Peroneal Tendonitis: Causes, Symptoms, and Treatment Options

Peroneal tendonitis is a common overuse injury that affects the peroneal tendons located on the outer side of the lower leg and ankle. This condition can cause pain, swelling, and discomfort, impacting daily activities and athletic performance. In this article, we'll explore the causes, symptoms, and treatment options for peroneal tendonitis to help you better understand this condition and manage its effects.


Peroneal tendonitis can result from various factors, including:

  • Overuse: Repetitive strain on the peroneal tendons, often due to activities like running or jumping, can lead to inflammation and irritation.
  • Biomechanical Issues: Foot and ankle alignment issues, such as overpronation or high arches, can place excessive stress on the peroneal tendons, increasing the risk of tendonitis.
  • Poor Footwear: Wearing inappropriate or worn-out shoes can exacerbate biomechanical issues, contributing to peroneal tendonitis.
  • Trauma: A sudden injury or direct impact to the peroneal tendons may result in inflammation and tendonitis.
  • Tight Calf Muscles: Tightness in the calf muscles can increase strain on the peroneal tendons, making them more susceptible to injury.


Common symptoms of peroneal tendonitis include:

  • Pain: This may be felt along the outside of the lower leg or ankle, often worsening with activity or weight-bearing.
  • Swelling: Inflammation in the affected area may cause visible swelling or a thickened appearance of the tendon.
  • Tenderness: The area around the peroneal tendons may be tender to touch.
  • Warmth: The inflamed area may feel warm due to increased blood flow.
  • Weakness or Instability: Peroneal tendonitis can cause a sense of weakness or instability in the ankle, making it difficult to perform certain activities.

Treatment Options

The treatment for peroneal tendonitis typically involves conservative measures, including:

  • Rest: Taking a break from activities that cause pain and discomfort can help the affected tendons heal.
  • Ice: Applying ice to the inflamed area for 15-20 minutes several times a day can help reduce swelling and pain.
  • Compression: Wearing a compression bandage or ankle brace can provide support and help manage inflammation.
  • Elevation: Keeping the affected leg elevated above the heart level, particularly during rest periods, can help reduce swelling.
  • Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Over-the-counter medications like ibuprofen or naproxen can help alleviate pain and inflammation.
  • Physical Therapy: A physical therapist can design an individualized exercise program to improve flexibility, strength, and stability in the ankle and lower leg, promoting recovery and preventing future injuries.
  • Orthotics: Custom-made orthotics or supportive footwear may be recommended to correct biomechanical issues and alleviate strain on the peroneal tendons.
  • Activity Modification: Adjusting your exercise routine or incorporating cross-training activities can help prevent overuse and reduce the risk of peroneal tendonitis.

In rare cases, when conservative treatments fail to provide relief or if the tendon is severely damaged, surgery may be necessary to repair the injured tendon.


Preventing peroneal tendonitis involves addressing potential risk factors and practicing good self-care. Some preventative measures include:

  • Proper Footwear: Wearing appropriate, well-fitting shoes that provide adequate support and cushioning is essential.
  • Gradual Progression: When starting a new exercise routine or sport, it's crucial to progress gradually and avoid suddenincreases in intensity or duration, which can lead to overuse injuries.
  • Strength and Flexibility Training: Incorporating strength and flexibility exercises into your fitness routine can help improve the overall function and stability of the ankle and lower leg. This may include exercises targeting the calf muscles, peroneal muscles, and ankle stabilizers.
  • Warm-Up and Cool-Down: Always take the time to warm up before engaging in physical activity and to cool down afterward. This can help to prepare your muscles and joints for exercise, reduce the risk of injury, and promote recovery.
  • Regular Stretching: Stretching your calf muscles and the muscles along the outside of the lower leg can help to maintain flexibility and reduce strain on the peroneal tendons.

Peroneal tendonitis is a common overuse injury that affects the outer side of the lower leg and ankle, causing pain, swelling, and discomfort. Understanding the potential causes, symptoms, and treatment options for this condition is crucial for effective management and recovery. By incorporating preventative measures, such as proper footwear, gradual progression, strength and flexibility training, warm-up and cool-down routines, and regular stretching, you can reduce the risk of developing peroneal tendonitis. If you're experiencing persistent pain or discomfort, it's essential to consult a healthcare professional for a thorough evaluation and personalized treatment recommendations.