What to know about peroneal tendonitis (2023)

You have thousands of tendons in your body. Tendons connect muscles to bones with tissue that is strong and flexible, but not very elastic. The tendons are very strong, but they can be pulled. The point where the tendon meets the bone is a common point of injury.

‌The peroneal tendons stabilize the foot and protect against sprains. When they are inflamed, moving the foot can be painful.

Here's what you need to know about peroneal tendinitis.

Where are the peroneal tendons?

Two muscles, the peroneus brevis and the peroneus longus, attach to the bottom of the fibula. Around the ankle, the muscles become tendons. The peroneus brevis tendon inserts on the little toe. The peroneus longus tendon runs under the foot and attaches to the arch on the other side. Both stabilize the ankle.

What is peroneal tendonitis?

Inflammation of a tendon is called tendinitis or tendonitis. Peroneal tendonitis occurs when one or both of the peroneal tendons become swollen and painful.

(Video) Acute Peroneal Tendinitis Evaluation with @OrthoEvalPal

Often tendonitis is the result of repetitive activity or overuse, but sometimes aging can also be a factor. As you age, blood flow to the tendons decreases and they become thinner and easier to injure.

What are the symptoms of peroneal tendinitis?

The main symptom of peroneal tendonitis is swelling and pain around the ankle. You may also experience pain on the outside of your foot and lower leg, making it difficult to run or walk. You may also have a tender area just behind your ankle bone. Your pain may be worse in the early morning.

Causes of peroneal tendonitis

When foot and leg pain develops gradually, it is likely due to overuse orrepetitive motion. Sometimes, however, an acute injury, such as an ankle sprain, can cause the tendons to swell.

Risk factors for peroneal tendinitis include:

  • age over 40
  • Conditions such as arthritis ordiabetes
  • previous ankle injuries
  • high arches
  • Overweight
  • Smoke

Why do some athletes have peroneal tendinitis?

Athletes may have peroneal tendonitis if:

(Video) Peroneal Tendonitis: Causes, Diagnosis, and Treatment

What conditions are similar to peroneal tendonitis?

Tendonitis is just one of several conditions that affect the peroneal tendon. Others are:

  • sharp tears. If the tendon tissues tear, you may experience weakness and instability in the ankle, along with pain.
  • tendinous. Sometimes the tendon degenerates from overuse, causing intermittent pain. Consequently, the ankle can be weak and unstable.
  • subluxation.This condition occurs when one or both peroneal tendons slip out of position. In addition to the usual pain, swelling, and instability, you may feel a popping sensation as the tendon moves around your ankle bone.

Because foot and leg pain can have many causes, it's important to see a doctor if you experience the symptoms described above.

How is peroneal tendinitis diagnosed?

Your doctor will begin the diagnostic process by taking your medical history. Be prepared to tell your doctor when the pain started and if it occurred after activity or injury. Your doctor will ask about any recent illnesses and what medicines you have taken. Steroid injections and certain antibiotics can affect the tendons.

Your doctor will then do a physical exam by pressing on your foot and asking you to move your ankle. Your doctor can use imaging to rule out injury and learn more about how your foot is working. Image may include:

(Video) Peroneal Tendonitis (Side of Foot Pain), Causes & Self-Treatment.

A combination of medical history, physical examination, and imaging tests can pave the way for a diagnosis of peroneal tendonitis.

How is peroneal tendinitis treated?

Treatment of peroneal tendonitis begins with ice, rest, andanti-inflammatory drugs. Rest is especially important, as the peroneal tendon can heal quickly if the tendons have a chance to recover.

Other conservative treatments include:

  • Compression.Wear a compression bandage to reduce swelling.
  • invigorating.If your tendinitis is mild, you can use aclampto stabilize the ankle.
  • immobilizationA soft boot or cast can allow the tendons to heal.
  • Physiotherapy.Exercises and stretches can help you regain your strength and range of motion.
  • steroid treatment. In some cases, your doctor may recommendsteroid injections.

If these treatments don't work, you may need surgery for peroneal tendinitis. Called a synovectomy, the surgery used to treat this condition involves removing damaged tissue. Surgeons sometimes perform traditional open surgery and sometimes perform a less invasive type calledarthroscopy. If you are a candidate for arthroscopy, you may have smaller incisions and a faster recovery time.

How long is the recovery time for peroneal tendinitis?

Recovery from peroneal tendinitis usually takes about a month. Your doctor can tell you when it is safe to resume your normal activities, evenrunor play sports. If you have surgery, your recovery will take longer. You will be in a cast for 4 to 6 weeks, probably followed by physical therapy.

If you receive physical therapy as part of your treatment, with or without surgery, yourphysiotherapistit will probably give you exercises to do at home. Exercises for peroneal tendonitis often include stretching, resistance training, and range of motion. You can use a flexible tube or towel to provide resistance. A wobble board is also good for rehabilitation.

What are some exercises for peroneal tendonitis?

A foot and ankle conditioning program can help prevent another injury. A typical program includes:

  • 5 to 10 minutes of low-impact activity like walking to warm up your legs
  • Stretching activities suggested by your doctor or physical therapist
  • Exercises to increase strength andrange of motion
  • A repetition of the stretching exercises.

Typical exercises include:

  • The heel cord is stretched.Stand facing a wall with your good leg forward and your affected leg behind you. Place your hands on the wall for support and press your hips forward, keeping your heels flat on the floor. This stretch can be performed by keeping the affected leg straight or slightly bent.
  • The calf increases.Hold on to the back of a chair. Stand on the affected foot and bend the other leg at the knee. Keeping the affected leg straight, raise and lower the heel.
  • Ankle range of motion.Sit in a chair with your feet off the ground. Use the affected foot to trace the letters of the alphabet in the air. Keep your movements small.
(Video) Peroneal Tendinopathy or Tendonitis - Causes & Treatment


1. How to Treat Peroneal Tendonitis with Seattle Podiatrist Larry Huppin
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2. Peroneal Tendonitis Treatment 2021 [Peroneus Brevis & Longus Pain!]
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3. Does peroneal tendonitis go away?
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4. Peroneal Tendon Subluxation Briefly - Everything You Need To Know - Dr. Nabil Ebraheim
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5. Peroneal Tendonitis Stretches & Exercises – Ask Doctor Jo
6. Peroneal Tendonitis Treatment, Information and Solutions
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