Got Side of Foot Pain? The Problem Could Be Your Leg (Length!)

Recently in our Long Island podiatry practice, we’ve seen many patients with side-of-foot pain due to peroneal tendonitis. There are several different reasons why this condition may develop. But one of the more common—and less frequently diagnosed—ones is a leg length discrepancy. (The term we use to describe a difference in length, even one as negligible as a few millimeters, between your two legs.)

While we can’t even out your leg length—at least not without a painful surgery—we can address the discrepancy. In turn, we can relieve your side of foot pain and make sure that it doesn’t return. Here’s what you need to know.

What is Peroneal Tendonitis?

This condition describes inflammation in the two tendons that run behind your fibula (the bone on your outer ankle.  outer ankle bone (fibula). Symptoms of this condition include:

• Side of foot pain and tenderness, often emanating from behind your outer ankle bone. It tends to worsen when you’re active and improve with rest. It may also flare when you stand up after sitting for a while.

• A feeling of instability of weakness when you traverse uneven ground

Common Causes

Peroneal tendonitis can be caused by a variety of factors. It’s a common overuse injury, especially for runners whose repetitive motions out undue pressure on your tendons. Instability in your ankle—often due to a past injury like an ankle sprain or fracture, can also lead to this condition. But there’s another, less expected cause we need to talk about—leg length discrepancy.

What is a Leg Length Discrepancy?

Leg length discrepancy describes a condition in which one of your legs is shorter than the other. The difference in length could be due to your anatomy, as some people’s femur or tibia bones differ in length, because of old fractures, injuries to your growth plate or even defects in your development.  Sometimes, the discrepancy between your legs results from dysfunction rather than actual length disparities. This can occur when your knee, hip or ankle joints contract or your muscles tighten, creating the illusion of different leg lengths. Even a tilt in your pelvis could lead to a leg length discrepancy. And, if the condition is left untreated, you could develop a host of uncomfortable symptoms, including side of foot pain.

 How Leg Length Discrepancy Leads to Side of Foot Pain

When your legs are two different lengths, your body has to compensate for the discrepancy. Often, your shorter leg will force its foot to roll outward; that movement puts stress on the tendons of your outer ankle as they try to stabilize your body. Over time, that strain can lead to pain, inflammation or even tears in your tendons. Luckily, if we treat the root cause of your tendonitis along with your symptoms, we can resolve side of foot pain and keep it from returning.

Treatment Protocols

When you have peroneal tendonitis caused by a leg length discrepancy, we have to treat the your tendons and your legs. To resolve your side of foot pain, we’ll recommend rest and regular icing of the area several times each day, for between 15 and 20 minutes each time. Stretching, especially under the supervision of a physical therapist, can help relieve the built-up tension in your outer ankle area. Specific areas of focus usually include the soleus muscle, right beneath your knee; your calves; and your ankles.

At the same time, your physical therapist may recommend rehabilitative exercises designed to strengthen the muscles supporting your inflamed tendon. This can help with your recovery while improving stability in your ankle. If the condition has progressed, you may need to support your ankle during the recovery by using an ankle brace or by taping the area. And while over-the-counter medication can often manage your discomfort during the recovery, we may also recommend applying Tolcylen’s Transdermal CBD/CBG cream, available for purchase in our office. Both CBD and CBG are hemp plant extracts; they have pain relieving properties but are free of THC, hemp’s psychedelic compound. As such patients who use this product never have to worry about getting high, but they do report targeted pain relief and a noticeable reduction in inflammation!

Keep Side of Foot Pain from Returning

If we only treat your peroneal tendonitis, the pain will likely return, because it’s main cause—the difference in your legs’ lengths—will still be a problem. For that reason, we’ll also have to help even out your legs with the use of custom orthotics that include a lift on the insert to be worn on your shorter leg. This will improve your body’s alignment, reducing pressure on your peroneal tendons, and helping prevent chronic pain and inflammation.

When to See a Doctor

As soon as you notice foot pain, it’s important to contact our office and request an appointment with Dr. Mark Gasparini or Dr. Novneet Chhabra. While physically evening out your leg length would require major surgery, our non-invasive interventions are effective at reducing pain and restoring balance. And the sooner we begin treatment, the sooner you’ll begin to feel better. So call us today at 516-804-9038 or follow this link to request an appointment.