Peroneal Tendonitis Treatment in NYC

Manhattan Physical Therapy
Peroneal Tendonitis Treatment in NYC

What Is Peroneal Tendonitis?

Peroneal tendonitis is inflammation of the tendons that run along the outside of your ankle and foot. These tendons—primarily the peroneus longus and peroneus brevis—connect your lower leg muscles to the bones in your foot. They play a critical role in stabilizing your ankle, supporting foot movement, and protecting you from injuries.

This condition often develops gradually due to repetitive overuse, such as long-distance running, jumping sports, or standing for extended periods. It can also appear suddenly after an ankle injury, like a sprain. Left untreated, the tendons can weaken, leading to partial tears, tendon displacement, or even rupture, which can cause severe pain and instability.

Causes of Peroneal Tendonitis

Peroneal tendonitis can develop due to a combination of sports-related strain, anatomical factors, and individual health conditions.

Sports and activity-related causes

Overuse of the peroneal tendons during activities that involve running, jumping, or sudden changes in direction—such as tennis, soccer, basketball, or paddle tennis—can create small injuries in the tendon fibers. Repetitive stress and microtrauma can outpace the body’s natural healing, leading to inflammation and pain. Long periods of standing, walking, or running, especially with sudden increases in intensity or duration, can also contribute. Poor exercise technique or insufficient recovery between sessions increases the risk further.

 

Anatomical and personal risk factors

Certain physical and health characteristics make some individuals more prone to peroneal tendonitis. These include:

  • Degeneration of tendons in middle-aged or elderly active individuals, increasing the likelihood of rupture.

  • High arches (pes cavus valgus), which place extra strain on the tendons.

  • Advanced age, overweight, or diabetes, which can weaken tendon resilience.

  • Inflammatory conditions like rheumatoid arthritis or psoriatic arthritis.

  • Weak or tight muscles in the feet or lower legs.

  • Unsupportive footwear, including sandals or worn-out shoes.

  • Prolonged use of corticosteroids or certain antibiotics (fluoroquinolones).

  • Previous injuries or surgeries to the feet or ankles.

Symptoms of Peroneal Tendonitis

Patients with peroneal tendonitis typically notice:

  • Pain along the outer ankle or foot that worsens with activity and eases with rest.

  • Swelling, redness, or warmth around the affected tendon.

  • Tenderness when pressing on the tendon or during ankle movement.

  • Instability or imbalance when walking on uneven surfaces.

  • Snapping or popping sensations if the tendon is partially dislocated or torn.

How Is Peroneal Tendonitis Diagnosed?

Diagnosing peroneal tendonitis can be challenging because its symptoms overlap with other ankle and foot conditions, including sprains, arthritis, and fractures. At Manhattan Physical Therapy, our clinicians perform a detailed evaluation, which typically includes:

  • Physical examination

  • Range-of-motion assessment

  • Functional testing

  • Imaging when needed

Early and accurate diagnosis is critical. Studies show that up to 60% of peroneal tendonitis cases are initially misdiagnosed, delaying effective treatment and increasing the risk of chronic problems.

How Physical Therapy Helps Peroneal Tendonitis

Physical therapy is highly effective for peroneal tendonitis, targeting pain relief, tendon strength, and ankle stability. Research on lower-limb tendinopathies shows that structured exercise programs, including eccentric strengthening and progressive loading, can reduce pain by 50–70% and improve functional ability within weeks.

Manual therapy combined with targeted exercises enhances range of motion and balance, allowing patients to return to daily activities and sports more quickly. Clinicians track progress with standardized pain and functional scales, confirming measurable improvements. Early, consistent physical therapy significantly lowers the risk of chronic tendon degeneration or rupture.

Exercises for Peroneal Tendonitis Relief

Follow these exercises to strengthen your ankle, reduce tendon pain, and restore stability. Perform them consistently for the best results.

1. Heel Raises

Strengthen peroneal tendons and calves.

  1. Stand with feet shoulder-width apart.

  2. Hold onto a sturdy surface for balance.

  3. Slowly rise onto your toes.

  4. Lower back down to the starting position.

  5. Repeat 10–15 times for 2–3 sets.

2. Toe Raises

Improve tendon endurance and ankle control.

  1. Stand with feet hip-width apart.

  2. Lift your toes while keeping your heels on the ground.

  3. Hold for a few seconds, then lower toes.

  4. Repeat 10 times for 2–3 sets.

3. Calf Stretch

Reduce tendon tension and improve flexibility.

  1. Stand with feet flat.

  2. Step one leg forward and bend the knee.

  3. Keep the back leg straight, heel on the ground.

  4. Hold the stretch for 30 seconds.

  5. Switch legs and repeat 2–3 times per leg.

4. Wall-Supported Ankle Dorsiflexion

Stretch and strengthen ankle muscles.

  1. Stand with your back and hips against a wall.

  2. Keep feet slightly away from the wall.

  3. Lift toes toward your shins, balancing on your heels.

  4. Hold for 15 seconds.

  5. Repeat 5 times.

5. Seated Plantar Fascia Stretch

Relieve pressure on the peroneal tendon.

  1. Sit in a chair with feet flat on the floor.

  2. Place a rolled-up towel under one ankle.

  3. Hold both ends of the towel and gently pull it toward you, keeping your leg straight.

  4. Feel the stretch along your arch and calf.

  5. Hold for 15–30 seconds, then switch legs.

  6. Repeat 2–3 times per leg.

6. Eccentric Calf Strengthening

Reduce tendon pain and improve load tolerance.

  1. Stand on a raised surface (like a step) with feet hip-width apart.

  2. Lift one heel so you’re standing on your toes.

  3. Slowly lower the heel below the level of the surface, holding for 2 seconds.

  4. Return to starting position.

  5. Repeat 10 times per leg for 2–3 sets.

These exercises are most effective when performed under the guidance of a licensed physical therapist. Gradually increase repetitions and intensity as pain decreases and strength improves.

Preventing Peroneal Tendonitis

Prevention focuses on reducing overuse and protecting tendon health:

  • Warm up and stretch before exercise.

  • Wear supportive footwear designed for your activity and foot type.

  • Gradually increase activity intensity and duration.

  • Strengthen lower leg and foot muscles regularly.

  • Address biomechanical issues, such as high arches, with orthotics if needed.

If you are feeling extreme pain, call us today at (212)-213-3480 or book your appointment online.

What Do They Say About Us?

Alexander Liu

"Everyone on the team at Manhattan Physical Therapy is super nice and caring. They were able to pretty quickly diagnose my knee and hip problems and immediately put me to work to reduce the pain.."

Henry Myerberg

"You're not just a patient when you come to the Manhattan Physical Therapy. You feel like family there. In particular, Erica with her colleagues John, Lidia and Joe not only fix and improve you physically, they make you feel welcomed and cared for.."

Hakyung Kim

"Everyone is so kind and helpful! my knee and hip pain have improved massively since starting Manhattan PT, highly recommend to anyone. special thanks to Bianca, Lidia, Joe, and John!"


Manhattan Physical Therapy

✆ Phone (appointments):
(212) 213-3480

Address: 385 5th Ave, Suite 503, New York, NY 10016