Peroneal tendinopathy is a common overuse injury affecting the peroneus longus and peroneus brevis tendons, which run along the outer side of the lower leg and ankle. These tendons play a critical role in dynamic foot stability, especially during gait cycles, lateral movements, and uneven terrain navigation. For runners and walkers, repetitive loading, poor biomechanics, or inadequate footwear can lead to microtrauma and tendon degeneration of the peroneal group. Symptoms typically include lateral ankle pain, swelling, and stiffness—especially after long runs or prolonged walking.
Your trusty OHL Physiotherapist uses a combination of clinical reasoning and functional testing to best understand and assess your peroneal tendinopathy. This includes gait analysis, single-leg balance tests, resisted eversion strength testing, and palpation of the tendon pathway. For runners, assessments may also include stride pattern evaluation, foot strike analysis, and load distribution mapping to identify contributing factors like overpronation or excessive supination. These insights help confirm a diagnosis, as well as tailor a rehabilitation plan that addresses not just the symptoms, but the underlying movement inefficiencies that led to the injury. Because lateral ankle pain can stem from various sources, physiotherapists carefully differentiate peroneal tendinopathy from conditions like Achilles tendinopathy, lateral ankle ligament sprains, fibular stress fractures, and chronic ankle instability.
Treatment begins with highly evidence-based load management strategies, including specific isometric exercises, activity modification (yet still trying to keep you fit) and icing. As symptoms settle, rehab progresses to eccentric strengthening, proprioceptive retraining, and neuromuscular control drills—especially important for runners and walkers to restore tendon resilience and prevent recurrence. Taping, orthotics, and footwear advice are often integrated to optimize biomechanics and reduce tendon strain during high-impact activities.
Your OHL Physiotherapist may enlist the help of our OHL Podiatrist to provide these treatment options and ultimately get you back to the activities and sports you love! If you are plagued by pain on the outside of your ankle complex, reach out to either an OHL Physio or Podiatrist today! You can book on 9431 5955 and/or you can book online via our Client Portal 24/7.
