- Rest. Avoid activities that increase the pain or swelling. …
- Ice. To decrease pain, muscle spasm and swelling, apply ice to the injured area for up to 20 minutes several times a day. …
- Compression. …
- Elevation.

Peroneal tendonitis occurs when the peroneal tendons become inflamed. This happens when there is an increased load and overuse of the tendons, leading to them rubbing on the bone.
This friction causes the tendons to swell. Over time, the tendons will thicken in size to try and manage the increased load more efficiently.
Peroneal tendonitis is particularly common in athletes and especially runners, as they are more likely to make their feet roll outwards, causing friction between the tendon and bone.
The peroneal tendons are located in the foot, attaching muscle to bone. They assist with weight-bearing and stability.
A tendon is a band of tissue that attaches muscle to bone.
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.
One peroneal tendon attaches to the outside of the foot at the base of the little toe (fifth metatarsal). The other tendon goes underneath the foot and attaches to the inside of the arch.
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.
People who take part in a sport that involves repetitive ankle motion are most prone to peroneal tendonitis.
Factors that can contribute to peroneal tendonitis include:
- overuse
- a sudden increase in training, particularly weight-bearing activities, such as walking, running and jumping
- improper training techniques
- inadequate or unsupportive footwear
There are also some other issues that can increase a person’s risk of developing peroneal tendonitis:
- higher foot arches
- lower limb muscles and joints not working well together
- imbalanced muscles in the lower limbs
If someone fails to complete a rehabilitation program following an ankle injury, such as a sprain, they are also more likely to develop peroneal tendonitis.
Over time, the damaged peroneal tendons will thicken as scar tissue tries to repair the damaged area. This makes the tendons weaker and more prone to tearing.
Peroneal tendonitis can either be acute, meaning that it comes on suddenly; or it can be chronic, meaning that it develops over time.
In both cases, there are some common symptoms:
- pain at the back of the ankle
- pain that worsens during activity and lessens during rest
- pain when turning the foot in or out
- swelling at the back of the ankle
- instability of the ankle when bearing weight
- the area is warm to the touch
To begin with, the doctor will discuss the person’s medical history with them. This will often point to overuse, increased activity, or some other cause of peroneal tendonitis.
It is important to determine that the pain is in the peroneal tendons and not the fibula, as this could indicate a different problem.
A physiotherapist or doctor will use a variety of techniques in a physical exam to look for symptoms, generally by moving the foot and ankle into different positions and applying pressure.
An X-ray, ultrasound, or MRI scan might also be used to rule out any breaks, identify abnormal swelling or scar tissue, and further help with diagnosis.

*Disclaimer: This information is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider.
Please consult your healthcare provider with any questions or concerns you may have regarding your condition.
The information provided is for educational purposes only and is not intended as diagnosis, treatment, or prescription of any kind. The decision to use, or not to use, any information is the sole responsibility of the reader. These statements are not expressions of legal opinion relative to the scope of practice, medical diagnosis, or medical advice, nor do they represent an endorsement of any product, company, or specific massage therapy technique, modality, or approach. All trademarks, registered trademarks, brand names, registered brand names, logos, and company logos referenced in this post are the property of their owners.