Peroneal Tendinopathy / Tendinitis

What are the Peroneal Tendons?

The peroneal tendon runs behind the lateral malleolus or the bony bit on the outside of the ankle (video). The peroneus longus tendon runs around the back of the lateral malleolus and under the foot to attach at the outside of the first metatarsal and cuniform bones. The peroneus brevis passes around the back of the lateral malleolus and attaches to the outside of the foot on the base of the 5th metatarsal. The muscles act to plantar flex the foot (point foot downwards) and evert the foot.

Symptoms of peroneal tendinopathy

• Pain and swellilng on the outside of the ankle or heel.
• Pain is worse during activity and gets better with rest.
• Pain when pressing in on the peroneal tendons.
• Pain when the foot is passively inverted (stretching the peroneal muscles) and with resisted eversion.
• Calf muscles may be tight.

Causes of peroneal tendinitis

• Running along slopes causing excessive eversion (rolling out) of the foot.
• Tight calf muscles
• Overuse, particularly in dancers or basketball players.
• Overpronation of the foot or excess eversion of the foot.

Treatment of peroneal tendinopathy

• Rest
• NSAID's (non steroidal anti inflammatory drugs) may be prescribed to reduce pain and inflammation.
• Stretching the calf muscles (and peroneal muscles).
• Deep tissue sports massage to the peroneal muscles to reduce tension and help lengthen the muscles.
• In severe cases surgery may be required.