Peroneal Muscle and Tendon Injury and Overuse Explained

Brisbane Sports Podiatrist from Shoes Feet Gear explains peroneal muscle and tendon injury and overuse. The peroneal muscles are on the outside of your lower leg and become extremely painful. The tendons from these muscles wrap around the back of the ankle to join the outside of the foot. These are commonly injured with rolled ankles. More information on diagnosis, treatments and prevention can be found on our website here: shoesfeetgear....

[@JohnnyB21401]

You described this better in 3 minutes than my podiatrist did in a half hour. Exact spot of pain in my leg and foot. Unfortunatel,y, poor fitted orthotics caused this for me.

[@elisebernier8352]

agree!

[@craigkeller]

Best explanation I’ve found describing my year long injury.

[@narutouchiha1082]

Bro year long????? 😭😓 i think i got it cuz im overtraining (basketball)

[@tkucey8689]

This was very valuable for me trying to figure out why I've had pain and cramping both of the top of the peroneus longus and then underneath that the arch of my foot. And my cause? Driving I'm being too small for my seat so only the ball of my foot is on my gas pedal. Showing this in case anyone else might have a similar problem

[@jypsydog6079]

I'm wondering now if pedaling my stationary bike is MY gremlin...

[@massd3783]

I had a previous strain to my tibialis anterior and began wearing orthodics that increased my arch and pushed my heel upward. Several days after figuring out the root of that strain, I jumped and was pushed off balance mid air and fell hard on the outside of my foot, which I believe strained my peroneus brevis. Now I have two minor strain/ tendonitis injuries on the opposite sides of my foot, which caused instability.

[@JoB-7]

Thanks so much! This is the information I badly needed! I’m in soooo much pain just by walking on uneven ground!

[@ShoesFeetGearBrisbane]

Hi Jo, I'm glad that it helped! A nice stable shoe, strapping your ankle in the short term and even an orthotic made by a good sports podiatrist should be able to sort these issues out long term. Good luck!

[@JoB-7]

I guess it means no heels! 😂 I’m just kidding, I’m not wearing high heels since many years. Thanks for you response 😘

[@gamingodriscoll5714]

Shoes Feet Gear - Brisbane Podiatry can you suggest me cheap shoes that may solve the issue? My bigget is around $80. I think my shoes may have caused it? I’d love feedback, thanks!

[@sl2608]

@@gamingodriscoll5714 I've asked questions and he never responds. Good luck.

[@Gabby-hw7my]

@@gamingodriscoll5714 any shoes help?

[@kennethbrady]

Excellent explanation. Thank you.

[@R5123]

Great job and thank you for the illustrations. This made it much easier for me to understand

[@ShoesFeetGearBrisbane]

Excellent! Hopefully that helps you get back on track.

[@maikeru01]

i have this problem but my podiatrist said the opposite. he said its because i over pronate, and then his answer was orthotics that put extra support on the inside of the foot. but ive been having this pain for years so ill try anything.

[@ShoesFeetGearBrisbane]

Hi, if the pain is through the outside of the lower leg, then the issue is your foot is rolling outwards at some stage of gait and these muscles are having to pull you back in. It is more common for feet to roll inwards, so your other podiatrist may have just given you the standard blurb. Some people pronate through the back half of their foot (roll in) and then supinate (roll out) as they push off the forefoot. Either way, if these muscles are over worked, then you will need a neutral shoe that is stable (not too soft and wobbly), an orthotic that supports the outside of your foot (not so much the arch) or strap your ankles. I hope this helps. Pete, Sports Podiatrist

[@JesusLovesnLives]

This is awesome I see most insoles are made for over pronating not supinating. Are there any insoles you can recommend purchasing online for the supination and supporting the outside of the foot

[@henrycogo3013]

Great explanation. I'm just fascinated by the use of EXPO dry-erase markers. I guess it's not like using Sharpie permanent markers.

[@briankendrick5]

Great explanation but have no idea what was said at the very end of the video

[@gregorythomas2674]

Interesting and informative video. Thats almost what it feels like, pain in top outer calf just below knee trying to redirect. I bought arch supports for plantars fasciitis. Maybe they are tipping my inside foot up to much. May pull then and flatten feet more and see. Worth a try. Thanks!!!

