Peroneal Tendonitis

Peroneal tendonitis is a condition caused by an inflammation of the peroneal tendons. These tendons run along the lower leg and outer ankle. The injury often occurs as a result of overuse.

What You Need To Know About Peroneal Tendonitis

What is Peroneal Tendonitis?

The peroneal tendons run on the outside of the ankle just behind a bone called the fibula. The peroneal tendons and the fibula connect the peroneal muscles of the calf to the foot bone. When functioning normally, this anatomy allows the ankle to turn towards the outside.

Peroneal tendonitis occurs when there is an increased use of the tendons. Overuse creates friction between the tendons and the bones. As a result, the tendons swell and become inflamed, leading to pain and difficulty walking.

If you are struggling with pain in your foot and/or ankle, make an appointment with a Resurgens physician today.

What Causes Peroneal Tendonitis?

Peroneal tendonitis is caused by overuse and repetitive ankle movements. It is common among athletes who participate in vigorous weight-bearing activities, such as long-distance runners. Improper athletic training methods or improper shoes can also contribute to the inflammation of the peroneal tendons.

People who have a high arch in the foot are at more risk for developing peroneal tendonitis. This is because the slightly inward tilt of their heel adds additional stress to the tendons. Those with abnormalities or imbalances in the lower limb muscles and joints may also be at a higher risk for developing peroneal tendonitis.

What Are the Symptoms of Peroneal Tendonitis?

Peroneal tendonitis symptoms will usually include pain, swelling, and inflammation around the back and outside of the ankle. Turning the foot towards the inside might be painful, and turning the foot towards the outside may make the ankle feel weak. The patient may also feel heat radiating from the ankle area. Overuse also exacerbates these symptoms.

If you have any of these symptoms, contact a physician at the Resurgens Foot and Ankle Center today.

How is Peroneal Tendonitis Diagnosed?

To diagnose peroneal tendonitis, your Resurgens physician will first discuss your medical history with you. Then your doctor will do a physical exam where they will apply pressure and move the foot and ankle to determine whether the pain is coming from the peroneal tendons or the fibula, since pain in the fibula may be caused by a different condition. You may experience some mild irritation during this portion of the exam.

Your doctor may also recommend diagnostic imaging like an X-ray, ultrasound, or MRI to rule out fractures, breaks, abnormalities, or scar tissue swelling. Using all of these test results, your physician will create a unique treatment plan for your healing.

Treatment for Peroneal Tendonitis

There are many treatment options for peroneal tendonitis. Since peroneal tendonitis is a result of overuse, it often heals without surgery. The length of recovery time depends on the severity of the condition. Your Resurgens physician will discuss your treatment options and decide which methods are right for you, including non-surgical and surgical treatment for peroneal tendonitis.


Since the condition is caused by repetitive motion and overuse, rest is one of the best approaches for peroneal tendonitis. Using a boot or brace to immobilize the foot and ankle can help with the healing process. Icing the affected area frequently can help control swelling. Over-the-counter anti-inflammatories like ibuprofen can help with pain relief and inflammation.

Once the patient has had a long enough rest period, physical therapy can help regain strength and range of motion in the foot/ankle. Your doctor may also recommend orthotics to give your shoes more support.

If your pain is severe, your doctor may recommend a cortisone injection to reduce day-to-day pain. However, a cortisone injection may increase the risk of rupturing the peroneal tendons.


In the rare case that the patient's condition does not respond to non-surgical treatment, surgery may be required. If there is a tear running along the length of the tendons, surgery may be recommended.

One surgical method creates a groove in the back of the fibula bone to give the tendons more space. In more severe cases, the tendon may need to be resected, and the longus and brevis need to be surgically attached. The surgeon may also perform a tendon release or a full tendon repair.

Your Resurgens physicians will recommend a treatment plan tailored to your unique condition.

Schedule an appointment now to learn more about peroneal tendonitis treatment.