When is custom orthotics recommended for peroneal tendinopathy?

The peroneal tendons run along the outer ankle and help stabilise the foot. Repeated loading, an ankle injury, or a foot shape that makes the tendons work harder can lead to pain and tenderness behind or below the outer ankle. An orthotic can provide support under the foot and influence how pressure is shared during each step.

A custom device is considered only after the clinician has checked the tendon, ankle stability, strength, footwear, and walking or running pattern. It may complement a period of activity modification, rehabilitation exercises, and a gradual return to sport. It should not be used to push through increasing pain.

Ask for an examination if outer-ankle pain continues, particularly after a twist or a change in training. Bring your everyday and sports shoes. If an orthotic is prescribed, start with short periods, check the skin, and follow the strengthening and balance programme provided.

Keep high-impact activity within the limits set by your clinician. Contact them if the insert creates pressure, causes new pain elsewhere, or makes the ankle feel less stable. A fit adjustment or a different plan may be needed.

Seek prompt care for a sudden snap, rapid swelling, inability to bear weight, obvious deformity, or an ankle that repeatedly gives way. New numbness, a cold or discoloured foot, or severe pain after injury also needs timely assessment.

Ask whether the tendon is irritated, torn, or affected by ankle instability; what the orthotic will support; and which exercises should continue. Ask how to progress walking or sport and what change would mean the device needs review.