What Are The Peroneal Tendon

The peroneal Tendon is a set of 2 tendons that run alongside the lateral aspect of your leg. These tendons are responsible for eversion/plantar flexion and are major stabilizers of the 1st Ray. These tendons help to counteract the forces of the Anterior Tibialis tendon.  The peroneus brevis attaches to the base of the 5th Metatarsal while the Peroneus Longus attaches to the plantar medial aspect of the base of 1st metatarsal.

Causes of Peroneal Tendon

Causes of Peroneal tendonitis include:

  • Rapid dorsiflexion of an inverted foot

  • Injury to the Peroneal Retinaculum

  • Usually occurs active patients

  • Ankle Sprains

  • Fibula anatomical deformity (shallow grooves in the fibula)

  • Low lying peroneus brevis muscle belly

  • Can lead to subluxation and longitudinal tears in the tendons.

Symptoms of Peroneal Tendonitis

Pain associated with Peroneal tendonitis usually begins as at the lateral aspect of the leg around the ankle joint. Swelling to the posterior aspect of the lateral leg. The patient may hear a popping sound.

  • Swelling to the lateral ankle

  • Feeling of instability

  • Pain/tenderness with palpation to the peroneal tendon

  • Popping sound with eversion against resistance

How To Diagnose Peroneal tendonitis

Peroneal tendonitis is diagnosed by a provider at Premier Foot and Ankle Center by our providers asking a few questions about the pain and swelling and a physical to observe the range of motion and flexibility. Imaging such as an x-ray, MRI or Ultrasound may also be ordered.

When to Seek Treatment for Peroneal Tendonitis

It is important with any foot and ankle injury to seek medical care. With Peroneal tendonitis, it is most beneficial to seek care immediately.


Treatment for Peroneal tendonitis can be conservative or with surgery depending on the patient’s symptoms and severity.

  • Rest and reduce your physical activity.

  • Physical therapy to stretch and strengthen muscles.

  • Applying ice to the painful inflamed area and elevating the foot.

  • Anti-inflammatory medication can help with pain and inflammation.

  • Supportive footwear or custom orthotics. At Premier Foot & Ankle Center we use an innovative method called a VFAS procedure to fit orthotics that can be taken home the same day if not sent out to the lab.

  •  Chronic cases will need Achilles tendon repair surgery.

Peroneal tendonitis Surgery

Peroneal tendon repair surgery can usually be done as a minimally invasive and minimal incision procedure depending on the severity of the injury. Surgical intervention will take place at a hospital/surgery center.


Peroneal Tendon takes around 6-8 weeks to heal after surgery depending on the severity