[@ShoesFeetGearBrisbane]

Gregory Thomas . Yes, standard orthotics that support the arch and shoes that help pronation can make this problem worse.

[@marlee1108]

Yes!!!! It's good thing to know. I also have plantar fasciitis insoles, and since I start using them I feel more pain in that cuboid area. Will take them off and see how do I feel. Thank you so much!

[@sl2608]

@@ShoesFeetGearBrisbane So is an orthotic for Supination a good one for treating Peroneal Tendonitis? I can't afford custom ones so I wear Powersteps. They have one for Supination. Wondering if I should try that one. Your advice would be appreciated. Thanks!

[@andrewdc1]

I have horrible pain in my right leg in that exact spot going down the side of my leg down to the outside of my ankle. I also notice my ankle rolls easier now so I'm positive this is the issue. This started after I did a 10K Spartan run (I've never run more than 3 miles before so I think I overdid it)

[@rexbabyrabbits]

Can get lateral compartment syndrome there with those muscles and the superficial peronial nerve.

[@sl2608]

It's very frustrating when great, very informative videos are posted but then no one responds to our questions. I was hoping you might be an exception to that, but I never received an answer from you to my question from 3 weeks ago. I'll try one more time. You recommend a particular type of orthotic for Peroneal Tendonitis, that tips the front of the foot out. But where can we get this orthotic for PT? Is there a brand you recommend that we can purchase online? I hope you will be kind enough to take a moment and respond. Please. It would really be appreciated.

[@Nick-zy9tx]

broke my foot earlier this year and this tendon is the main thing that hurts

[@emmanuel-in-greece6954]

I fractured by cuboid bone and now have dull pain along this tendon below my ankle. Have you found any useful sources of info for relieving the pain? Thanks!

[@ShoesFeetGearBrisbane]

Emmanuel-in-Greece The trick will be to strengthen this tendon gradually. Heel raise exercises on one foot can be a great start. Then gradually progress to lunges, step ups, skipping, hopping until it is strong again.

[@emmanuel-in-greece6954]

@@ShoesFeetGearBrisbane Will give that a go, thank you!

[@larryps]

Great info, thank you

[@shinymetalvids]

Great detail. Mine pain has been only in the outside (where you mentioned) of my foot in the morning infrequently. Recently it’s been while walking (I hike a lot) and at rest now too some days, with some pain in calf briefly. I’m resting it now and think my shoes may have been laced too tight also?

[@itb4255]

Yeah, i injured one of the peroneous muscles from trail running. And then I ran on concrete with tightly laced shoes which caused excruciating pain.

[@dallantobler6144]

I’ve been running for years, never even a sign of this problem. Got a 3rd metatarsal fracture was in a walking boot for 6 weeks, tried to run at 7 weeks, after I was healed up. And I got some pretty bad peroneal pain on the lateral portion of my foot. Right where that cubiod bone is. First time running and pain came the next morning when I woke up. And, I’m confused on why?

[@suraj1238]

I just walked out from running today because i have a pain that I couldn’t tolerate it. Could you suggest me any shoes

[@sl2608]

I'm in the USA. Where can I get an orthotic like the one you suggest in the video for Peroneal Tendonitis? Do you have a type/brand you recommend? Thanks.

[@hammill444]

Trust me---- this injury never goes away. I've had it for 2 years and have tried everything. I've given up

[@Fari106]

Did you try having surgery for it?

[@rexbabyrabbits]

Use a massage stick and stretch it

[@kyreejackson5566]

I get this pain sometimes after dunks its not a feeling where it would make me stop jumping but its there and it kinda worries me😭its not everyday but we practice 6 Days a week and i still go to the gym on sunday so maybe like 4/7 days i feel it. do you recommend wrapping the area where it hurts?

[@zackbutler5697]

You still feel it?

[@jaydenheron876]

Same here, don't know if I should though it out or rest it

[@ipucu4410]

Can you suggest a shoe for this please?

