The 4 Key Symptoms Of Peroneal Tendonitis To Watch For

Peroneal tendonitis is an often-overlooked cause of outer ankle pain, especially in people who are physically active. The peroneal tendons run along the outside of the lower leg, behind the ankle, and attach to the foot. These tendons play a vital role in stabilising the foot and ankle during movement, making them essential to overall foot health. When inflamed due to overuse or repetitive strain, they can cause significant pain and limit mobility.

Unlike acute injuries that occur suddenly, peroneal tendonitis develops gradually. Early recognition of symptoms is essential in preventing more serious complications, such as tendon tears or chronic instability. Here are four key symptoms of peroneal tendonitis to be aware of.

Pain along the outside of the ankle is the hallmark symptom of peroneal tendonitis. This discomfort typically begins as a dull ache and may progress into a sharper pain, especially during or after physical activity such as running, walking on uneven surfaces, or climbing stairs. The pain often localises behind the fibula (the outer lower leg bone) and may extend down into the foot.

Unlike ankle sprains, which usually result from a single traumatic event, peroneal tendonitis develops over time. Individuals frequently dismiss the early signs as muscle fatigue, only to experience worsening pain later. If outer ankle pain persists for more than a few days, it’s advisable to consult a foot clinic in Singapore for an accurate diagnosis and timely treatment.

Swelling near the back and outer part of the ankle often accompanies the pain. Inflammation of the tendon sheath may cause visible puffiness, tenderness when touched, and even a sensation of warmth in the area. Swelling may increase after periods of activity and improve slightly with rest, but it typically returns if the root issue remains unaddressed.

This swelling is part of the body's natural inflammatory response. However, chronic inflammation can damage tendon fibres over time, which underscores the need for early intervention. Peroneal tendon disorders can go undiagnosed for months, delaying recovery.

Because the peroneal tendons help stabilise the ankle, tendonitis can lead to feelings of instability or weakness during movement. Some patients report that their ankle feels like it might “give way,” particularly on uneven terrain or when changing direction quickly.

This symptom may not always be accompanied by severe pain, making it easy to ignore. However, even minor instability can increase the risk of falls or secondary injuries. If your ankle feels unsteady without any recent trauma, it’s worth having it evaluated by a professional specialising in podiatry in Singapore.

One of the clearest patterns in peroneal tendonitis is that the pain typically worsens with use and improves with rest. Activities that involve ankle motion—especially those with side-to-side movement or uneven weight-bearing—tend to aggravate the condition. Conversely, resting the foot often brings temporary relief, which may lead people to underestimate the severity of the problem.

However, rest alone rarely resolves tendonitis completely. Left untreated, peroneal tendonitis may develop into peroneal tendinosis, a degenerative condition that involves long-term damage to the tendon fibres (Maffulli et al., 1998). Early identification and structured treatment are the best approaches to full recovery.

Recognising these symptoms early can prevent progression to more severe issues like tendon tears or chronic ankle instability. Conservative treatment options—such as physiotherapy, orthotic devices, and temporary activity modification—are most effective when started early.

If you notice ongoing pain, swelling, or weakness in your ankle, don’t wait for it to worsen. Prompt evaluation and treatment are key to avoiding long-term damage.

Family Podiatry Centre offers expert care for peroneal tendonitis and other lower limb conditions. With two convenient locations, at Jln Serene in Bukit Timah and Joo Chiat Road along East Coast, their team of experienced podiatrists is well-equipped to provide personalised, evidence-based care. Visit Family Podiatry Centre to book an appointment and take the first step towards lasting relief.

Maffulli, N., Khan, K. M., & Puddu, G. (1998). Overuse tendon conditions: time to change a confusing terminology. Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association, 14(8), 840–843. https://doi.org/10.1016/s0749-8063(98)70021-0