Understanding Peroneal Tendon Issues: Causes, Symptoms, and Treatment Options 

The peroneal tendons, located along the outside of the ankle, are crucial for stabilizing the foot and enabling smooth movement. While these tendons are resilient, they can become injured or inflamed, leading to discomfort and mobility challenges. This blog will explore common peroneal tendon issues, their causes, symptoms, and available treatment options. 

What Are Peroneal Tendon Issues? 

The peroneal tendons include two fibrous bands: 

1. The peroneus longus tendon, which runs under the foot and attaches to the arch. 
2. The peroneus brevis tendon, which connects to the base of the fifth metatarsal. 

Together, they help stabilize the ankle, protect against sprains, and support side-to-side motion. Common conditions affecting these tendons include: 

• Peroneal Tendonitis: Inflammation due to overuse or repetitive stress. 

• Tendon Tears: Small or large tears in the tendon fibers caused by trauma or degeneration. 

• Subluxation/Dislocation: Tendons slip out of their normal position, often due to ankle instability or injury. 

Causes of Peroneal Tendon Issues 

Peroneal tendon problems are often associated with: 

• Overuse: Common in athletes, especially runners and dancers, due to repetitive stress on the ankle. 

• Trauma: Sudden injuries like ankle sprains or fractures can damage the tendons. 

• Foot Anatomy: High arches or imbalances in foot mechanics increase the strain on peroneal tendons. 

• Degenerative Changes: Tendon wear and tear over time, particularly in older adults or those with chronic ankle instability. 

Symptoms to Watch For 

Signs of peroneal tendon issues can vary depending on the severity of the condition but commonly include: 

• Pain and swelling along the outside of the ankle. 

• Weakness or instability in the ankle, particularly during physical activity. 

• A popping or snapping sensation during movement, often linked to subluxation. 

• Difficulty walking or bearing weight on the affected foot. 

Diagnosis and Treatment 

Diagnosis: 

Peroneal tendon issues are typically diagnosed through a physical exam and imaging tests like X-rays, ultrasound, or MRI to evaluate tendon damage and rule out other conditions. 

Treatment Options: 

• Non-Surgical Treatments: 

• Rest, ice, and anti-inflammatory medications to reduce swelling. 

• Bracing or taping to stabilize the ankle and support healing. 

• Strengthening exercises and mobility work to prevent recurrence. 

• Surgical Treatments: 

Surgery may be necessary for severe tears, chronic subluxation, or tendon degeneration. Procedures typically involve repairing or reconstructing the tendons to restore function and stability. 

Complications of Untreated Peroneal Tendon Issues 

Left untreated, peroneal tendon problems can lead to chronic pain, persistent instability, and a higher risk of recurring ankle injuries. Severe cases may result in permanent limitations to mobility and activity levels. Early diagnosis and treatment are critical to avoiding these outcomes. 

Preventing Peroneal Tendon Injuries 

To minimize the risk of peroneal tendon issues, consider these preventive measures: 

• Strengthen the muscles surrounding the ankle to support tendon stability. 

• Wear proper footwear for physical activity, ensuring adequate arch support. 

• Avoid sudden increases in activity intensity or duration. 

• Address any foot mechanics issues with orthotics or physical therapy. 

Recovery and Outlook 

With timely treatment, most peroneal tendon injuries heal well, allowing patients to return to their normal activities. However, severe or chronic cases may require a longer recovery period and more intensive interventions. 

If you’re experiencing ankle pain or suspect a tendon injury, ROC’s specialized sports medicine team is here to help. Our experts provide tailored care to diagnose and treat peroneal tendon issues, getting you back to the activities you love. Get in touch with us today to schedule your consultation.