The Center for Podiatric Care and Sports Medicine

Take the Edge Off Your Foot Pain with Peroneal Tendonitis Treatment!

Posted by on Thursday, October 4th, 2012


It’s frustrating when you have pain on the edge of your foot. It seems like people never want to believe you know where it hurts. You describe it and they say, “Oh, pain under your arch in the middle of your foot? That’s plantar fasciitis,” or “Pain on top of your midfoot? Sounds like a foot sprain.” And you just sigh and say, “No, the edge, trust me, I know where it hurts…”

With that in mind, let’s talk about one of those injuries that can occur on the outside edge of your foot: peroneal tendonitis.

Peroneal tendonitis? I have a foot, not a peroneal. Is this somehow connected to my ear? No, sadly, as that would be absolutely fascinating. First, let’s have a little anatomy review.

Oh no. Trust me, this is fantastically useful. You’ll be able to entertain party goers with peroneal tendon facts for years to come and may even be tempted to go to medical school (though the med school debt may scare you off).

Now as you may remember, tendons connect muscles to bone. You have two peroneal tendons on each foot that both run down behind your ankle bone.The peroneus brevis tendon continues forward along the outside edge of your foot and attaches to the base of the fifth metatarsal, the long bone that runs from your midfoot to the base of your little toe. The peroneus longus tendon turns under your foot and connects to the inside of your arch. These tendons help stabilize and support your foot and ankle. Unfortunately, tendons are susceptible to tendonitis, or inflammation in the tendon.

What would cause my peroneal tendons to become inflamed? Passionate love for a new pair of shoes? No, tendonitis is generally an overuse injury. Peroneal tendonitis is more common in the peroneal brevis, or the one that attaches to the outside of your foot. It’s often caused by running or walking frequently on sloped or uneven surfaces (I get a chill of uneasiness writing that, as I run up and down hills every day; so far, so good, but now I’m on alert nonetheless), or wearing worn out shoes too long. Peroneal tendonitis may also occur along with a sprained ankle.

How would I know if I had peroneal tendonitis? If you have the more common tendonitis in the peroneal brevis tendon, you’ll feel a dull pain on the outside of your foot in the midfoot area when you walk or stand; pain from tendonitis in the peroneal longus tendon is felt further back, closer to the ankle bone. You may especially notice pain from peroneal tendonitis first thing in the morning, or with that “first step” after you’ve been sitting for a while. The painful spot may feel warm to the touch; there may also be some swelling. It can be a difficult injury to diagnose, though, and can easily be misdiagnosed, so the best way to find out for certain whether you have peroneal tendonitis is to have your foot examined by a podiatrist at The Center for Podiatric Care and Sports Medicine (212.996.1900).

What if I do have peroneal tendonitis? What do I do? You’ll need to take a break from activities that put stress on your foot; in some cases you may have to have your foot immobilized to let it heal, either in a walking boot or with ankle brace. Pain and swelling can be reduced with anti-inflammatory medication such as ibuprofen or aspirin, and by icing the injured area a few times a day. You may also be given physical therapy, or advised to stretch your foot (here are some stretches that are targeted to your peroneal tendon).

If your podiatrist thinks your foot structure may have contributed to the injury–for example, high arches can make people more prone to peroneal tendon injuries–he or she may recommend orthotics to help support the area.  It will be at least several weeks before you can return to your full range of activities. Surgery is not usually necessary, unless the tendon is in such bad condition that it needs to be repaired, or if the ankle bone is irritating the tendon.

Peroneal tendonitis is as frustrating as any injury to your foot that keeps you from doing what you want to do. If you take care of it the right way, though, you should be just fine. Make sure you don’t ignore that pain on the side of your foot–get it checked out by a podiatrist!



If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.