Introduction

Have you ever worn shoes that felt like clouds... and others that made you want to throw them across the room halfway through the day? Even if they’re your size, sometimes your feet just hate your pick, and you’re not imagining it.  

The truth is, your feet are trying to talk to you, and when you ignore them, they get louder. First it's a twinge, then it's a dull ache, and before you know it, walking feels like punishment. That pain in your ankle could be something deeper, like peroneal tendonitis. It creeps in when you wear shoes that don't support you properly, especially if you’re on your feet a lot. 

If your feet are hurting and you’re wondering what went wrong (and how to fix it), you’re in the right place. 

Understanding peroneal tendonitis

Peroneal tendonitis

What is peroneal tendonitis anyway?

You’ve got two little guys called the “peroneal tendons” running along the outside of your lower leg, behind the bony part of your ankle. Their job? Keeping your foot stable helps you move it side to side without twisting the ankle often. Now imagine overworking your tendons. Maybe your shoes are too flat, or your foot keeps rolling outwards, or you’ve been walking more than usual. Over time, tendons get irritated. The pain can be felt along the outside of your ankle, swelling, or even a weird feeling of weakness in your foot. That’s what we call peroneal tendonitis.¹

Symptoms to recognise

You’re probably wondering, “ Well, how do I know it’s peroneal tendonitis and not just a bad foot day?” 

Here are a few ways to understand if your tendons might have had enough: 

1. Pain on the outside of your ankle—especially when walking or standing too long
2. Swelling
3. Pain that gets worse with activity and, weirdly, better with rest (classic sign of tendon irritation) 
4. Weakness in your foot—where limping a little gives temporary relief²

Now that we have the basics, understood and confirmed the symptoms were in fact not just in our heads but are very real, let’s dive in deeper. 

The role of footwear in prevention and management

How shoes can negatively impact your tendons

We all love a good-looking shoe. The kind that makes your outfit pop or adds that extra inch of confidence (and height). But here’s the not-so-glam side: your favourite kicks could secretly be causing chaos for your feet. 

• No arch help = No pardon

When your shoes don't support your foot well, mainly the arch, your tendons (peroneal ones too) must work too hard just to hold you up.³ See it as walking a thin rope in flip-flops. Not good, right?

• Flat or high? Both bad

Very flat shoes (like ballet flats) or tall heels shift how your weight sits. This shift puts stress on the side of your foot, just where tendon troubles are found.⁴

• Shaky shoes: Risky spot

Shoes that fail to hold you firm (yes, those cool foam shoes and old gym shoes!) can make your ankle turn too much. The cords get pulled wrong, and trust me, they remember that.¹

• Tight shoes - Mad cords

When shoes press on your feet hard, like how a sausage is packed, there's limited space to move as you should. That squeeze can hurt your cords with each step you take. It's like making them move in a very small box.²

Key features of supportive footwear (aka: what your feet actually want) 

I want to make this clear before you jump to any thoughts: You don't need to get special shoes unless the doctor says so. But your feet do need some help to stay in good shape: 

• Arch help (that works well)

Check the shoe - can you see a curve for your arch? If it looks too flat, it can cause discomfort. Good arch support spreads pressure and saves your tendons from too much work.

• Strong, soft soles

The base of the shoe should hug your foot - strong to keep you stable, yet soft to ease hits. If a shoe bends or twists a lot when you hold it, it might not support your foot well. A fine shoe must feel tough, most of all in the centre.

• Firm heel support 

The back part of your shoe, which holds your heel, must be hard, not soft. It stops your ankle from shaking and keeps your tendons calm.

• Wide space for toes 

Your toes shouldn't feel packed. They need room to move, bend, and be free without tightness.

• Right size 

Shoes that are too tight or loose make for rubbing, slipping, and odd bends that mess up how you walk – all trouble for those busy peroneal tendons.³

Choosing the right shoes for peroneal tendonitis

Picking the right shoe isn’t just about looks – it’s about comfort, support, and making sure your feet feel protected. If you’ve got peroneal tendonitis or you’re trying to dodge it, here are some features to look for that can actually help!

