Ankle Pain: Peroneal Tendon Tear

The 26 Review

  • What is a Peroneal Tendon Tear Typically a long cut or tear in the middle of the tendon
  • Causes A strong force, pressure or chronic irritation can cause the tendon to tear.
  • Symptoms Pain, swelling, weakness, instability of the foot and ankle, popping noises
  • Diagnosis Physical examination, ultrasound, and MRI
  • Treatment Immobilization, braces, laser, physical therapy, anti-inflammatory medications and surgery ( tendon debridement and tendon repair)
26 Foot and Ankle Peroneal Tendon Tear Injury

Let’s take a closer look…

A peroneal tendon injury is a painful tear or recurrent dislocation of the tendons. There are two peroneal tendons within the body. One peroneal tendon attaches to the outer part of the midfoot, while the second tendon runs under the foot and attaches near the inside of the arch. The main function of the peroneal tendons is to stabilize the ankle and foot, as well as protect one from sprains. The peroneal tendons are prone to injury as the ankle turns or rolls.


Peroneal tendon injuries can develop over time due to inflammation from overuse or occur suddenly. If peroneal tendon injuries are left untreated, they can result in a tear. Peroneal tendon tears typically occur from repetitive movements, like running and jumping. Athletes who do physical activity on uneven surfaces or wear improper footwear are more likely to experience this injury.


Minor injuries can cause pain, swelling, weakness, or instability within the ankle and foot. Individuals battling a degenerative tear will experience sporadic pain on the outside of the ankle and an increase in the height of their arch. Dislocation will produce a snapping feeling around the ankle bone, occasional pain, and ankle instability.


Peroneal tendon injuries can at times be misdiagnosed and will worsen without proper treatment, so it is advised to seek medical evaluation. Diagnosis of a peroneal tendon injury will involve a physical examination to identify the point of pain, instability, swelling, warmth, and weakness. In conjunction, an X-ray, MRI, and other advanced imaging study, such as an ultrasound, may be ordered to further evaluate the injury.


Treating a peroneal tendon injury can be difficult without surgical intervention. Before surgical intervention, immobilization, braces, physical therapy, and anti-inflammatory medications can temporarily relieve symptoms. Laser therapy combined with KT taping and boot immobilization for multiple weeks can sometimes facilitate healing by way of scar tissue development and natural tendon healing. In severe cases, surgery is almost always necessary.

There are two surgical options available depending on a patient’s situation. A tendon debridement is a procedure that includes a podiatric surgeon dividing the sheath around the tendon to remove degenerated and diseased tissue. A tendon repair procedure involves dividing the sheath around the tendons and either removing the torn tendon completely or suturing the tear along the length of the tendon. The tendon sheath is then repaired to finish the surgery. Total recovery time is typically between 6 to 12 weeks, depending on the extent of the surgery. Physical therapy is helpful after surgery to restore the strength and range of motion in one’s ankle and foot.

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