Foot Pain After a Big Hike? Don’t Ignore Peroneus Longus Tendon Irritation

You made it through a long hike or charity walk—only to find your foot aching later, especially when you lift it or roll onto the side. That deep, grinding or snapping sensation under your arch or near the outer sole might point to a peroneus longus tendon irritation, a condition that often flies under the radar.

What Is the Peroneus Longus Tendon?

The peroneus longus is a key lateral leg muscle whose tendon wraps behind the outer ankle, under the foot, and inserts at the base of the first metatarsal and medial cuneiform. Its role? Stabilising the lateral ankle and helping maintain the arch during walking and push-off.

Why It Gets Irritated After Long Walks

Untrained long-distance walking (e.g. 50–100 km) can lead to:

  • Tendon overload, especially on uneven terrain

  • Fatigue of intrinsic foot stabilisers

  • Rolling or flattening of the arch under load

  • Excessive pronation or forefoot pressure over time

Symptoms of Peroneus Longus Irritation

  • Aching or grinding sensation in the lateral plantar region

  • Pain during dorsiflexion or when rolling through the foot

  • Local tenderness around the cuboid or outer midfoot

  • Possible snapping or crepitus along the tendon path

Healing Timeframe

Mild tendinopathies may resolve within 6 to 8 weeks, while chronic or persistent cases (especially involving subluxation or cuboid impingement) may take 3 to 6 months.

Taping for Lateral Foot Support

Using low-dye or lateral foot taping, we can offload strain from the peroneus longus and support the arch:

  • Reduces pronation

  • Unloads the cuboid tunnel

  • Minimises shear along the tendon

Osteopathic Support for Recovery

At Jo Martin Osteopathy, treatment is aimed at:

  • Releasing calf and fibularis tension

  • Correcting cuboid and fibular head mobility

  • Addressing pelvic or gait asymmetry

  • Providing tailored strength and control exercises (e.g. isometric foot eversions, short foot drills)

Home Care Tips

  • Avoid barefoot walking or flat shoes during recovery

  • Apply ice post-activity to reduce inflammation

  • Try gentle plantar fascia mobilisation and toe spreading exercises

  • Use arch-supportive footwear or orthotics temporarily

Conclusion

Peroneus longus irritation is more common than you think—especially after a long, untrained walk. With targeted osteopathic treatment and the right taping strategy, recovery can be smooth, and your feet can return to full strength without long-term issues.

References

  1. Sobel, M., Pavlov, H., Geppert, M.J., Thompson, F.M., & DiCarlo, E.F. (1993). Microvascular anatomy of the peroneal tendons. Foot & Ankle, 14(8), 448–452. https://doi.org/10.1177/107110079301400803

  2. Arangio, G.A., & Salathe, E.P. (2001). A biomechanical analysis of the support structures of the lateral side of the ankle joint. Foot & Ankle International, 22(7), 583–587. https://doi.org/10.1177/107110070102200709

  3. Ferran, N.A., & Maffulli, N. (2006). Epidemiology of sprains of the lateral ankle ligament complex. Foot and Ankle Clinics, 11(3), 659–662. https://doi.org/10.1016/j.fcl.2006.07.002

  4. Ryan, J.D., & Rodriguez, J. (2018). Tendinopathy of the peroneus longus. In: Easley, M.E., & DeLee, J.C. DeLee & Drez's Orthopaedic Sports Medicine, 5th ed., Elsevier.

  5. Clanton, T.O., Haytmanek, C.T., & Williams, B.T. (2014). Chronic lateral ankle instability: Surgical treatment options. Journal of the American Academy of Orthopaedic Surgeons, 22(10), 601–609. https://doi.org/10.5435/JAAOS-22-10-601

  6. Saxena, A. & Fullem, B. (2004). Peroneal tendon injuries: An evaluation of 49 surgical cases. Journal of Foot and Ankle Surgery, 43(5), 276–282. https://doi.org/10.1053/j.jfas.2004.06.003

  7. Cheung, R.T.H., & An, W.W. (2017). Effects of footwear on foot motion during walking and running. Journal of Foot and Ankle Research, 10(1), 3. https://doi.org/10.1186/s13047-017-0184-z

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