Peroneal tendonitis

The tendons of peroneus longs and peroneus braves run from the peroneal muscles in the lateral calf to the foot. The peroneal muscles are involved in stabilising the foot and providing support to the ankle to prevent lateral rolling of the joint. Peroneal tendinitis is most commonly a result of overuse of the peroneal muscles or of inversion sprains which stretch the peroneal muscles have to work harder to stabilise the foot when it is printed.

Running and jumping involve repeated contraction of the peroneal muscles and can lead to  inflammation of their tendons. Runners who often run on uneven surfaces or have excessive pronation often develop peroneal tendinitis.

Cause of injury

Over-pronation of the foot during running or jumping. Prior ankle injury leading to an incorrect path of travel for the tendons.

Signs and symptoms

Pain and tenderness along the tendons. Pain is most severe at the beginning of the activity and diminishes as the activity continues. Gradual increase in pain over time.

Complications if left unattended

Unattended tendinitis can lead to a complete rupture of the tendons. Peroneal tendinitis can lead to subluxations. The chronic inflammation can also lead to damage to the ligaments surrounding the tendons.

Immediate treatment 

Rest, especially from running or jumping activities. Ice. Anti-inflammatory medication.

Rehabilitation and prevention

Stretching of the calf muscles and a gradual reintroduction into activity is important for rehabilitation. During the recovery period it is important to identify and correct  any foot or gait abnormalities that may be contributing to the problem. Prevention of this condition requires strong, flexible muscles of the lower leg to support the foot and ankle.

Long-term prognosis 

With proper treatment, peroneal tendinitis will usually heal completely with no lingering effects. In rare cases the tendinitis may not respond to traditional treatment and may require surgical intervention to relieve the pressure causing the inflammation. Orthotics to support the medial arch may be required in some cases.

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