Ouch--peroneal tendinosis and cycling

[Onno]

During a longish and hilly ride a couple of weeks ago, my right ankle got fairly sore. I've done a bit of research, and I'm pretty sure that I have peroneal tendinosis, which is inflammation and tenderness of the tendon that runs on the outside of the ankle. I've sprained my ankle plenty of times running and hiking, but I've never had an ankle injury from cycling before.

Have any of you had this? Is there any treatment other than staying off the bike (which I really DO NOT want to do, since our season up here in the northeast will be over soon, and these are the last fine beautiful days of the year!) I've been icing and taking Aleve, but this doesn't seem to be helping. Is there a chance that something about my bike, shoe, cleat set up is contributing?

Thanks in advance,
Onno

[inlimbo87]

Have you had a bike fit?

[Onno]

Yes, several over my 30 years of cycling. I've ridden several thousand miles on the current bike, and I feel as though it fits really well. What issues with fit might affect an ankle, though?

[dgauthier]

How many miles do you have on your cleats, pedals and shoes? If any are worn out and need replacing, that might be the cause. Have you participated in any new activities off the bike that might have placed unusual stress on your ankle?

[benb]

Several over 30 years of riding is not many.. among other solutions it might be time for another fitting as things change.

It might also be time to go over your bike very carefully and make sure it is still set up exactly the way you assume it should be based on your last fit. My bikes always seem to have this way of coming out of adjustment through maintenance, something slipping, etc..

[Dustin]

Fwiw, if you have a sore and inflamed tendon, it is more likely tendinitis, and not tendinosis/tendinopathy. The latter refers to less of an acute inflammatory condition than a degenerative/scarred up tendon that refuses to heal.

Ask me how I know.

[Onno]

And my ankle is still pretty sore. Finally saw a doctor, and he says I do have degeneration of the peroneal tendon (based on an MRI), and that surgery might help, but he suggested waiting until the pain got much worse before risking it. I've tried the Shimano R171 shoes, which allow the cleat to go further back than my old Specialized shoes. That clearly helps some, but not enough. Time to go to a mid-sole cleat, I think.

Unless, there are other pedal/cleat ideas out there. I've only ever used SPD-R pedals and cleats. Is there another combo that might get my foot further forward, or are new or modified shoes the only route here?

[hooter]

I had an inflamed tendon in my heel last season. Dropping my seat down a little helped, along with spinning at a higher cadence and moving my cleats back as far as they would go.

It took about a month before I could ride without any pain.

[etu]

Not exactly what you're suffering from, but I turned my ankle last year and didn't have any pain until a few days later on the outside of my foot in front the ankle. I started used foam rollers to loosen the trigger points along the peroneal muscles in the lateral compartment of the lower leg, and it's no longer a problem.

[Ed-B]

I've had tendinitis in various areas, more frequently in recent years. I'm finding that increasing my vitamin C supplementation in addition to the fish oil that I have been using is providing some relief.

I was surprised to learn that humans are one of but a few mammals that cannot produce vitamin c in their bodies. Vitamin c is essential for the production of collagen, and collagen is essentially what holds us together.

There are a number of Internet sites that have recommendations for treating tendinitis with supplements in addition to other therapies, you might want to look into it.