What Is the Difference Between Plantar Fasciitis and Peroneal Tendonitis?

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Your feet play a vital role in your wellbeing. They support up to 1.5 times your body weight when you are walking or running.

They also act as shock absorbers, cushioning up to a million pounds of pressure, during a single hour of strenuous activities such as lifting weights. As you can see, your feet are highly susceptible to various injuries.

Plantar fasciitis and peroneal tendonitis are among the most common foot injuries. While both medical conditions usually present with painful feet, they also tend to have some slight differences.

Plantar Fasciitis

Plantar fasciitis is a common foot condition that causes heel pain. If you are suffering from plantar fasciitis, you will experience a stabbing pain in your heels when you take the first steps out of bed. As you move around more, that pain will eventually decrease. However, if you spend your entire day standing, then that pain will return.


If you are obese or overweight, then you are prone to developing plantar fasciitis, as a result of the increased pressure on your foot’s plantar fascia ligaments. Also, some pregnant women might experience symptoms of this condition at some point, especially during late pregnancy. Long-distance runners are also at risk of developing plantar fasciitis, as well as people whose careers involve standing for long periods, such as waiters, servers, nurses and factory workers. Also, if you have underlying structural foot issues then you are at risk of developing plantar fasciitis. Tight Achilles tendons may also lead to this foot condition. Wearing shoes with poor arch support or those that have soft soles might also lead to plantar fasciitis. Therefore, you need to be extra careful in your choice of footwear.

Treatment and Prevention

If you experience stabbing pain in your heel when you take the first steps out of bed in the morning or when you stand up after sitting for prolonged periods, then you should visit a physician. Your doctor will examine your feet and check your medical history. With that information, the physician will determine whether you have plantar fasciitis. The physician might also decide to conduct imaging tests to rule out other issues that might be causing the pain such as heel spurs. There are various methods for treating plantar fasciitis. They include:

  • Home remedies: You can manage and alleviate the pain caused by plantar fasciitis at home, through some simple remedies. For instance, if your plantar fasciitis has resulted from overuse, then you should give your feet enough time to rest. It’s also a good idea to incorporate some stretching exercises into your rest. Stretching exercises will prevent your plantar fascia from tightening and pulling. If this condition has been caused by prolonged standing, then you need to start wearing supportive shoes. For instance, if you are a nurse, then a pair of nursing clogs (see my reviews) or nursing sneakers (also reviewed here) will provide proper support to your feet, thus helping to alleviate the pain that comes with plantar fasciitis. Wearing night splints can also provide relief from the pain caused by plantar fasciitis – since they stretch your calves and arches. Night splints tend to be more effective for individuals who’ve had this affliction for at least six months. Simple massages and applying ice to your feet can also help to minimize pain and inflammation. And if you are overweight, shedding a few pounds can help to minimize the pressure on your feet and alleviate the pain caused by this painful foot condition.
  • Medical treatments: If over-the-counter medications and home treatments don’t ease your pain, then your physician might recommend some invasive treatments such as corticosteroid injections. The physician will first use an ultrasound device, to help identify the best place for the injections. Physical therapy can also help to ease plantar fasciitis pain. A therapist will recommend some exercises that can help to strengthen your leg and foot muscles, thus helping to stabilize your walk while lessening the pressure exerted on your plantar fascia. If medical interventions fail to work and the pain continues, then your physician might advise you to undergo extracorporeal shockwave therapy. This treatment method involves bombarding your heels with shockwaves, in an attempt to trigger healing inside the ligament. However, extracorporeal shock wave comes with some side effects such as numbness, pain, swelling, and bruises.

Surgery can also be recommended as an intervention to treat plantar fasciitis, mainly as a last resort. During the procedure, the surgeon will remove the plantar fascia from the heel bone. After the procedure, you might have to wear a boot or splint, to minimize pressure on the area that has been operated on. You also have to limit your movements until you’ve fully recovered from the surgery.

Peroneal Tendonitis

Peroneal tendonitis is a medical condition, usually characterized by the inflammation of the peroneal tendons. It mostly affects athletes after they have increased their training suddenly, leading to an overuse of the tendons. When the tendons are overused, they will rub against the bone and swell. With time, these tendons will thicken, in an attempt to manage the increased workload. This condition might be chronic or acute, meaning that it can occur suddenly or develop with time, depending on the underlying factors.


Apart from athletes, people with raised arches are also at risk of developing this foot condition. Every time you force your peroneal tendons to overwork, you are increasing your chances of developing this condition. Some of the common causes of peroneal tendonitis include:

  • Running: Athletes who run frequently on uneven surfaces, cambered roads or slopes are at risk of peroneal tendonitis. When running on such surfaces, you will be forcing the foot to assume an unnatural position.
  • Injury: If you have an ankle injury or you suffer from recurring ankle sprains, then you are also prone to peroneal tendonitis. Damaging the ligaments and tendons that support the ankle and foot repeatedly, will lead to instability and weakness. Eventually, the peroneal tendons will be forced to overwork, leading to peroneal tendonitis.
  • Muscle imbalance: Weakness in the peroneal and calf muscles, combined with tight calf muscles can contribute to tendonitis. Also, an abnormal foot position will also make your peroneal tendons and muscles to work harder, thus increasing the risk of peroneal tendonitis.

Peroneal tendonitis is sometimes misdiagnosed or confused with other common foot conditions. And without proper treatment, it may worsen, make it hard for you to walk or work. Therefore, if you are experiencing pain and tenderness at the back of the ankle, pain when you turn the foot in and out or pain that increases during an activity and subsides during rest, then you should see a foot specialist right away. If the physician determines that you have peroneal tendonitis, then they will recommend the most appropriate treatment method.


As noted above, peroneal tendonitis is an overuse injury. Therefore, most people will heal without any sort of treatment, as long as they rest enough. A person with this condition should minimize walking or other movements that might aggravate it until the pain has completely disappeared. Some of the most common treatment methods for peroneal tendonitis include:

  • Medication: Painkillers and anti-inflammatory medications can help to reduce swelling, pain, and discomfort.
  • Immobilization: Minimizing foot and ankle movements using a support structure or a boot will help to ease the pain
  • Physical therapy: Heat, ultrasound and ice therapies can be used to ease pain and inflammation.
  • Cortisone injections: Some doctors might recommend cortisone injections, depending on the extent of the problem. However, this treatment is rarely applied, since cortisone injections might lead to ruptured tendons.

If non-surgical treatment methods fail to work, then surgery might be considered as the last option. Surgery might be used to remove tissues that might be causing irritation around the tendons. Also, it might be used to repair damaged tendons.


Peroneal tendonitis is a serious foot condition. Apart from limiting your mobility, it can prevent you from engaging in various physical activities. Some of the things you can do to prevent or avoid this condition including wearing proper footwear, stretching the peroneal and calf muscles, and increasing your training workload gradually. With adequate rest, you should be able to recover fully from this condition and resume a normal lifestyle. However, you need to be patient enough, to allow the peroneal tendons and muscles to heal completely.

Final Thoughts

Peroneal tendonitis and plantar fasciitis are both caused by overuse, with plantar fasciitis being the most common of the two. Both medical conditions can be treated using over-the-counter pain medication, immobilization, adequate rest and physical therapy, as well as invasive treatments such as surgery or injections. If you experience any form of pain on your feet, you should visit a medical professional right away. The physician will then examine your feet, make a diagnosis and then recommend the most appropriate treatment method. Wearing proper footwear will go a long way in preventing both medical conditions.

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