Recommended shoe types

• Stability Running Shoes – These are good and not limited to runners. They give strong support for your arch and control foot movement, which is vital to reduce stress from the peroneal tendons
• Orthopaedic or motion control shoes – These offer more support and are best if your feet roll in or if you need more help to keep your feet straight
• Hiking shoes or trail runners – These are very good for day-to-day use, where they are made for rough grounds, which means more softness, support for the ankle, and strong soles – all good for sore tendons
• High-top shoes – These help your ankles by cutting down on stress to the tendons on the sides of your ankle. 
• Shoes without insoles – You can put in your own special shoe pads if you need them, letting your feet feel good with fit-for-you help^1,3

Features to look for in footwear

• Solid heel back - This is the back bit of your shoe that holds your heel, and must be strong, not weak. A firm heel back keeps your foot still and stops it from moving side to side
• Arch help - Get shoes that softly help your foot's curve, more so if you have tall arches (a big reason for tendon pain). You want a soft rise, not too high
• Soft feel - Your foot should seem like it's on soft clouds, not falling into them. Good softness takes in shock and cuts down on stress on the tendons
• Hard midsole - Bend the shoe, and if it bends easily, that's not good. A firm midsole keeps your foot right
• Big toe area - Your toes need room to move as they should when you walk
• Soft bottom - This cuts down on the hurt when you step, more so if you walk on hard floors a lot
• Correct size - It seems clear, but it's big. Too small, and it's tight on your foot. Too big, and your foot works hard to stay still^4,2

Custom orthotics and insoles—when to consider them

Let’s say you’ve tried the good shoes and done the stretches, and your feet still feel like they’re not happy. This might be when custom orthotics or insoles step into the spotlight. 

So, what even are they?

Insoles are soft inserts you place into your shoes, sometimes found in-store, sometimes custom-made. Orthotics are like insoles on steroids: specially crafted to match your feet, often prescribed by a podiatrist. 

When should you consider them?

• Pain that lingers—If your foot still hurts even when you wear good shoes, getting orthotics might fix how your foot moves
• High arches or no arches - If your foot's odd shape is making too much pressure or not being steady, tailor-made insoles can give the right support
• Always standing - If your work needs you to be on your feet all day, inserts can cut down on tiredness and stress
• Your foot doc says so - Trust the experts! If a foot doctor says custom orthotics could help, think about it.⁴

Footwear mistakes to avoid

• Wearing a worn-out shoe

That old pair of shoes from five years back? They've likely lost all their cushy feelings. When their softness and build are gone, your tendons take on all the work, and soon, they'll give up. 

• Style over support

Those cool, flat shoes look great, but if they don't help the arch of your foot or give softness? It's a big no from your tendons.

• Ignoring your foot type 

Not all feet are the same - flat ones, high ones, wide ones. Each moves in its own way. Shoes that don't fit your foot shape will cause a lot of pain in your side tendons.

• Going too minimal too fast 

Shoes with less to them, like barefoot styles, can work well IF your feet are used to them. Start too fast, and you may hurt your tendons and find yourself in a lot of pain.

• Skipping break-in time 

Even top shoes need time to fit well on your feet. Wearing new shoes on the first day for a long walk or gym time? You're making it easy to get hurt and end up with blisters.⁴

Additional tips for managing peroneal tendonitis

Taking care of peroneal tendonitis is not only about having the best shoes - it's about making good habits that help your feet all the time.

Stretch and make muscles strong exercises 

Your peroneal tendons work hard each time you walk, so it is key to keep the muscles around them bendy and strong. You could try various exercises such as:  

• Calf stretches, perhaps while making your favourite meal. These stretches relieve tension in the lower leg
• Ankle circles while watching your favourite TV show. This helps to build strength and mobility
• Toe pick-ups by taking things from the floor with your foot. In doing this, we wake up those tiny foot muscles 

In doing this, a few minutes a day can prevent future flare-ups.²

Proper walking and running techniques

This is an important part because how you move matters. Walking on uneven surfaces, causing your feet to slide, or even slamming your feet down can irritate your tendons. There are ways to improve your walking and running techniques.

1. Walk heel to toe. Occasionally we tend to walk quickly with a bit of skipping and hopping, which can cause strains on our tendons. It might not be noticeable at first, but at a later stage, the pain becomes noticeable
2. When going for a run, aim for a smooth stride. It’s beneficial for your tendons to always start small and then aim for longer distances, so your feet get used to it

When to replace shoes for optimal support

As much as we love our footwear, if it is worn out it needs to go out. 

1. Replace your running shoes every 6-12 months, depending on how regularly you use them
2. Always remember to check your insoles - if they are flat or uneven, it's time
3. If your feet suddenly start hurting in shoes that were fine before, that needs to be taken into consideration. It's important to listen to our bodies when they try to communicate in ways they know we’ll respond⁴

Summary 

Bad shoes can lead to a foot problem called peroneal tendonitis. While being in style is cool, putting your health first matters more. Know that shoes do more than just look good—they must keep our feet well. Picking the right shoes is key to stopping and handling this foot issue. 

Treat picking shoes as you would any other body part. It's not just for feeling good but also for moving with no pain and enjoying your life.

If pain stays, do not try to fix it on your own. See a doctor. They can figure out the issue and offer other ways to make your feet feel better, now or later. 

Your feet move you around, so treat them well.