[@mstrlucky652]

If the pain of the upper peroneal, say mid calf up does that indicate anything specific ? Thank you

[@Fsharptunes]

Mine snaps crackles and pops and won’t get better

[@cesardejeronimo8184]

How would you treat peroneal cramping? I developed an overuse injury in that area on my left long only. I don’t think it’s a major strain or treat since I can still walk on it. I don’t have any pain in my ankle region as well. However when I try running downhill or uphill is when I feel the pain the most. There isn’t any swelling in my lower leg. It’s been about 3 weeks now since I developed this issue and regrettably I tried to continue running on this leg as I’m training for a marathon that takes place in about 8 weeks. Any advice? I’m planning on not running for a week due to this and am feeling better slightly now. Been using the Saucony Endorphin Shift 2 if that helps. Would greatly appreciate any advice you can give.

[@asianpan00dles15]

May be stupid question but if I do have pain there should I be walking/running on it if I have pain in these tendons? I’m running 4 miles every 4 hours for 48 hours and got pain there on the 3rd of 12 sessions and have still been running on it for the next 4

[@mattbalfe2983]

This makes sense, I've had bad peroneal tightness for years now whenever I run a lot. I have pronated feet ( inward), my guess is that still my big toe doesn't function correctly. Do you have any ideas what to do?

[@ShoesFeetGearBrisbane]

Hi Matt, yes, this is probably correct. If the big toe doesn’t bend easily (through actual joint stiffness or because the fascia tightens to prevent it bending correctly), then the big toe works as a still lever making you tip out at toe off. If the big toe can’t physically bend to 40 degrees when your foot is non-weight bearing, then you will need a clever orthotic design or wear the Asics Glideride 2 shoes (the rocker and stiff forefoot will help big time). If the big toe joint can bend when non-weight bearing and it is the tight fascia preventing it bending with gait, you will need an orthotic design that supports/lifts the outside of the forefoot and allows the big toe to drop down. An experience sports podiatrists can help. Either way, if you peroneals are getting over worked, your foot is tipping outwards too much for some reason. Strapping your ankles when you run is only a temporary fix, but would help you with higher load exercises if you are stuck. Good luck!

[@sl2608]

Why does no one respond to our questions???

[@sonareclipse9810]

I have foot pain on the lateral side but lower than what is shown here. It's essentially the fat pad that runs laterally from the heel to midfoot position - running parallel to the ground. What would be causing that pain?

[@ShoesFeetGearBrisbane]

Hi, if I was to guess, the most likely thing is the calcaneal branch of sural nerve getting compressed under the heel. This is a very small nerve that supplies feeling under the outside of the heel and it can get compressed between the hard heel bone and hard floors/shoes (especially with working from home barefeet or hard soled shoes). If you roll your weight into the outside of the heel, you should feel the pain. The solution is extremely soft cushioning under your heel strictly for a few weeks to allow the inflamed nerve to shrink down to normal. Wear super soft footwear, no barefeet, add soft padding into the heel of your shoes (you can cut up soft yoga mat or something). The softer the better to relieve the pain for an extended period. Topical anti inflammatory cream/gel and speed up the recovery a little, but cushioning at all times is the key. Good luck! Pete (Sports Podiatrist)

[@simonloo1588]

I have this massive problem , but some video suggest it due to pronation onward but it seem u suggest it due to supination instead. Which is which to avoid this pain? I have flat feet and I wearing neutral shoes. I Want to alter my running landing to correct this , kindly advise or I mistook what u say. Tks

[@ShoesFeetGearBrisbane]

Simon Loo . If you have pain through these muscles on the outside of the lower leg, then your foot is supinating (tipping outwards). This usually happens as you push off the forefoot. This can make it a little confusing as standing still you may still have ‘flat feet’/feet roll in/pronate at the back half, but when you push off the forefoot you would ‘toe-off’ laterally/roll outwards making these muscles work hard. A stable neutral shoe is helpful, strapping ankles will give you short term relief and a custom orthotic that supports the outside of the foot designed specifically for your foot angles is the best. Good luck!

[@sl2608]

Is there a Powerstep insole/orthotic that will help with this issue? Or do you have another orthotic you can recommend? Custom Orthotics are out of the question for me. My insurance will not pay for it. Thanks.

