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Overview Peroneal tendonitis is an inflammation of the tendon and lining of the tendon sheath characterized by pain on movement of the associated foot.


Peroneal tendonitis is an inflammation of the tendon and lining of the tendon sheath characterized by pain on movement of the associated foot. The most common symptom of peroneal tendonitis is progressive increase in intensity of pain in your foot.  Learn more about peroneal tendonitis. In this article you will find information about disease process, treatment and prevention. Peroneal tendonitis is an inflammatory condition of the peroneal tendon.  This inflammation occurs along the outside of the lower leg, behind the ankle and under the foot.  If you are runner, if you are athlete you have increased risk for a peroneal tendonitis. The peroneal tendon is surrounded by, a synovial sheath that secretes fluid which allows the tendon to slide up and down without friction as the foot moves outward and inward.

Disease process

Repetitive damages the fibers in the tendon of the involved foot, cause extravasations of tissue fluid and setting up an inflammatory process.
If you have excessive pronation of the foot places stress on the peroneal tendon, that cause the tendon to have to work hard to provide foot stability. If the foot over pronates, the tendon is over stretched and that can cause inflammation and localized sharp pain. The tendon connects muscle to the bone. When your tendon becomes inflamed, then you can feel pain.


Repetitive movements, strain, or excessive, unaccustomed exercise may be causes. Peroneal tendonitis can be caused by a sudden increase in the intensity of training, a rapid increase in the frequency of training, repeated training on rigid surfaces, poor core strength and genetic abnormalities. Underlying systemic disease like rheumatoid arthritis, gout, sclerosis, and disseminated gonococcal infections may also be a cause. Peroneal tendonitis can be a result of injury, overuse, or can be in relation with aging as the tendon loses elasticity. The greatest risk has middle aged and older adults and athletes or individuals with occupations requiring repetitive motion. Peroneal tendonitis is common for the runners as an overuse condition. If you begin an exercise program or increase your level of exercise you can experience symptoms of peroneal tendonitis. The foot is unaccustomed to the new level of demand, and tendon overuse will cause an inflammation and tendonitis.

Signs and symptoms

Most of patients complain of pain and swelling in the prominent long bone on the outer side of the foot. Some patients feel pain in groove for the peroneus longus tendon; also pain may occur behind the outer ankle bone. If you have peroneal tendonitis you may have increase in intensity of pain with weight bearing, pain with inward movement of the foot and pain with resistance to outward movement of the foot.  Most common symptoms of peroneal tendonitis include: pain and tenderness along a tendon, usually in proximity to the ankle or foot, pain at night, worse pain with movement or activity, tenderness and swelling over the bit where the tendon inserts onto the ankle or foot, stiffness after exercise, pain when you try to bend the ankle or foot against resistance.

Diagnostic tests

The diagnosis is based on a history of repetitive motion or underlying disease and physical examination of the foot. To evaluate your condition your doctor will ask you many questions about the pain in your foot. Some of questions are: when pain began, does the pain increase with activities, does anything seem to relieve the pain. You probably will have X-rays of foot. The X – rays help your doctor rule out similar conditions. When doctor evaluates your medical history, X – rays, he may observe you walk, it may be observed for any unusual characteristics.


Your doctor will give you some medication to control pain. He may prescribe a non-steroidal anti-inflammatory medication such as Advil or ibuprofen to help reduce the pain and inflammation. A non-steroidal anti-inflammatory medication can be helpful but they have side effects. Side effects can include stomach upset and bleeding problems.

The steroid drug injections can be used in treatment of peroneal tendonitis. These injections reduce peroneal tendonitis inflammation, and relive pain. You should know that repeated cortisone injections may weaken the tendon or cause undesirable side effects. This treatment with steroid drug injections can also increase your risk of rupturing a tendon.

The doctor will give you some recommendation to reduce inflammation and swelling, and protect the injured leg. The most important part of the treatment and recovering from peroneal tendonitis is rest. If you have peroneal tendonitis you should restrict or limit your activity. That means that you should decrease both the frequency and duration of your exercise routine. Some individuals have taken a few weeks off and then gone right back to the same routine which doesn’t provide your body the kind of rest it needs in order to recover.

To reduce swelling and reduce the pain, you should apply ice on your foot. You can use cold therapy device cold pack, or ice massage. To massage your foot with ice, you can fill a paper cup with water. When you freeze the ice, you should tear back the top portion of the paper exposing the ice. You should massage your foot gently over the injured area in a circular fashion. This massage you should repeat for 15 minutes 3 or 4 times per day. Sometimes you could overexpose the skin whit ice, you should be careful.

You should stretch both before and after all activities, that increases flexibility and can prevent the injury from returning. Perform these stretching exercises stretching exercises may be performed 3-4 times per day.

If you have any abnormal problems of the lower extremity, you should tell that to your doctor. You must be careful when you by running shoe. You should ask your doctor to recommend you the type of running shoe you will wear, arch supports and a foot strap. Consult a doctor or qualified therapist for a professional evaluation.
Returning too soon to your sport or activity can cause permanent damage. The goal of treatment is to return to your sport or activity as soon as medically possible. You should know that the goal of your rehabilitation should be to decrease pain, strengthen the muscles of the peroneal region and improve flexibility. If you had peroneal tendonitis your return to sports activity must be carefull and slowly. You should follow doctor’s advice regarding your activity level and date of return. How long recovery will last is individual and vary from person to person. 


To prevent peroneal tendonitis you should slowly increase the intensity of your exercise, vary the types of activities you perform, and try not to cycle between periods of activity and inactivity. You shouldn’t train hard when muscles are stiff from a previous workout. You must have proper footwear. You should have new training levels gradually, and train on a variety of surfaces. Proper training should include lower body strength training, aerobic fitness, and lower body flexibility training. Flexibility is the key in preventing peroneal tendonitis.

If you already had peroneal tendonitis, you should know that this condition can return again, but with a good approach to your exercise or activity routine, peroneal tendonitis can often be avoided.