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Peroneal Tendonitis

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Peroneal tendonitis is a condition affecting the peroneal tendons that run along the outer ankle and then behind it. These tendons become sore and inflamed as a result of overuse. This leads in turn to pain and swelling on the outside of the ankle, over the peroneal tendon area. This pain and swelling are the main symptoms of peroneal tendonitis. Its main cause is excessive use of the ankle in activities requiring repetitive foot movements. Peroneal tendonitis is sometimes also a result of a sudden increase in training intensity among athletes without proper preparation.  Treatment of peroneal tendonitis involves resting the ankle by keeping weight off it as much as possible. It usually also requires icing, compression and elevation.This is one of five tendonitis subtypes that fall under the umbrella term of ankle tendonitis.

What Are The Main Causes Of Peroneal Tendonitis?

This type of ankle tendonitis occurs when overloading the peroneal tendons causes them to rub against the adjacent bones. It is frequently observed among avid runners or other athletes in sports that require plenty of running. These athletes have tendencies to make their feet roll outwards while running. This in turn causes friction between the peroneal tendons and the bones to which they are attached.

Peroneal tendonitis can also be a result of wearing footwear with inadequate foot support In some cases, it is also attributable to incorrect training techniques. In some cases, there may be anatomical factors at play. If you have unusually high arches or muscle imbalance in your lower limbs, you are more at risk of developing this type of tendonitis.

If you sprain your ankle and do not properly rehabilitate it before returning to normal activity, that can also  lead to peroneal tendonitis.


Symptoms of peroneal tendonitis  can include some or all of the following:

  • Pain at the back of the ankle, or when you try to twist the foot sideways (the peroneal tendons play a key role in this type of movement);
  • The pain gets worse when you are active and subsides when you are not;
  • Warmth and swelling at the back of your ankle.

If your injury is on the severe side, you may feel as though your ankle is “giving way” when you try to place weight on it.

Treatment Of Peroneal Tendonitis

Treatment of this condition almost always requires resting the ankle.  Avoid strenuous activity for a while and try to keep your weight off the injured ankle if possible. If you do need to move around, consider using crutches while the injury heals.

A walking boot or ankle brace can provide additional support to the ankle and aid the healing process.

Additional treatments for peroneal tendonitis may include:

  • Icing the ankle regularly, or using a topical analgesic;
  • Taking NSAID medications like aspirin for further control of pain and inflammation;
  • Whenever possible, elevating your ankle above the level of your heart while sitting or lying down;
  • Applying compression to your ankle using an elastic bandage, for example.

If the peroneal tendonitis does not respond to the above treatments, your physicians may suggest anti-inflammatory cortisone injections. However, be aware that these can result in more serious damage in the form of tendon rupture.

Another possible treatment option is tendon release. This is a surgical procedure under which excess tissue around the tendons (that may be causing irritation and inflammation)  is removed. Except for this procedure, surgery is not usually necessary to treat peroneal tendonitis.

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