Peroneal tendinopathy is an injury to the peroneal tendons. These tendons run along the outside of each ankle bone. You may have inflammation or a small tear in them. Pain can be acute (short, sharp, or intense) or chronic (long-lasting). Tendinopathy is often a chronic (long-lasting) condition.

This injury can be treated. Contact your doctor if you think you may have it.


Peroneal tendinopathy often occurs as a result of:

  • Repetitive overuse injuries (eg, injuries from regular activities like racket sports, basketball, skiing, and manual work)
  • Acute trauma to the ankle (eg, a sudden twisting of the ankle or foot)
  • Inversion of a sprained ankle (the ankle turns inward)
  • Overstretching of foot (for people with a high arched foot)

Risk Factors

These factors increase your chance of this injury. Talk to your doctor if you have any of these risk factors:

  • Having feet that are turned inward slightly or a high arched foot
  • Previous ankle sprain or injury
  • Ankle instability (bad or weak ankles)

Sports enthusiasts are at greater risk of ankle injuries.


If you have any of these do not assume it is due to peroneal tendinopathy. These symptoms may be caused by other conditions. Tell your doctor if you have any of these:

  • Along the bottom of the foot or side of the ankle:
    • Pain
    • Tenderness or swelling
    • Redness or warmth
  • Ankle instability or weakness
  • Prolonged discomfort after a simple sprain


Your doctor will ask about your symptoms and medical history. A physical exam will be done. You may see a specialist for diagnosis and treatment.

Tests may include the following:

  • Range of motion tests
  • Other physical tests for sensation, strength
  • Imaging tests such as:
    • MRI scan—a test that uses magnetic field and radio waves to make pictures of structures inside the body
    • Ultrasound—a test that uses sound waves to examine the inside of the body
    • Stress radiography—an x-ray that looks at the bone(s)
    • CT scan—a type of x-ray that uses a computer to make pictures of structures inside the body
  • Injection procedures such as:
    • Diagnostic injection with anesthetic—a special injection that relieves and helps determine the source of the pain


Talk with your doctor about the best plan for you. Treatment options include the following:


A cast, splint, or brace may be needed. They will help keep your foot and ankle from moving. You may be asked to wear special shoes or inserts. It may also be best to stay off inclined surfaces.


Your doctor may give you medications for pain. This can include:

Steroid injections may also be prescribed to relieve pain. Care must be taken with injections. There is a possibility of tendon rupture after steroid injection.


You may need surgery to repair the tendon or other structures of your foot.

Physical Rehabilitation

Often after surgery, physical therapy is needed. Therapy will help to regain strength and range of motion within the foot and ankle.


To help reduce your chance of getting peroneal tendinopathy, take the following steps:

  • Do not put yourself at risk for trauma to the ankle.
  • Make sure your ankle sprain is fully healed before returning to activities.
  • Build strong muscles. Stay active and agile. Try to commit to a regular strength training program that includes your ankles and feet. Always warm up before exercising with calf stretches and heel lifts.