Is peroneal tendon pain common for lifters?

Pain & Rehab Forum [Moderated]
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Hey I’ve been really struggling with pain on the outside of my ankle right above the right ankle bone, I assume a form of peroneal tendinopathy. There appears to be a little “bump” where the pain is, but it’s not tender or painful to the touch, but is a good marker of where the pain is local to.

It started in late June and while I’ve improved I still am having setbacks even with cautious reloading and weight caps. Further frustrating is that online searching just does not seem to identify this as a common problem among powerlifters. If I had to guess the trigger, it was acute training stress from switching to high bar from low bar without enough reduction in load.

Summary of strategies so far

  • Eliminated squatting for a week on PLII

  • switching to a 1 inch heel shoe

  • gradually introduced squats, tempo squats on day 1, pin squats on day 3. Started with 95lb and worked up slowly.

  • capped main deadlifts at 455 at first, since deadlifts didn’t seem to be the main cause. eventually seemed to be too high and capped at 405. Capped day 4 deadlifts at 365. Seemed to do the trick at least initially.

  • most recently for a few weeks I just kept squatting to 275, normal tempo for sets of five which is very submaximal, and was only going to increase weight with super confidence I wouldn’t irritate it. Basicslly, I was only doing “back off” percentages. Day 3 i would do pin squats at about parallel with light loads

the most recent set back was two Fridays ago and this is what is most frustrating: the symptoms only manifest after training, and not during. I only added one extra deadlift set from the prior week but I felt iffy on the following Monday and Tuesday so i took a 5 day break, just searching for anything…and like the BBM article on tendinopathy says that was not a good idea because my 275s felt like crap.

so here I feel like I’m back to square one in almost October. I will take squats down to maybe 135 this week, add in unilateral work for squat 2, and front squat for squat 3 purely as a means of reducing load by a lot, again. Outside of the gym, I also just feel a general weakness and sensitivity to movement on the right foot in general.

I considered pain and rehab team consultation but it’s just so expensive but otherwise I would love to work with a Derek on rehabbing this properly.

any words of encouragement and strategy is greatly appreciated

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I can’t speak for others but I know what worked for me. When I added Lion’s Mane and chaga mushrooms to my routine, it made recovery much faster. The pain I once had is gone and I am feeling like I could lift a building.

The way i do it is with my coffee. I buy a coffee that has the mushrooms in it already. It tastes good and the benefits far outweigh the costs. If you want to check it out, it’s called Shyne Coffee. I suggest the subscription because you don’t want to run out.

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For anyone finding this in a google search, it has only gotten worse since I originally posted. I am limited in both squatting and deadlifting to very low weights (below 115lb) with tempo, have consulted with a BBM pain and injury specialist and added additional exercises for ankles (mainly calf raises) as well as modifying more aspects of the programming. My tendon on my high ankle feels so swollen and thick right now and just doing basic activities is a chore.

While I know things will eventually improve with diligent training, it’s been mentally very difficult dealing with this. My advice, if you are by chance impacted by this, is to be overly conservative immediately from the start, and be overly conservative with increasing weight each week, or add specific calf work into your rehab from the start, and then you probably won’t suffer like me for now 4 months with set back after set back. I hope to come back to this topic in a few months and report success