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If there is persistent pain below the ankle or a "pop or snap" around the heel, consulting a physician immediately is highly recommended as an Achilles tendon rupture could be a likely cause. "Startup pain" or pain first thing in the morning around the ankle.Pain when pressing in on the peroneal tendons on the outside of the ankle.Swelling on the outside of the ankle, below the lateral malleolus.Mild or severe pain on the outside of the ankle, below the lateral malleolus (bony bit) that worsens with activity.Most individuals who have developed peroneal tendinitis experience the following symptoms: Also, individuals who have recently tried a new exercise or have significantly increased their level of activity in a short period of time are prone to developing peroneal tendinitis. Peroneal tendinitis most commonly occurs in athletes and individuals with high-arched feet or feet with a misaligned heel that is inclined or tilted inwards. This is a natural response the body has to injury and often causes pain, swelling, or irritation. Peroneal tendinitis is the inflammation of the peroneal tendons and usually occurs because these tendons are subject to overuse and excessive repetitive forces during standing and walking. These peroneal tendons help to control the position of the foot during walking and are also responsible for turning the ankle to the outside. The peroneus longus on the other hand has a longer course it starts higher on the leg and runs underneath the foot to connect to the first metatarsal (big toe) on the inside of the foot. The peroneus brevis has a shorter muscle and starts lower in the leg and runs around the back of the fibula on the outside of the leg and connects to the fifth metatarsal (pinky toe). Tendons connect muscle to bone and allow them to exert force across the joints. There are two peroneal tendons that run on the outside of the ankle, along the back of the fibula - the peroneus brevis and peroneus longus. Home / Specialties / Foot + Ankle / Ankle / Peroneal Tendinitis Peroneal Tendinitis