[@ShoesFeetGearBrisbane]

Nothing that I have ever seen. All of the pre-made orthotics are designed for feet that roll inwards (which is far more common), so these will do nothing or make you tip out which makes things worse. A quick temporary fix would be to use some adhesive thick felt (semi compressed felt) and stick it under the shoe liner that comes with it. Stick it along the outside half and use scissors to trim and angle it like a ramp to tip your foot inwards. It should be like a wedge under the liner the runs the length of the outside of the foot that tips you in. If you can do this, it will work like magic, but might only last a month or so before needing replacement. Good luck!

[@sl2608]

@@ShoesFeetGearBrisbane Thanks very much for responding. In the video he talked about an orthotic that was used to treat this. At [2:59] he talks about the proper shoes to wear, then he says "After that we will use an orthotic . . . to tip the foot inwards". What kind of orthotic is he referring to? I was hoping to get more specific information, or a name of the product. Thanks for the tips about making something using felt. I have collapsed arches and was told by a podiatrist that I need an orthotic for pronation. I'm so confused. I don't know what I need anymore -- or even if my foot can ever be fixed.

[@theyracemesohardchair]

I wish you were near me because this is exactly why I can’t run right now. Could this be caused by a new set of running shoes rather than overuse? I’ve had this issue ever since changing to a pair of Nike Flynit 3’s.

[@matthewmoeder521]

I’ve been having Lateral pain for about a week now out of the blue during a run (no significant injury) and can’t tell what it is, and my tendon in that area is feeling pretty creaky, but I have no past history of tendinitis, so I figure I must have strained one of those tendons around the cuboidal/5th metatarsal area. Would an orthotic that supports this area of my foot relieve this pain, or do I need wait for this injury to heal?

[@ShoesFeetGearBrisbane]

Matthew Moeder Hi Matthew, generally any lateral foot pain will respond to support under the outside of your foot to reduce the foot tipping outwards. A good stable shoe (neutral) such as the Asics Cumulus, Brooks Ghost, Mizuno Sky or similar will be a good base to work off (avoid supportive/anti-pronation models). Strapping the ankle works very well short term. An over the counter orthotic won’t work as they are simple arch supports for feet that roll inwards. A good sports podiatrist can design an orthotic that supports the outside of your foot to stop rolling outwards. If there is tendon injury, the normal rehab exercises, etc will be important. I hope this helps! Pete (Sports Podiatrist/Director)

[@mag8925]

I feel like paralyzed this part of my leg, but i do not have problem with moving my leg and my foot, just a numbness-paralizy feeling...., what shoud i do? ( i do not feel any pain) Thank you😶

[@ShoesFeetGearBrisbane]

Hi, this sounds like a nerve entrapment. The most likely spot is on the outside part of the knee and the sensation radiating down the outside of your leg. Google ‘common peroneal nerve entrapment’ and look at stretching all the way from your hips down (Glutes, hamstrings, ITB, TFL, calf, peroneal muscles). Anti-inflammatory cream/gel on the entrapment site as per packet instruction can help. In rare cases is can be a form of sciatica from a lower back condition as well, but less likely. I hope this helps.

[@mag8925]

@@ShoesFeetGearBrisbane thank you so much

[@davedicerbo1382]

Never had pain on the outside of my leg, just the bottom of the foot. Cant get it to 100% and can't run on the roads. It's been 11 months almost

[@dex4959]

Hey I have this pain too. Do you feel any better now?

[@davedicerbo1382]

@@dex4959 After 18 months I got off running IR and did a 5k in March (in person.) Since I've done a 15k, and 5 milish race and this Sunday doing a 4 mile race. I feel 100% and am also just about past the mental aspects as well. Is your injury your peroneal (outer foot just in front of your heel?) If you are in the NYC area, NY Custom PT and Lisbeth is who got me back. Very grateful!!! Let me know and hopefully I can be helpful in some way to you getting back to running or whatever you love to do, to keep active

[@dex4959]

