Peroneal Tendonitis

Pain and Swelling Around the Outer Edge of Foot or Ankle

What could be my problem?

Peroneal tendons run on the outside of the ankle just behind the bone called the fibula to the outside edge of the foot to the base of the fifth metatarsal.  When peroneal tendonitis occurs there is enlargement and thickening with swelling of the tendon.

What causes Peroneal Tendonitis?

  • Usually the result of overuse due to repetitive activity that irritates the tendon over long periods of time.
  • Improper athletic training or rapid increases in training
  • Improper footwear
  • People with a hind foot various posture, where the heel is slightly turned inwards requiring the peroneal tendons to work harder

When to see a doctor for foot pain that could be Peroneal Tendonitis:

  • If you have pain and swelling around the outer edge of the foot and/or the back of the ankle.

If I have Peroneal Tendonitis, what are my treatment options?


  •   Rest
  •   Ankle brace
  •   Walking boot
  •   Custom orthotics for hind foot various deformity
  •   Proper footwear to support the foot structure
  •   Physical therapy


If foot and/or ankle pain continues after four to six weeks of conservative treatment, one or more of the following surgical procedures may be indicated for proper healing:

  • An incision is made along the outside of your foot or ankle, the foot surgeon opens the sheath surrounding your peroneal tendons and inspects the tendons for any tears.   If less than 50% of the tendon has tears running through it the tendon tissue usually can be sewn back together with sutures.
  • If more than 50% of the tendon is torn or frayed then your surgeon generally performs a procedure called tenodesis. The damaged portion of the tendon is cut away and the remaining portion is sutured to the other peroneal tendon next to it.

In cases where the tendon has dislocated, the tissue that typically holds your peroneal tendons in the tunnel behind your fibula is loose. Suturing this tissue (retinaculuar) back to itself can tighten the tendon tunnel. A tighter tunnel helps prevent further tendon dislocations.