How To Treat Peroneal Tendonitis Naturally
- Dr. Angela Walk
- 6 days ago
- 4 min read
Updated: 3 days ago
Peroneal tendonitis can be a frustrating and persistent condition—especially when it's not treated properly. The good news? Most cases can be resolved with conservative, movement-based strategies that focus on progressive strengthening, not just rest or passive treatments.
Where Are the Peroneal Tendons?
The peroneal tendons run along the outer side of your lower leg and ankle. There are two main peroneal tendons:
The peroneus longus
The peroneus brevis
These tendons travel behind the bony bump on the outside of your ankle (called the lateral malleolus) and help stabilize your foot and ankle—especially during walking, running, and side-to-side movement. When overused or overloaded improperly, they can become irritated or weakened, leading to pain and dysfunction, known as peroneal tendonitis (or peroneal tendinopathy).
The Problem with Traditional Treatment
Peroneal tendonitis can be challenging to treat, largely because it’s often misunderstood or undermobilized. Many healthcare providers underload the tendon, recommending only rest, ice, and stretching. But tendons don’t respond to underuse—they respond to strategic loading.
Weak Peroneal Tendons and Plantar Fasciitis: The Overlooked Link
Emerging research suggests that weak peroneal tendons are not only a cause of lateral ankle pain, but they may also be a contributing factor to plantar fasciitis.
Here’s why:
The peroneals are key movers and stabilizers of your foot and ankle. When they are weak or underactive:
Your foot loses lateral stability
Arch support diminishes
Excess strain is shifted to the plantar fascia
This instability can lead to compensatory stress on the bottom of the foot, making plantar fasciitis worse—or even causing it in the first place.
So, resolving peroneal tendon weakness isn’t just about fixing outer ankle pain—it’s also about building a resilient foundation that supports total foot function.
Tendons Speak in the Language of Load
To heal, tendons need progressive loading—not just gentle movements or static stretches. Without enough load, the tendon’s capacity to handle stress won’t improve. And without improved capacity, symptoms linger or return.
This is why bodyweight alone isn’t enough. You must gradually increase resistance, range of motion, and control in a systematic and progressive way.
4 Key Exercises to Resolve Peroneal Tendonitis
These exercises are focused on strength and progressive resistance, which is the most effective strategy for tendon healing. Begin slowly, with control, and increase load over time.
1. Double-Leg Calf Raises
Start on flat ground.
Press through the balls of your feet and lift your heels slowly.
Pause at the top and lower slowly (3–4 seconds down).
Do 3 sets of 10–15 reps.
Progression: Add resistance (dumbbells or weight vest) as tolerated.
2. Calf Raises on a Slant Board or Step
Stand on a slant board or step with heels hanging off the edge.
Perform slow, controlled calf raises through full range of motion.
Focus on keeping your foot aligned and activating the peroneals.
Tip: The decline allows deeper tendon engagement.
3. Single-Leg Calf Raises
Stand on one foot and lift your heel slowly.
Use a wall or counter for balance, if needed.
Aim for 3 sets of 8–12 reps per side.
Progression: Add weight or increase reps as strength improves.
4. Eccentric Calf Raises
Rise up on both feet, then slowly lower down on one.
Emphasize a 4–5 second controlled descent.
This loads the tendon while it lengthens—a powerful rehab strategy.
Do 3 sets of 6–10 reps per leg, 3–5 times per week.
Don’t Forget Fascial Adhesion Release
Strengthening is key—but so is soft tissue mobility. Fascial adhesions (tight, sticky areas in the connective tissue) can restrict movement, create dysfunction, and prevent the tendon from loading properly.
To support recovery:
Use a stainless steel soft tissue tool every 2 days
Focus on the peroneal muscle area, outer calf, and lateral ankle
Perform gentle scraping in a controlled manner to break up restrictions and restore glide
This promotes blood flow, improves tissue quality, and helps the tendon respond better to loading.
The Footwear Connection:
Go Functional
Shoes matter. A lot.
Most modern shoes are narrow at the toe, have thick cushioning, and feature an elevated heel—all of which can alter foot mechanics, weaken intrinsic foot muscles, and increase lateral foot strain (which affects the peroneals).
To support healing:
Choose functional footwear that is wide in the toe box and zero drop (flat from heel to toe).
Avoid high heels or tight shoes that compress the lateral foot.
Take a look at my Approved Shoe List for the shoe I approve and recommend for plantar fasciitis and peroneal tendonitis
This gives your foot space to move naturally and reduces stress on the peroneal tendons.
Final Thoughts: Train Smarter, Not Softer
Peroneal tendinopathy doesn’t need rest—it needs smart loading.
Remember:
Progressively increase intensity.
Respect pain, but don’t avoid movement altogether.
Address soft tissue restrictions with regular fascial work.
Choose footwear that supports natural foot mechanics.
Understand the role peroneals play in stabilizing the whole foot—especially in plantar fasciitis.
Healing takes time—but with the right loading program, mobility tools, and natural support, your peroneal tendons can regain strength and resilience.
Need help with your recovery?
My tendon-strengthening programs are designed with a progressive, movement-first approach that gets real results.
You've got this,
Dr. Angela Walk
The Plantar Fasciitis Doc
➡️ Work With Me
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