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Peroneal Tendon Strain

A strain occurs when there is a stretching or tearing of muscle fibres or tendons. The peroneal tendons are the tendons that run on the outside of the ankle and attach to the foot. The peroneal muscles to which these tendons attach to are responsible for pulling the foot outwards (eversion of the foot).

How does a Peroneal tendon strain occur?

The strain may occur when there is forced inward (inversion) of the foot or if the foot is forced upwards towards the shin. This results in stretching or tearing of the tendons. Strain to the tendons may also occur during running on slopped surfaces or running in shoes with excessive wearing of the outside heel.


Pain would present on the outside of you lower leg and ankle. There may also have been a pop or a snap at the time of injury and there is most likely to be some swelling on the outside of the lower leg.

Diagnosis and treatment

Your physiotherapist will be able to diagnose if you have had a peroneal tendon strain. X-rays may be required in severe injuries to rule out the possibility of any damage to the bone where the tendons attach.
In the initial stages of treatment the aim is to reduce pain and inflammation.

Your physiotherapist may use such things as electrotherapy modalities, ice, gentle circulation massage and gentle mobilizations. In this stage rest from sport and other aggravating activities is essential to allow time for healing. Gentle range of motion exercises would also be prescribed as well as elevation and ice.

Once the initial inflammation has settled treatment would then move onto focussing on progressive strengthening of the peroneal tendons as well as strengthening of the other muscles surrounding the ankle joint. Your physiotherapist would then assist in you in a gradual return to sport. They will be able to provide you with education about things such as footwear and will provide you with a long term program of stretches and strengthening exercises. They would also look at any predisposing factors (e.g. foot biomechanics) and correction of these to prevent any further reoccurrences or injuries to the ankle.