Think You Have Peroneal Tendonitis?

Peroneal tendonitis is not the most common tendonitis of the ankle. Could this be the cause of your ankle joint pain? What does this tendon do? How do you know if this tendon is inflamed? And what can you do for it?

What are the Peroneal Tendons?

The peroneal tendon is located on the lateral or outside aspect of the ankle. There are two peroneal tendons; the longus and the brevis. Both travel behind the lateral ankle bone.The brevis attaches to the base of the 5th toe and the longus travels under the arch and attaches to the bottom of the foot.

Peroneal Tendons

The peroneal tendons function in assisting with moving the ankle both down and laterally or out to the side. It also helps in performing lateral ankle stability with activities that involve side to side movement.

Peroneal Movement

What is Peroneal Tendonitis?

Tendonitis of one or both of these tendons simply means an inflammation of the tendons. Tendons often become inflamed with over use. Agility activities such as tennis, basketball, volleyball, and soccer can all place significant stress on these lateral tendons.

In addition, if you have had previous ankle sprains, the possibility of having peroneal tendon issues increases. When ligaments become torn or stretched, they are unable to provide the stability they are designed to. When this occurs, the lateral tendons are required to work harder in order to provide that lateral stability.

Typical Signs and Symptoms

The most common symptoms of tendonitis of the peroneal tendons are lateral ankle pain and swelling. Pain will generally be immediately behind the lateral ankle bone.

Peroneal Tendonitis Symptoms

Another symptom related to the peroneal tendons is tendon snapping. Subluxation of the peroneal tendons can occur following a significant lateral ankle sprain. When a significant ankle sprain occurs, it can disrupt the tissue (called the retinaculum) that keeps the tendons in place. If these tendons are allowed to move easily they can become inflamed and painful.

Peroneal Subluxation

Typical Treatment

Like many types of tendonitis, the first goal is reducing inflammation. The use of ice therapy can be specifically helpful in reducing tendon inflammation. Because the tendons are superficial, they respond well to ice massage. To utilize ice massage, fill Styrofoam cups with water and freeze them. Once frozen, peel off the top of the cup exposing the ice. Massage the ice over the painful tendon area for 5 minutes and repeat a few times a day.

The use of anti-inflammatory medication is also commonly used for tendonitis (consult your doctor regarding medication). Because of the superficial nature of the tendons, the use of an anti-inflammatory cream such as Voltaren gel can be effective.

Avoiding activities that recreate pain is important in reducing inflammation. Modify activity until symptoms improve.

If pain persists, the use of an immobilizer may be suggested. The goal is to limit all activity of the tendon in order to all it to heal. The length of immobilization will be based on the extent of the symptoms.


Surgical intervention is rarely warranted with tendonitis of the peroneals. Surgery should only be considered if significant pain persists and conservative treatment has failed. If surgery is recommended, it is most commonly associated with subluxation of the tendons.

Physical Therapy

Formal physical therapy can be greatly helpful in reducing pain associated with peroneal tendonitis. Modalities such as ultrasound, iontophoresis, and electric stimulation can all be effective in reducing pain and inflammation. Manual soft tissue massage can help to reduce the thickness that accumulates around inflamed tendons.

Peroneal tendonitis does not have to been an issue that keeps you off the sidelines for long. Follow the conservative treatment recommendations and you can be back on your feet in no time.

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