​@@davedicerbo1382 The pain seems to be around the lateral part of the bottom heel, so yes. I was running about 25 miles/week at the time but I've taken time off. I didn't roll my ankle though, I think I just increased my mileage too soon and that led to tight calves, so I am assuming my Peroneal Longus is very tight. I think the root cause was my soft shoes that I use. I have more wide and flat feet, and I think the combined intensity with not using my left toe as much when running led to this. I live in Canada so unfortunately I cannot see that PT at the time. Do you have any tips for removing the pain from the bottom heel? Thanks man

[@davedicerbo1382]

@@dex4959 I was given McConnell tape. Don't put it directly on your skin and it will rip away are the epidermis. If you go on Amazon you can get it with cover-roll stretch. There was some type of spray she used to help the cover-roll hold and the McConnell tape over it. Here in NJ, I would get about a week during the autumn and almost 2 weeks in the winter. This time of year probably only a few days. It will gradually improve if you keep doing that over a couple of months. I spent actually 6 months going to them so patience is the key. Gradually incorporate running without it as it begins to improve. Your scenario may be different from mine, as I'm not you to know exactly what it feels like. There was also a bunch of different exercises I was given. Calf raises with weight. Resistance band stuff, etc.

[@rexbabyrabbits]

I'm stretching it and using a massage stick

[@MrBourne0070]

I have had ankle issues for a year now and 2 days ago whilst playing football I kicked the ball awkwardly and I limped it off but played a football match that same day - it was all fine. Yesterday I went football training and I was in a duel with an attacker, he put some weight into me and changed my stride, making me slam my foot into the Astro turf. It hurt immediately and I tried to run it off but came off 30secs after. Now it occasionally hurts the outside of my ankle when I walk, plantarflex forcefully and bend my knee (adding extra weight onto the ankle). As I said previously I have had ankle issues, a medial ankle sprain and a bit of trouble with the outside (I assume peroneal tendon) but it has always cleared up quickly. I am also quite certain it is not an ankle sprain since there is barely any swelling and no pain when I roll my ankle outwards. Do you have any clue as to what this could be?Also the peroneal tendon appears to snap (sublux?) when I plantarflex with force. Best regards, Jay

[@kamilcatalan352]

How are you Jay

[@mohamedn87]

I believe I have pain in the lower peronal on my left foot. This happens most after being a active on my feet. It's on or around left side of my left ankle. though both feet and ankles get in pain during and after activity but the pain on the left side of the left ankle is the worst. My piodatrist says its cause I am flat footed but didnt bother really doing any tests or telling me to have x Ray's done on my feet/ankle. I suspect that's more than flat feet or not even the flat feet itself. I have gotten x Ray's done in defiance of what my piodatrists advice. I cant go always go off what my medical professional says. Any advice?.

[@ShoesFeetGearBrisbane]

Hi, pain in the areas marked in the video are most commonly the peroneal tendon and muscle. It’s role is to resist the foot rolling outwards. This works especially hard with feet that roll outwards it with side to side movements. Stable neutral shoes are helpful, orthotics that are different to what are normally used that support the outside of the foot, strapping the ankle, stretching, massage and rehab to strengthen the injured tendon are all helpful. I would be careful about getting a standard orthotic for ‘flat feet’ as this can tilt you out more making things worse if the podiatrist doesn’t understand this problem fully. Good luck!

[@mohamedn87]

@@ShoesFeetGearBrisbane . . . . Its mainly a bad/severe pain. I don't have any past injury to the feet/ankles. Thank God. My piodatrists past and present havent been much help.

[@mohamedn87]

The worst pain is in the lower foot above the heel around the left side of the left ankle. Not so much going towards knee . .but the pain is most further down from there around the ankle.

[@Gabby-hw7my]

What shoes have helped any of you?

[@ShoesFeetGearBrisbane]

Asics Cumulus 23 is great or the Brooks ghost 14 or 15. The new cumulus is a bit soft. Nike Vomero is good. Anything neutral and stable. Avoid the super cushioned models as they will act like a ‘wobble matt’ and make these tendons work harder. Anything with a wide sole and good ground contact along the outside part of the outsole is what you are looking for. I hope this helps!

