Published October 14, 2026 · Updated November 1, 2026 · Protocol Archive Editorial
Peroneal tendinopathy exercises: a stage-by-stage home program
Talk to your doctor first. General education, not medical advice.This content is general education, not medical advice, diagnosis or treatment. Get approval from your physician or another qualified healthcare provider before starting any exercise program, especially if you have a medical condition, a recent injury or surgery, are pregnant, or take medication. Stop and seek medical advice if an exercise causes pain, dizziness, chest discomfort or shortness of breath. You choose to exercise at your own risk. Read the full medical disclaimer.
The two peroneal tendons run down the outside of your lower leg and behind the bony bump on the outer ankle. They help steady your foot and ankle, especially on uneven ground and when you stand on one leg. Peroneal tendinopathy means these tendons have become irritated and less able to handle load, which causes pain on the outer ankle or along the outer edge of the foot.
It often follows a change in activity, such as a sudden increase in walking, running or standing, or it can start after an ankle sprain. Walking or running on uneven ground, unsupportive or worn shoes, extra body weight and diabetes can all make it more likely.
Tendons generally recover best with the right amount of movement and gradually increasing load, not complete rest. A steady strengthening program may help the tendon tolerate everyday activity again.
Stage 1: Settle the pain and keep the ankle moving
Keep the ankle moving without stirring up pain, and ease calf tightness.
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Ankle Alphabet
Sit barefoot and move only at the ankle, in a slow, controlled way.
Typical dose: Trace the letters A to Z slowly with your foot; repeat 5 times, 3 times a day1
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Calf Stretch for Plantar Fasciitis
This video is filmed for plantar fasciitis, but it is the same general wall calf stretch. Use the straight-knee version with the painful leg behind and the toes turned in slightly, both heels on the floor, and press your hips gently toward the wall.
Typical dose: Back knee straight: hold 30 seconds, relax 30 seconds, repeat twice2,3
-
Soleus Stretch (Bent-Knee Calf Stretch)
Same wall position, but bend the back knee to reach the deeper calf muscle. Keep the heel down.
Typical dose: Back knee bent: hold 30 seconds, relax 30 seconds, repeat twice2,3
- Keep moving rather than resting completely. Keeping still for long periods can weaken the muscles; get up and move every 20–30 minutes if you sit for long spells.1
- Wear supportive shoes such as running-style sneakers or lace-up hiking boots with a slight heel. Avoid hard, flat, slip-on or very flexible shoes.2,4
- Swap high-impact activity like running for lower-impact options such as swimming or cycling while symptoms settle.2
Stage 2: Build strength on a flat surface
Strengthen the muscles that turn the foot outward and the calf, and improve single-leg balance.
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Resistance Band Ankle Exercises (4-Way)
Focus on the outward (eversion) direction. Keep the heel down and move only the foot, not the knee. Take about 4 seconds out and 4 seconds back.
Typical dose: Turning the foot outward against the band: up to 10 slow reps, building toward 1–3 sets, until the ankle feels tired2,5
-
Toe Stand Strength Exercise
Rise up and lower slowly. Stop the set if the ankle feels tired or shaky. Do these on flat ground, not on a step.
Typical dose: Two-leg heel raises: up to 10 reps, 3 times a day, holding a counter or chair2,3
-
Stand on One Foot Balance Exercise
Hold a wall or counter at first. Poor balance on the painful side is common with this problem.
Typical dose: Hold 30 seconds, repeat 5 times, 3 times a day; build toward 2 minutes1,4
- Mild pain below 5 out of 10 that settles within 24 hours is generally fine; keep going. If pain goes above 5 out of 10 or lasts more than 24 hours, ease back and build up again once it settles.1
- Do strengthening on a flat surface. One NHS leaflet warns that exercising on a step can make this problem worse.3
- Muscle tiredness is expected. If the reps or holds feel too hard, do a little less and build up to the target.1
Stage 3: Load and return to activity
Progress to single-leg and standing strength work so the tendon can handle walking, running and uneven ground.
-
Ankle Strengthening for Stability
Use the calf-raise part of this routine, on flat ground only, not a step. Turning the toes in and the heels out puts more work through the peroneal muscles. Shift weight slightly off the painful side if needed.
Typical dose: Standing heel raises with toes turned slightly in: 4 seconds up, 4 seconds down, until the legs feel tired; 1–3 sets on alternate days or 2–3 times a week5
- Progress two-leg heel raises to single-leg heel raises on the affected side once you can do them comfortably; one leaflet suggests moving on when you can do 30 two-leg reps in a row.1,2
- Return to sport, longer walks or running gradually, using the same pain rules to guide you.1
- Some discomfort during strengthening is okay, but stop if pain becomes more than tolerable and make the exercise easier.5
Want this as a checklist? Turn these exercises into a printable home program with videos and daily check-offs. Adjust the list and doses with your clinician.
