Peroneal Tendonitis

The peroneal tendons run on the outside of the ankle and connect the lower leg muscles to the foot. These tendons allow the foot to turn outwards and provide stability to the ankle during weight bearing activities. Inflammation of these tendons causes pain and swelling on the back and outside of the ankle.

Causes and risk factors

  • Overuse or rapid increase in training from activities such as running
  • Improper footwear
  • Patients with a hindfoot varus posture (heel is slightly turned inwards)


  • Pain in back and outside of ankle
  • Pain with inversion (turning inward) of the foot
  • Feeling of weakness with eversion (turning foot outwards)

Diagnosis and treatment

Most cases of peroneal tendinosis heal without surgery. Your orthopedic surgeon may recommend rest, ice, non-steroidal anti-inflammatories (NSAIDS), a walker boot, or physical therapy. New shoes or orthotics may be recommended when the patient resumes activities. If the tendon has torn and requires surgery, it may need to be cleaned out and repaired. In severe cases, the two tendons may need to be connected surgically to heal.