[@K.mersch]

I've had Peroneal Tendonitis for the past 7 months now, the pain is located on the Peroneal Retinaculum to be exact. I've tried everything from: doing eversion and inversion ankle exercises with a TheraBand, foam rolling the Peroneal Longus & Brevis Muscle, Dry Needling, Icing + Heating, Rest but the small pain still lingers on when I run. I don't know what more I can do? I'm only running 2-3 times per week very easy running on soft trails. I appreciate any help. Thanks

[@elenamandaglio491]

Hi, did it heal? If so, did you do anything to help it? I've been struggling with it for more than 4 months now.

[@K.mersch]

@@elenamandaglio491 Hi, turns out I had a Bone Cyst from when I rolled my ankle. I found this out 1 year later when I got an MRI. I then got a CT Guided Cortisone Injection. The Pain went away eventually but its still not 100% (I'm not running as much anymore because now I have knee pain for 6 months now) but if It annoys me when I increase my running again I would need to have surgery, my Doctor said. Hope you get better. Just get an MRI if it is taken too long to heal.

[@elenamandaglio491]

@@K.mersch thank you very much for your clear reply. Get well soon.

[@savajsavaj527]

Same problem

[@hossainmoonem3943]

I feel pain in top most point of blue mark zone after every football match.

[@ShoesFeetGearBrisbane]

Hossain Moonem , this muscle is important to stop your foot rolling outwards and it will be working extra hard with the side to side movement of football. A short term solution would be to strap your ankle (any strapping first a sprained ankle that comes up reasonably high above the ankle will work). Long term, you will need to support the outside of your foot from the middle part right down towards the toes. This will stop the foot rolling outwards too much and these muscles can just go back to only providing balance when you side step. I hope this makes sense! Pete

[@hossainmoonem3943]

Thanks brother! Watching your videos after 3 years

[@frankienunez7222]

I get pain there after my football games any help 😤

[@ShoesFeetGearBrisbane]

Frankie Nunez See the comment I made above about strapping the ankle for fast relief and supporting the outside and front of your foot long term. Podiatrists with experience in sport can make a specifically designed orthotic to do this accurately in your shoes

[@ShoesFeetGearBrisbane]

Hi Frankie, Strapping your ankles for games is a short term fix. Long term, choosing stable football boots (ones where you don't feel like you are tipping out) and ideally putting a custom made orthotic from a good sports podiatrist will support the outside of your foot to fix this properly. Standard orthotics that support the arch won't work and probably make it worse. Good luck!

[@glamournie8235]

Which shoes is ideal for someone experiencing this?

[@ShoesFeetGearBrisbane]

Hi, the best shoes for this condition are neutral shoes (not shoes with support for pronating/flat feet). Ideally they should be stable (very soft and cushioned shoes will be wobbly, so avoid air bags, springs, super soft foams, etc). The best neutral, stable running shoes will also be reasonably wide in the heel and good ground contact along the outside of the shoe. I commonly recommend the Asics Cumulus, Brooks Ghost, Mizuno Sky 4 or the Nike Pegasus for narrower feet. There are plenty of others depending on foot shapes and angles. I hope this helps. Pete (Sports Podiatrist)

[@tedrichardson1205]

Agree with response and like the video, definitely a neutral shoe, I do like cushion for this issue especially if you run on pavement, having a shoe with some extra cushion will put less strain your stability muscles but like the pro said don'tdo shocks or any of those silly things, I just got this issue and I've had it before and usually it means it's time for a new pair of shoes, I went with Vomeros, Nike shoes usually have nice feeling cushioning

[@benjanson7484]

These bad boys of mine are as tight as hell even after a week of foam rolling the shit out of them and sitting on their trigger points until my foot was shaking. Lesson learnt don’t use over the counter orthotics just do foot stabiliser strengthening exercises

[@ShoesFeetGearBrisbane]

Ben Janson Hi Ben, yes standard orthotic designs will tip your foot out more and make this problem worse. Running shoes with support on the inside will also make them worse. The key is to stop the foot tipping outwards, so a stable shoe and support on the outside of the foot will be magic. Strengthening the muscles and tendons themselves will help, but some people won’t get enough strength and stamina out of them because of their foot rolling out too much or the amount of training they are doing. Glad you are on track.