Printable handout (PDF, 2 pages). Every exercise on this page with a usual starting amount, boxes for your clinician to write your plan, a pain guide and a 6-week tracker.
Download PDF A4 size Large printEn español: PDF · A4
Watch the exercises
Every exercise above links to its own page with a video and step-by-step instructions. Here are two to start with.
What to expect
These are what published guidance usually says. Your own recovery may be faster or slower.
| Question | What sources say |
|---|---|
| When to move to stage 2 | When daily walking is comfortable and the stage 1 exercises no longer increase pain the next day.1 |
| When to move to stage 3 | When you can do the stage 2 exercises at the full dose with only mild pain that settles within 24 hours.1,2 |
| Typical recovery time | Most people improve within about 3 months, but full recovery can take up to 12 months of steady rehab.1,2,4 |
| Flare-ups | Flare-ups are common and most settle within about 6 weeks. Ease back, stay active and build up again; get advice if one has not settled after a couple of weeks.1,2,4 |
| If you are not improving | If there is no improvement after about 6–8 weeks, ask your clinician about a referral to physical therapy or podiatry.1,4 |
What to avoid or change for now
- Pushing through sharp or worsening pain, or pain above 5 out of 10 that lasts into the next day.
- Doing heel raises or other strengthening on the edge of a step early on.
- Long walks or runs on uneven ground, especially in worn or unsupportive shoes.
- Sudden jumps in walking, running or standing time.
When to get help
- You cannot put weight through your foot or ankle, or you have a new significant injury to the leg, ankle or foot. Get urgent care the same day.1
- A sudden pop or snapping feeling at the back of the ankle with sudden pain, which can mean an Achilles tendon tear. Go to the emergency department.1
- Marked swelling, color change or warmth in the foot or ankle, or swelling spreading up the leg. Get urgent care the same day.1
- Constant pain at night that stops you resting or sleeping.1
- Fever, night sweats, feeling generally unwell or unexplained weight loss with the pain.1
- Your ankle gives way more and more often, or you feel the tendons click or slip over the outer ankle bone.
For a medical emergency, call 911 (US and Canada), 999 (UK), 000 (Australia) or 112.
Next steps
Related guides: Achilles tendinopathy, Shin splints, or see all conditions.
Need a physical therapist? How to find one in the US or UK, including direct access and checking registration.
More exercises: browse the free exercise library, every one with a video.
Frequently asked questions
What exercises help peroneal tendinopathy?
NHS leaflets commonly recommend ankle mobility, resisted pushes of the foot outward with a band or belt, heel raises, calf stretches and single-leg balance. These are built up gradually over several weeks.
Should I rest peroneal tendinopathy completely?
Usually not. Staying active at a level the tendon tolerates is generally better than complete rest, which can weaken the muscles. Cut back on activities that clearly flare it, such as long walks on uneven ground.
How long does peroneal tendinopathy take to heal?
Most people improve within about 3 months of steady exercise and load management, but full recovery can take up to 12 months. Flare-ups along the way are common.
Is it okay to feel some pain during the exercises?
One NHS program says mild pain below 5 out of 10 that settles within 24 hours is acceptable. Pain that is higher or lasts longer means you should ease back.
What shoes are best for peroneal tendon pain?
Supportive running-style sneakers or lace-up boots with a slight heel are usually recommended. Avoid flat, hard, slip-on or very flexible shoes while it settles.
Sources
- East Lancashire Hospitals NHS Trust (MSK Service): Outer ankle tendon pain (peroneal tendinopathy)
- NHS Borders Podiatry: Peroneal tendinopathy
- Kent Community Health NHS Foundation Trust: Peroneal tendinopathy
- NHS Lanarkshire: Peroneal tendinopathy
- Livewell Southwest Podiatry (NHS, Plymouth): Peroneal conditioning
Last checked October 2026. Found something out of date? Email hello@protocolarchive.com.
This guide summarizes published hospital, health-service and professional-body advice listed under Sources. It is general information, not medical advice, and does not replace an assessment by your own clinician, whose plan may differ for good reasons. Stop an exercise and get advice if it causes sharp or worsening pain. Protocol Archive is independent and is not affiliated with the NHS, AAOS or any hospital or video publisher named on this page.
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