Strengthening the peroneal muscles and other supporting ankle muscles as well as the proprioception or co-ordination of the ankle is important in the rehabilitation of a peroneus brevis tendon injury.
The rehabilitation guidelines below are for information purposes only. We recommend seeking professional advice before attempting any rehabilitation. Static strengthening exercises which do not involve any movement of the foot or ankle should be done initially building up to dynamic exercises then more functional sports specific training.
Static eversion ankle exercise
These exercises will specifically strengthen the muscles that stop the ankle from being turned over or inverted including the peroneus brevis muscle. Static exercises, also called isometric exercises are where the joint does not actually move during the exercise but muscle contract against an immovable resistance such as a wall, chair or partners hands. Hold for 5 seconds, rest for 3 seconds and repeat until you feel the muscles working. This exercise can be alternated with static inversion strengthening to balance the ankle out.
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Dynamic eversion exercise
The second exercise will strengthen the muscles dynamically or when moving and can be done as long as pain allows and 3 or 4 days of isometric or static exercises have been done. Using a resistance band or equivalent the foot is turned outwards against resistance working the peroneal muscles on the outside of the calf. Resistance can also be applied by a partners hands. Start with 3 sets of 10 reps and build up. The exact number of reps will vary depending on the amount of resistance and the strength of the ankle. Aim for high reps, low resistance in the early stages.
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Calf raise exercise
This exercise will strengthen the calf muscles which consist of the gastrocnemius muscle and the soleus muscle. This exercise can be performed against a wall or on a step. Rise up and down on the toes in a smooth movement. You should be able to progress quite quickly with this one but aim for 3 sets of 10 and build up steadily, a few each day. A beginners version of this exercise can be done in a seated position. This works the soleus muscle more than the larger gastrocnemius muscle.
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Front of the ankle strengthening
This exercise works the dorsi flexors or muscles that pull the foot upwards. Using a rehabilitation band pull the foot and toes up against resistance and then down again. Aim for 10 to 20 repetitions and 3 sets with a short rest in between. This is an important strengthening exercise, however it is important not to over do this one. Remember you will still have to walk on the ankle after the strengthening session so do not take the ankle to fatigue. Over time this may also lead to pain in the front of the shin - less is probably more with this exercise.
Play dorsi flexion ankle strengthening video.