What is peroneal tendinopathy?  

Screenshot 2020-06-17 at 13.19.35Peroneal tendinopathy is an irritation to the tendons that are located on the lateral (outside) of the ankle; this includes both the peroneal longus and brevis tendons. 

Peroneal tendinopathy is most commonly diagnosed by a physiotherapist or other healthcare professional by a thorough history and examination; in some cases imaging (e.g. Ultrasound Scan or MRI) may be used to aid diagnosis.  

The condition typically takes between 3-9 months to resolve with the appropriate treatment and advice but in some acute cases it can resolve quicker.   


Signs and symptoms
  • Pain to the outer ankle and foot particularly on walking, running, turning.  
  • Swelling  
  • Startup pain first thing on a morning or after a long period of rest  
  • Weakness in foot (particularly on moving the foot outwards (everting). 
  • Burning and altered sensation – the sural nerve is located at the lateral ankle and can become more irritable due to the local inflammation.  
  • In some cases the tendon may feel like it is ‘popping’ or subluxing in and out of the groove behind the ankle.  
What are the causes and risk factors?

There are a number of risk factors and causes identified for peroneal tendinopathy including: 

  • Sudden increase in load or force through the lateral ankle.  
  • Altered foot biomechanics can predispose to excess forces through the lateral ankle (e.g pes cavus (high arches).  
  • Poor footwear  
  • Obesity –Weight increases the force through the tendons and can cause problems. 
Treatment options

Anti-inflammatory medication – In the early stages in can be useful to decrease the inflammatory response from the tendons. Consult your GP or pharmacist.  

Ice pack – This can again help reduce inflammation in the early stages; apply for 20 mins 2-3 x per day. Wrap the bag of ice in a thin tea towel/ material to prevent burns to the skin. 

Activity modification – Try to reduce those activities which exacerbate symptoms in the short term. Once your pain has started to settle gradually build these activities back up.  

Cross training – If you are finding that running is aggravating your symptoms it may be advisable to stop for a short period and start to cross train with activities such as swimming and cycling before starting running again.   

Orthotics – Some insoles can be beneficial if your foot position is impacting on your symptoms.  

Bracing/Taping – In some severe cases this can help in the early stages to reduce load placed through the lateral ankle and decrease pain.  

Exercise therapy – Specific exercises to target the peroneal tendons which can help to increase load and improve function (see exercises below with videos on the SIMS website).

Please note that if your symptoms are not improving with the advice and exercises within 6-12 weeks then contact your GP or SIMS team for a full assessment or review with one of the team. 

Exercise sheets and videos

Click here to download our What is peroneal tendinopathy and exercise sheet.

View our ankle exercise videos below


Or click here to view all ankle videos on youtube


Please note -
These are general exercises, seek advice if you are unsure.

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