Peroneal tendonitis is a common cause of foot and ankle pain secondary to inflammation. This happens when there is an increased load and overuse of the tendons, leading to them rubbing on bone. This friction causes the tendons to swell. Over time, the tendons thicken in size to try and manage the increased load. Peroneal tendonitis is particularly common in athletes especially runners.

There are two peroneal tendons in each leg. They run side by side down the lower leg bone (fibula) and behind the bony lump on the outside of the ankle called the lateral malleolus.

The peroneus brevis is the shorter of the two tendons and it attaches to the base of the fifth metatarsal, while the peroneus longus starts laterally and turns to run along the bottom of the foot to attach to the base of the first metatarsal.

The peroneal tendons provide stability to the ankle when it is bearing weight and protects it from sprains. They also help turn the foot out and stabilize the arch when walking. The amount of stress placed on the peroneal tendons varies depending on what type of foot structure you have.


  • Overuse leading to inflammation
  • High arch foot
  • Acute increase of activity
  • Improper training techniques
  • Unsupportive footwear

Signs & Symptoms

  • Pain along the course of the tendons
  • Warm to touch along tendons
  • Pain when turning the foot in or out
  • Instability of the ankle when bearing weight
  • Pulling or tearing sensation along tendons when walking

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