Peroneal Tendonitis Causes, Symptoms & Treatment Options

Peroneal tendonitis is a condition characterized by 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.

Peroneal tendonitis occurs from:

• Overuse
• Improper training techniques
• A sudden increase in training
• Footwear that’s inadequate or unsupportive

Peroneal tendonitis is common in these sports:

• Basketball
• Lacrosse
• Soccer

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

• Pain on the outside portion and back of the ankle
• Pain that worsens with activity
• Pain when turning the foot in and out
• Swelling, especially with activity

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

If you have pain on the outside of your ankle 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 tendonitis 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

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

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 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.