Pain on the outer ankle

Lateral ankle pain

The peroneus longus and brevis run down the outer side of the lower leg, across the ankle at the lateral malleolus to the midfoot at the cuboid. They evert the foot, or move it laterally, stabilizing the ankle and preventing an inversion sprain. If you have ever sprained your ankle, it’s likely that these tendons were affected.

Over time, especially with activities such as running, cutting, and jumping, these tendons can become irritated, with inflammation and subsequent degenerative changes occurring in the tendon.

With peroneal tendinopathy, pain is located at outside of ankle, and can run down to the 5th metatarsal at the side of the foot, or along the lateral heel and under the arch of the foot if the peroneus longus tendon is involved.

Acutely, symptoms can be addressed with rest, assessment of footwear to limit pronation of the foot, and then strengthening.

If these symptoms are chronic or nagging, we need to address deficits in strength, and load the tendon to improve its tolerance of activity. Strengthening of the foot intrinsic muscles is also important so that the entire foot and ankle complex is more stable.

Tendon issues take time to resolve, so don’t give up on the exercises if you don’t see immediate results. It can take a few months of consistent work to improve. And see a PT if you need help managing symptoms!