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Physical Therapy for Peroneal Tendonitis – Information, Exercises, and More

You are just about to finish your run when you begin to experience a sharp pain in the back of your ankle.

Now, you experience this pain each time you put weight on your foot.

This could be a symptom of peroneal tendonitis.

In this guide, we will discuss the signs and symptoms of peroneal tendonitis and treatment options like physical therapy that may be right for you.

What is Peroneal Tendonitis?

Peroneal Tendonitis refers to inflammation of the peroneal tendons.

The peroneal tendons help:

  • Ankle joints support weight and prevent sprains
  • Turn the feet outward
  • Stabilize the arch of your feet when you walk

When the peroneal tendons are overused and increased pressure is added, it can cause them to rub against the bone and create friction. 

Friction from the tendons rubbing against bone creates the inflammation and irritation know as peroneal tendonitis.

What Causes Peroneal Tendonitis?

Runners or any athlete that participates in activities requiring repetitive motion have a higher risk of developing peroneal tendonitis. 

Some causes of peroneal tendonitis are: 

  • A sudden increase in exercise or weight-bearing activities like walking, running and jumping
  • Overuse of the tendons
  • Incorrect form or training techniques
  • Unsupportive footwear
  • Higher foot arches
  • Weakened muscles or joints in the lower limbs
  • Imbalanced muscles in the lower limbs

Peroneal Tendonitis Prevention

There are several measures you can take to help prevent peroneal tendonitis:

  • Stretching. Stretch the calves and peroneal muscles before exercise
  • Wearing appropriate footwear. Wear footwear that supports the ankle and foot.
  • Training. Gradually move up to harder exercises or longer runs/walks.
  • Maintain a level of activity. If you play sports or physical recreational activities in seasons, be sure to maintain a level of activity during offseason to help maintain muscle tone in the leg, ankle, and foot.

Peroneal Tendonitis Symptoms

Peroneal tendonitis pain can be acute or chronic. 

Here are some symptoms you may experience with peroneal tendonitis: 

  • Swelling and pain in the back of the ankle
  • Pain that increases with activity and subsides with rest
  • Pain when turning the foot outwards
  • Ankle instability when bearing weight
  • The affected area is warm to the touch

It is important to speak with a doctor about your symptoms, as other foot and ankle injuries need to be ruled out.

Peroneal Tendonitis Treatment

Treatment for peroneal tendonitis is often based on the severity of pain and injury to the tendons.

In most cases, peroneal tendonitis can be treated with conservative measures.

You should always speak to your physician or Doctor of Physical Therapy before implementing a treatment plan, but here are some treatment options that may be recommended to you.

Home Care

For mild cases of inflammation, peroneal tendonitis can improve with home care using the R.I.C.E method:

  • Rest. Allow the tendons to recover by avoiding activities that increase your pain until your pain has resolved.
  • Ice. Apply ice for 10-20 minutes at a time to reduce pain and swelling. 
  • Compression. A brace may be used to reduce swelling and immobilize the tendon.
  • Elevate. Elevate the leg to where your foot is positioned above the heart to help reduce swelling. This practice can easily be implemented during rest or sleep.

Peroneal Tendonitis Brace

Your doctor may prescribe an ankle brace or walking boot to help immobilize the tendons and promote healing. 

Once the injury has healed, wearing a brace may be recommended for use during activities that require repetitive use of the tendons to prevent re-injury.


Anti-inflammatory medications such as ibuprofen or naproxen may be prescribed to help reduce swelling. 

Physical Therapy

Physical therapy can help strengthen the surrounding muscles of the peroneal tendons and improve motion in the tendon through targeted exercises.


Surgery is considered the last resort for treating peroneal tendonitis and is only recommended in severe cases. 

Surgery may be performed when:

  • Surrounding tissue is causing irritation and tendon release surgery is required.
  • A peroneal tendon tear is present and requires surgical repair.

Peroneal Tendonitis Physical Therapy – Will PT Help?

The answer is yes.

Physical therapy can help you safely return to recreational sports or daily activities by designing a treatment plan dedicated to:

  • Relieving peroneal tendonitis pain and swelling
  • Restoring or improving range of motion to the ankle joint
  • Strengthening the surrounding muscles that support the peroneal tendons
  • Restoring balance and improving controlled movements

Best Peroneal Tendonitis Exercises

It is important to note that you should always consult a Doctor of Physical Therapy before attempting any exercises by yourself.

Here are some examples of peroneal tendonitis exercises a physical therapist may prescribe.

Range of Motion Exercises

Manual therapy and stretching techniques may be used to help improve the range of motion in your ankle joint, foot, and toes. 

These exercises are vital to improving running and walking without injury.

Gentle stretching exercises may also be implemented to decrease muscle tightness in the calves and bottom of the feet that can also increase running and walking difficulty. 

Strengthening Exercises

Strengthening exercises are implemented to strengthen your lower leg, ankle, and foot.

Strengthening the surrounding muscles can help lessen the load of stress placed on the peroneal tendons and can help prevent injury.

Your physical therapist may create a strengthening program tailored to your needs using resistance bands, weights, and medicine balls. 

Functional Exercises

Functional exercises help you safely return to daily activities and recreational physical activities that you enjoy such as sports.

These exercises are aimed at helping retrain your body to use controlled movements to prevent re-injury. 

Your physical therapist may customize a functional exercise program based on movements you use in daily activities and recreational physical activities.

How In Motion O.C. Can Help With Peroneal Tendonitis

If you suffer from peroneal tendonitis, you are not alone.

As the #1 rated physical therapy center on Yelp! and Google, In Motion O.C. has helped hundreds of people like you recover from peroneal tendonitis. 

In Motion O.C. is committed to providing you with the best treatment possible so that you can get back to doing the activities you love pain-free.

*This information about physical therapy for Peroneal Tendonitis was reviewed by Dr Natalie Thomas, PT, DPT. If you have any questions, please don’t hesitate to contact us here.

In Motion O.C.