Pain Along the Outside of the Foot and Ankle

Many people come in the office experiencing pain along the outside of the foot and ankle.  This pain that patients describe could have started after an injury or it could be chronic and slowly getting worse.  Many times, this pain is due to inflammation from tendons on the outside of your leg called the peroneal tendons.

The anatomy of the tendons are important to understand why you could be experiencing  your symptoms.  The peroneal tendons start on the outside of the leg, just below the knee.  They course together down the leg, behind the back of the ankle bone and along the outside of the foot.  One of the tendons, called the peroneus brevis then attaches to the base of the 5th metatarsal (that bump you can see on the outside middle portion of your foot) and the other courses along the bottom of your foot in the deep arch and attaches to the bottom inside of your foot.  These tendons work together with every step to help your foot evert, or turn the foot out during gait. 

If you sprain your ankle or foot, the majority of the time the ankle and foot turn inside relative to the body.  When this happens, these tendons are forcibly stretched and can form small tears within the tendon.  These tears may not heal correctly so they fill in with scar tissue and become chronically painful.   For people who have pain but have not had an injury, it is usually do to the biomechanics of your feet.  Your foot may naturally be slightly inverted or turned to the inside and so this puts a gentle strain on these tendons.  Now imagine those tendons getting over stretched with every step, thousands and thousands of steps every day.  This then accumulates and causes pathology in the tendon.

Treatment begins with a thorough history and physical exam by one of the podiatrist at Advanced Foot and Ankle.  We will usually take X-rays to ensure that there is no bony problem as well.   After you have been diagnosed with peroneal pathology, there are many ways to improve your pain and symptoms beginning conservatively.  Some people will still have pain after conservative options and may need to have the tendon repaired surgically. 

At Advanced Foot and Ankle our providers have experience dealing with these issues and are here to help you.  If you have questions about this or any other foot/ankle issue, please call us at 972-542-2155 to be evaluated. 

Have a Wonderful Day,


Dr. Witt