Peroneal Tendonitis: Understanding the Condition and Its Treatment

Peroneal Tendonitis: Understanding the Condition and Its Treatment

Peroneal tendonitis, characterized by inflammation of the tendons connecting the lower leg to the foot, is a condition often brought on by overuse or sudden injury, such as an ankle sprain. Here's what you need to know about peroneal tendonitis:

What is Peroneal Tendonitis?

Peroneal tendonitis involves inflammation of the tendons running along the outside of the ankle and foot, connecting lower leg muscles to foot bones. These tendons play a crucial role in stabilizing and balancing the foot and ankle.

Who is Prone to Peroneal Tendonitis?

While peroneal tendonitis can affect anyone, it is more common in individuals participating in sports requiring significant ankle mobility. Risk factors include being over 40, lack of pre-exercise stretching, certain medical conditions like diabetes or arthritis, previous tendon injuries, high arches, obesity, tense tendons, and smoking.

How Common is Peroneal Tendonitis?

Although less common than other foot inflammations like Achilles tendinitis, peroneal tendonitis can still occur. Studies suggest a prevalence of less than 1% among runners.

Causes and Symptoms of Peroneal Tendonitis

Peroneal tendonitis can develop gradually due to repetitive tendon overuse or suddenly from acute ankle injuries. Symptoms may include ankle pain along the tendon, worsening pain with activity, swelling, warmth, tenderness, and the presence of a movable lump or nodule along the tendon.

Complications and Diagnosis

If left untreated, peroneal tendonitis can lead to tendon rupture or subluxation, causing instability, severe pain, and a snapping sensation. Diagnosis may be challenging, often requiring a physical exam and imaging tests like X-rays, MRIs, or CT scans to rule out other conditions.

Treatment Options

Conservative treatments typically alleviate symptoms within a few weeks and may include:

  • Wearing supportive footwear, such as DrLuigi medical shoes
  • Immobilization with a soft cast or boot
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) for pain and inflammation
  • Steroid injections around the tendon
  • Physical therapy involving exercises, stretches, and modalities like ice or heat therapy
  • Following the RICE method (rest, ice, compression, elevation)

Surgical Intervention

In cases where conservative measures fail, surgery like synovectomy may be necessary to remove damaged tissue surrounding the tendons. Less invasive procedures with shorter recovery times may be available for suitable candidates.


Peroneal tendonitis, though less common, can significantly impact foot function and mobility. Understanding its causes, symptoms, and treatment options is crucial for effective management and prevention of complications. Early diagnosis and appropriate treatment can help individuals recover and regain optimal foot health and function.

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