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Peroneal Tendonitis Causes, Symptoms & Treatment Options

Peroneal tendonitis is characterized by ankle inflammation or irritation of one or both of the peroneal tendons.

Peroneal Tendonitis Hero Image 2

Peroneal tendonitis is characterized by ankle inflammation or irritation of one or both of the peroneal tendons.

Tendons are bands of tissue that connect muscles to bones. The two peroneal tendons are located on the outside of the foot and ankle and connect the peroneal muscles of the calf to the bones of the foot. They provide stability of the foot and help us with balance.

What causes Peroneal Tendonitis?

Peroneal tendonitis occurs from:

  • Foot overuse injury
  • Improper training techniques
  • A sudden increase in training
  • Footwear that’s inadequate or unsupportive

Peroneal tendon pain is common in these sports:

  • Basketball
  • Lacrosse
  • Soccer

Symptoms

You may have peroneal tendonitis if you experience the following symptoms:

    • Outer ankle pain and pain on the back of the ankle
    • Pain that worsens with activity
    • Pain when turning the foot in and out
    • Swelling, especially with activity (ankle inflammation)

If peroneal tendonitis goes untreated or is severe, it can lead to peroneal tendon rupture . This will require surgical intervention.

 

Peroneal Tendon Tear

When to see a doctor

If you have outer ankle pain and think that you may have peroneal tendonitis, treat initially using the following steps:

  1. Resting the ankle
  2. Putting ice on the outside of the ankle intermittently throughout the day

If you have symptoms of peroneal tendonitis, make an appointment with an orthopedic specialist. If left untreated, peroneal tendon pain can worsen and may even lead to peroneal tendon rupture.

During your appointment, your doctor will ask you to describe your symptoms and will do a physical examination of the foot and ankle. Your doctor will place pressure on the foot and ankle to look for tenderness and will move the foot around to check range of motion

To make a diagnosis and to rule out damage to other structures, like a bone fracture, your doctor may prescribe the following imaging tests:

  • X-rays
  • MRI
  • Ultrasound

Non-operative treatment

Peroneal tendonitis is almost always treated using conservative, non-operative treatment methods, including:

  • Resting the foot
  • Immobilizing the foot with a brace or a boot
  • Orthotics to help provide support for the foot
  • Icing the foot intermittently throughout the day
  • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, to help relieve pain and inflammation
  • Steroid injections to reduce inflammation and relieve pain
  • Physical therapy with a licensed professional to increase mobility of the foot

Try these exercises to help address your condition:

Below is a PDF of the Exercise Program

Peroneal Tendonitis

 

Surgical Treatment

In rare cases, conservative treatments may not relieve symptoms of peroneal tendonitis, and a rupture of the peroneal tendon(s) can occur. Surgery can repair the damaged tendon and/or to reattach the torn tendon(s) and restore stability of the foot.

Recovery

Recovery from mild peroneal tendonitis typically takes two to four weeks with conservative treatments. Patients will be instructed to work with a physical therapist to regain mobility and strength of the ankle and foot. Athletes can return to full activities once they have recovered full range of motion with no pain.

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Sources

Frequently Asked Questions

It usually happens in athletes from a sudden, forceful motion—think snapping the ankle upward or rolling it outward. The tricky part? It’s often mistaken for an ankle sprain, so it gets overlooked.

Yes—if left unchecked. The peroneal nerve sits right near these tendons, and chronic swelling can start pressing on it. That’s when tingling, numbness, or weakness creeps into the foot and ankle.

Bad idea. Ignoring it risks a full tendon rupture—a much bigger problem to fix. Early assessment is key to stopping it from snowballing.

Tendons don’t get great blood flow, so they heal at a crawl. Instead of fresh oxygen and nutrients from blood, they rely on slow synovial fluid nourishment. That’s why repetitive stress keeps re-injuring them—they never quite catch up.

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