Peroneal tendonitis is an inflammatory disorder that affects the peroneal tendons. Unlike Achilles and patellar tendon injuries, these injuries are uncommon and are caused due to overuse or injury, resulting in discomfort, inflammation, and pain. Let’s understand the symptoms of peroneal tendonitis and possible peroneal tendonitis treatments.

What are Peroneal Tendons and Peroneal Tendonitis?

Understanding peroneal tendons is crucial before addressing the treatments of peroneal tendonitis. A tendon is a strip of connective tissue that connects muscle to bone, and there are two peroneal tendons in total in each leg. They run parallel to one another along the lower leg bone (fibula) and behind the bony bulge outside the ankle, known as the lateral malleolus. 

One peroneal tendon joins to the outside of the foot near the base of the little toe (fifth metatarsal). The other tendon runs below the foot and connects to the underside of the arch. These tendons roll the foot outward and aid your calf muscles in plantar flexing. They also help stabilize your ankle during weight-bearing activities. 

Peroneal tendonitis is a condition where the peroneal tendons get swollen. Whenever these tendons get swollen, it can lead to pain and discomfort, rendering walking or engaging in physical activity difficult. 

Causes of Peroneal Tendonitis

Individuals participating in sports requiring repeated ankle motion are more likely to develop peroneal tendonitis. Athletes who participate in sports that involve quick, jerky motions, such as basketball or soccer, are more prone to getting peroneal tendonitis. Consider the following reasons that can contribute to peroneal tendonitis:

  • Overuse.
  • An abrupt increase in training, particularly weight-bearing exercises, such as walking, running, and leaping.
  • Poor training practices.
  • Wearing shoes that are too small or too narrow.
  • Some factors that might raise a person’s chance of getting peroneal tendonitis include:
  • Foot arches that are higher than normal.
  • Improper coordination between the lower limb muscles and joints.
  • Muscle imbalance in the lower limbs.

Symptoms of Peroneal Tendonitis

Peroneal tendonitis treatment begins with assessing the severity of the injury and identifying any contributory variables. Peroneal tendonitis causes a sharp or agonising feeling along the tendons or on the outer side of your foot. 

This condition can also be acute and worsens gradually over time. Several symptoms are present in both cases:

  • Ankle soreness towards the back.
  • Pain intensifies with exercise and improves with rest.
  • Foot pain when turning in or out.
  • Swollen ankle.
  • Ankle instability when carrying weight.
  • The swollen area is warm to the touch.

Treatments for Peroneal Tendonitis

While surgery is necessary for some circumstances, excellent non-surgical peroneal tendonitis treatment can assist you in getting back on your feet. The great majority of instances of peroneal tendinosis recover without surgery. It is because it is an overuse injury that is healed with rest. Early detection and treatment improve the chances of effective conservative therapy.

  • The First Line Of Defence: Rest And Ice

Rest and ice are crucial as the first line of defence in treating this condition. Reducing inflammation and giving your body the time it needs to heal can be accomplished by resting the injured foot and avoiding activities that strain the peroneal tendons. 

Applying ice to the affected area for 15-20 minutes can reduce pain and swelling. You should be careful concerning the pressure used to apply the ice pack.

  • Physiotherapy

Physiotherapy is frequently required to address the underlying problems that may have contributed to peroneal tendonitis. Exercises to increase the strength and flexibility of the afflicted foot and ankle can be included in a personalised treatment plan made by your physical therapist. 

It could entail functional exercises, stretching, and range-of-motion exercises to lessen the strain on the peroneal tendons and speed up recovery. A physical therapist can also advise on appropriate footwear to ease the discomfort of daily activities while the foot heals.

  • Bracing and Compression

Peroneal tendonitis can be effectively managed with bracing and compression, especially when combined with other non-surgical treatments. Stabilising the foot and ankle with a brace or support can lessen the strain on the tendons and speed up healing. 

By improving circulation to the affected area, compression sleeves or wraps can also aid in reducing swelling. 

Orthotic: A Long-Term Solution

While peroneal tendonitis can be immediately relieved with bracing and compression, a custom orthotic is required for long-term management. An orthotic can treat peroneal tendonitis symptoms long-term and stop future flare-ups when used correctly. 

An orthotic can treat long-term peroneal tendonitis symptoms and stop future flare-ups when used correctly. Your doctor can suggest or prescribe a suitable orthotic based on your requirements and way of life. 

  • NSAIDs and Corticosteroid Injections 

Over-the-counter NSAIDs (nonsteroidal anti-inflammatory medicines)  such as ibuprofen or naproxen are also used to treat peroneal tendonitis. NSAIDs are used to reduce inflammation and for pain management. 

However, prescription-strength drugs are required for more severe pain. Nevertheless, these drugs can provide pain relief and reduce swelling but won’t be able to treat the underpinning cause of peroneal tendonitis.

  • Platelet Rich Plasma Treatment

Platelet-rich plasma treatment may be beneficial if you have sore tendons on the outside of your ankle. It employs components of your blood to assist your body in healing itself. PRP may help your ankle feel and function better. 

Platelet-rich plasma (PRP) treatment can expedite the body’s healing process, which can shorten healing times and lessen pain in the injured area. This non-surgical approach is gaining popularity for treating various ailments, such as arthritis and sports injuries.

Surgical Options for Peroneal Tendonitis

Surgery may be necessary if conservative therapies like rest, physical therapy, and medication are ineffective in treating peroneal tendonitis. Depending on how serious the condition is, there are various surgical options. Surgeons treat peroneal injuries using a variety of surgical procedures. Among these techniques are:

  • Tendon Debridement and Synovectomy

Your surgeon creates an incision in your ankle to remove degenerated and inflammatory tissues and the damaged tendon membrane. It has the potential to be utilised to treat tendinitis. Reliable Source.

  • Tendon Debridement and Tubularization

The damaged portion of your tendon is removed, and sutures are used to heal it. This procedure may be used to repair a partly torn tendon.

  • Arthroscopic Peroneal Tendoscopy

Arthroscopic peroneal tendoscopy involves inserting a lengthy tube with a camera into your tendon sheath. You require special equipment to remove the injured tissue. The majority of studies show satisfactory to outstanding performance with minor problems.

  • Endoscopic Retinaculum Repair

If your peroneal tendons shift from their normal placement, the band of tissue that maintains them in place might get injured. This tissue may require surgical repair via an endoscopic technique. An endoscope is a long, thin tube that contains a camera and other instruments.

  • Allograft or Autograft Reconstruction

An autograft uses connective tissue from another body region to heal your tendon. Allograft tissue from a donor is used to mend it.

Your condition will dictate the surgical approach, but you must discuss all options with your doctor to determine your best course of action. Rehabilitation following surgery is crucial for guaranteeing a complete recovery and minimizing the risk of complications.


A combined peroneal tendonitis treatment plan is the most effective way to get the greatest possible healing outcomes. This strategy frequently combines non-surgical therapies like physical therapy and orthotics with surgical alternatives for severe or chronic situations.  

Treatment for peroneal tendonitis includes stretching, strengthening, mobilisation, manipulation exercises, proprioceptive and balance exercises, ice, and ankle bracing. The rehabilitation regimen allows you to adapt to the requirements and goals of the particular patient. 

Exercise, stretching, and strengthening can help recover a complete range of motion and strength in the afflicted region. The patient must follow the directions of their healthcare professional and attend all planned visits. Failure to do so may cause a delay in healing and a longer recovery period.

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