Peroneal tendinitis or tears affect the lateral border of the ankle and foot. Mild cases may be notable only for pain and swelling along the tendon, and more severe cases lead to difficulty with balance and uneven surfaces.

The peroneal tendons are the major everters of the foot, which assists with side-to-side motion of the foot. Therefore, when it is weak or injured, balance can become difficult, especially when walking on banked or uneven surfaces.


Risk factors for this condition include overuse, distance running, high arches, cutting sports such as basketball, tennis, or soccer, obesity, diabetes, hypertension, prior trauma or surgery, and inflammatory arthritis.


The first step in diagnosis is appropriate imaging (weight-bearing x-rays of the foot and ankle) and a thorough physical examination. If there is suspicion for a tear of the peroneal tendons, an MRI will be ordered.



If the pain is so severe that walking is difficult, a short use of a camboot or walking cast to fully immobilize the foot and anklewill be necessary.

Offloading the lateral ankle by use of lateral post can be helpful over time.

NSAIDs should be taken around the clock for two to three weeks for anti – inflammatory dosing. Speak to your physician if you have concerns about whether anti-inflammatories are safe for you.

Only use ice if you have no numbness in your feet. If you have any neuropathy, ice application may not be safe. Set the ice pack on the floor and place a dry washcloth on top. Then, wrap this around the ankle. Ice for up to twenty minutes at a time, and be sure to wait an hour if you are going to repeat the ice application.

Physical Therapy
Physical therapy is not expected to change the shape of the foot or to repair tears. It works to improve strength and balance and stretch the muscles that tighten over time due to the injury. It can also address inflammation. Many people improve significantly with physical therapy and never go on to need surgery.

The surgery required for severe peroneal tendinitis or tears requires both addressing the inflammation and damage to the tendon as well as addressing the high arch when it exists, which requires bony cuts to reshape and reconstruct the arch.

Sometimes the tendon can be debrided of inflamed tissue and repaired, and other times the tendon needs to be removed and another tendon must be borrowed to reattach it.

Summary of Treatment

  • Rest/immobilization
  • Ice
  • Oral anti-inflammatories
  • Orthotics
  • Physical therapy
  • Surgery

Treatments to avoid

Do not immediately get injections or surgery for peroneal tendinitis. Injections should be avoided altogether to prevent rupture of the peroneal tendons, which cannot be repaired once ruptured. Oral steroids are not recommended as first-line treatment of plantar fasciitis because of the systemic risks; there are more specific treatment options in most cases.

Seek attention from a specialist if you are concerned that the pain is worsening, or it is not responsive to these treatments. Other sources of ankle pain should be ruled out.


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I fell down some stairs moving furniture and seriously thought I broke my ankle. Got in that day to see Dixon and was NOT disappointed (my best friend loves her and suggested I see her for my ankle). She was so friendly, figured out my ankle was just severely sprained – not broken- and actually cared about what my best options for recovery were. My follow up appointment was a breeze and because I followed her original instructions – I was back at running and working on my feet with ease and faster than I ever thought possible. Dixon is awesome! She cares and is so real. I recommend her to everyone!

Alisa R.

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First saw Dr. Dixon for a peroneal tear that was healed over. She was my 4th doctor. All I needed was a custom orthotic. Got it, bought good arch support tennis shoes. After 6yrs. it greatly improved. Previous doctors I went to, I received cortisone injections, foot braces, and recommended to purchase an Amazon orthotic. 2nd problem – I broke my foot on a Sunday. Got in the next day for x-ray and diagnosis. I had 2 breaks in my foot. I was offered surgery which would have been a faster recovery but I opted for the 12 week boot. I’m pretty much out of it now. I love her!!! I’m in the medical field and I know how things work in a medical practice. They’re professional, nice office, nice assistant. I highly recommend her. Sent my sister to her and she also was very happy!

Britt W.