What Is Peroneal Tendinitis?
Peroneal tendinitis occurs when the peroneal tendons become irritated or inflamed. Two peroneal tendons run along the outside of the ankle and foot and help support the ankle during movement.
Repetitive stress, overuse, or excessive strain on these tendons can lead to pain and inflammation. The condition may develop gradually, particularly in people who participate in activities involving repeated ankle movement.
Common Causes of Peroneal Tendinitis
Peroneal tendinitis may develop due to several factors, including:
- Repetitive ankle movements associated with running, jumping, or sports involving frequent changes in direction
- Overuse or a sudden increase in physical activity
- Previous ankle sprains or chronic ankle instability
- High-arched feet, including a cavovarus foot structure
- Unsupportive or worn footwear
- Walking or running on uneven surfaces
In some cases, more than one factor may contribute to increased stress on the peroneal tendons.
Symptoms of Peroneal Tendinitis
Symptoms may include:
- Pain along the outer side of the ankle or foot
- Swelling or tenderness around the outside of the ankle
- Pain that becomes more noticeable during physical activity
- A feeling of weakness or instability in the ankle
- Snapping or popping sensations in some cases
Symptoms often develop gradually and may become more noticeable with continued activity.
How Is Peroneal Tendinitis Diagnosed?
Diagnosis typically begins with a physical examination of the foot and ankle. The evaluation may include assessment of the location of pain and tenderness, ankle stability, tendon function, and overall foot alignment.
When additional evaluation is necessary, imaging may be used to examine the tendons and surrounding structures. This may include:
- MRI: May be used to evaluate inflammation, tendon damage, or tears.
- Ultrasound: May be used to assess the tendons and observe their movement dynamically.
The findings from the examination and any necessary imaging help determine the appropriate approach to treatment.
Treatment Options for Peroneal Tendinitis
Treatment depends on the severity of symptoms, the condition of the peroneal tendons, and whether underlying foot or ankle problems are contributing to the condition. Conservative treatment is generally considered first.
Non-Surgical Treatment
Non-surgical treatment may include:
- Rest and activity modification: Activities that increase pain or place additional stress on the tendons may need to be temporarily reduced or avoided.
- Ice and anti-inflammatory medications: These may help manage pain and inflammation when appropriate.
- Supportive footwear: Shoes that provide appropriate support and cushioning may help reduce stress on the peroneal tendons.
- Orthotics: Custom or over-the-counter inserts may be used to improve foot support and address alignment that contributes to tendon strain.
- Ankle brace or walking boot: Additional support or temporary immobilization may be recommended to reduce stress on the tendons during healing.
- Physical therapy: Rehabilitation may focus on stretching tight calf muscles, strengthening the muscles of the foot and ankle, and improving balance and proprioception.
The type and duration of conservative treatment depend on the individual condition and severity of symptoms.
When Is Surgery Considered?
Surgery may be considered when symptoms continue despite an appropriate period of non-surgical treatment or when the tendon has sustained significant damage.
Surgical treatment may also be considered when structural problems of the foot or ankle contribute to persistent tendon symptoms.
Surgical Treatment Options
The surgical approach depends on the condition of the peroneal tendons and any associated structural problems identified during evaluation.
Treatment may include:
- Removing damaged or unhealthy tendon tissue
- Repairing a torn or damaged tendon
- Stabilizing the peroneal tendons when instability is present
- Addressing underlying foot alignment when it contributes to continued stress on the tendons
The appropriate procedure is determined according to the specific tendon injury, foot and ankle structure, and individual clinical findings.
Recovery
Recovery from peroneal tendinitis depends on the severity of the condition, the extent of tendon involvement, and the type of treatment required.
With conservative treatment, activity is typically resumed gradually as symptoms improve and strength and stability return.
Recovery following surgery varies depending on the procedure performed and the condition of the tendon. Rehabilitation may include a gradual progression of movement, strengthening, and return to activity under medical guidance.
When to Seek Medical Care
Evaluation by a foot and ankle specialist may be appropriate if:
- Pain persists or becomes worse
- Swelling does not improve
- The ankle repeatedly feels unstable
- Symptoms interfere with everyday activities or sports
Persistent symptoms may require further evaluation to determine whether tendon damage, instability, foot alignment, or another underlying problem is contributing to the condition.
Key Takeaway
Peroneal tendinitis is a condition affecting the tendons along the outer side of the ankle and foot. Symptoms can often be managed with conservative treatment, while persistent symptoms, significant tendon damage, or underlying structural problems may require additional treatment.
A thorough evaluation can help identify the factors contributing to the condition and determine an appropriate treatment approach.
Your Surgeon for Peroneal Tendinitis Treatment on Long Island
Kristian Efremov, MD, PhD, is a fellowship-trained orthopedic foot and ankle surgeon. He evaluates and treats peroneal tendinitis for patients across Nassau and Suffolk County at NYU Langone Ambulatory Care East Meadow, 1530 Front Street, Suite 200, East Meadow, NY 11554.
Options covered on this page range from non-surgical care to removing damaged tendon tissue, tendon repair and tendon stabilization. The right option depends on your exam, imaging and goals.
Dr. Efremov completed his foot and ankle surgery fellowship at New England Baptist Hospital and is a Clinical Assistant Professor in the Department of Orthopedic Surgery at NYU Grossman Long Island School of Medicine.
To request an appointment, call (516) 324-7500 or read more about Dr. Efremov.
Medical Disclaimer. The information provided on this website is intended for general educational and informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare professional regarding any medical condition, symptoms, or treatment options.