want to consider:

• A physical therapist who is experienced in treating people with ankle tendinopathies.
• A physical therapist whose practice focuses on orthopedic or sports rehabilitation.
• A physical therapist who is a board-certified clinical specialist or has completed a residency or fellowship in orthopedic or sports physical therapy. This physical therapist has advanced knowledge, experience, and skills that may apply to your condition.

You can search for physical therapists who have these and other credentials by using Find a PT, an online tool provided by the American Physical Therapy Association.

General tips when you're looking for a physical therapist (or any other health care provider) include:

• Get recommendations from family, friends, or other health care providers.
• Ask about the physical therapists' experience in helping people with ankle tendinopathies.
• Be prepared to describe your symptoms in as much detail as possible, and say what makes your symptoms better or worse.