Peroneal tendonitis is inflammation in one or both of the tendons that connect your lower leg to your foot. It’s usually due to overusing the tendons, but it can also be the result of a sudden injury such as an ankle sprain. Pain and swelling in your peroneal tendons usually go away after several weeks of conservative treatments.
Peroneal tendonitis is inflammation in the tendons that run along your outer ankle bone and the side of your foot. These tough bands of tissue connect the muscles in your lower leg to the bones in your foot. They help stabilize and balance your foot and ankle, protecting them from injuries.
This type of foot tendonitis is usually the result of overuse, but it can also happen suddenly if you fall or injure your foot.
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Anyone can get peroneal tendonitis, but it’s more common in people who play sports that involve a lot of ankle movements. You’re also more likely to develop peroneal tendonitis if you:
Peroneal tendonitis isn’t as common as other types of foot tendonitis, such as Achilles tendonitis. In one study of several thousand runners, there were only 13 cases (less than 1%) of peroneal tendonitis.
Peroneal tendon inflammation can develop over time with repetitive overuse of the tendons. Or it might happen suddenly due to an acute ankle injury like a sprain. The tendons or the lubricated sheath that surrounds the tendons can swell, making it hard for them to move smoothly.
Symptoms of peroneal tendonitis may include:
Left untreated, peroneal tendonitis can progress to a tendon rupture. This occurs if your tendon partially or completely tears. Damaged or weakened tendons can also lead to subluxation, which dislocates the tendons. Ruptures or subluxation can cause:
Peroneal tendonitis can be difficult to diagnose. The symptoms are similar to those of other foot and ankle problems, like sprains, arthritis and fractures. One study suggests that out of 40 people with peroneal tendonitis, about 60% were initially misdiagnosed.
Your healthcare provider will perform a physical exam and review your symptoms, though. They may palpate (press) on certain parts of your foot and ankle to check for swelling or tenderness. Your provider might also ask you to perform certain ankle movements to evaluate the range of motion in the joint.
Sometimes imaging is necessary to make sure you don’t have a foot fracture, osteoarthritis, cartilage damage or torn tissue. Your provider might recommend an X-ray, MRI, CT scan or ultrasound, as well.
Conservative treatments usually help relieve tendon pain and inflammation within three to four weeks. Recovery might take longer if tendonitis is the result of another injury, such as a sprain.
Common treatments for peroneal tendonitis include:
If peroneal tendonitis doesn’t improve with conservative treatments, you might need surgery. Surgery consists of cleaning out the damaged outer layers of tissue from your peroneal tendons during a procedure called a synovectomy. Some people may be candidates for a minimally invasive synovectomy, which involves smaller incisions (cuts) and a faster recovery.
Like all surgeries, ankle surgery for peroneal tendonitis does carry some risks such as:
Tips for preventing peroneal tendon pain include:
Most people recover fully from this condition in about a month. Talk to your healthcare provider before getting back to full activities or your sport. Your recovery time from peroneal tendonitis will be longer if you have surgery. After surgery, you'll wear a cast on your lower leg for four to six weeks. You might need crutches for the first few weeks, as well. Your provider can tell you when it’s safe to put weight on your ankle again. Most people need physical therapy after surgery to regain strength and stability in their ankle.
Contact your healthcare provider if you:
A note from Cleveland Clinic
Peroneal tendonitis is irritation or inflammation in the tendons that run along the outside of your ankle and foot. It’s usually due to overexertion and typically heals with a few weeks of conservative treatments. But untreated tendonitis can get worse, leading to a tendon tear. Never try to push through foot or ankle pain. Remember to give your body the rest it needs between periods of intense physical activity.
Last reviewed by a Cleveland Clinic medical professional on 10/27/2021.
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