Professional Podiatry Services of New York

Ankle & Sports Medicine

Peroneal tendon injuries

The two peroneal tendons run behind the outer ankle bone and help stabilize the foot and ankle. They can become inflamed, tear, or slip out of position, often in people with repeated ankle sprains.

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What is it?

Injuries range from tendinitis to longitudinal splits and tears, and to subluxation, in which the tendons snap over the ankle bone because the retaining tissue is torn.

What causes it?

  • Repeated ankle sprains
  • Sports with cutting or quick direction change
  • High-arched feet
  • An acute injury during forceful ankle movement

What does it feel like?

  • Pain and swelling behind and below the outer ankle bone
  • A snapping or popping sensation
  • Weakness or instability of the ankle

How is it diagnosed?

Exam of tendon strength and stability. Ultrasound in the office can show tears and tendons slipping in real time; MRI is used for surgical planning.

When should you see a podiatrist?

  • Outer ankle pain lasting more than a couple of weeks
  • Snapping behind the ankle bone
  • Ankle weakness after a sprain

Nonsurgical treatment

Boot or brace
Rest the tendons.
Physical therapy
Strength and balance.
Orthotics
Particularly lateral wedging for high arches.
Anti-inflammatory measures
For tendinitis.

When is surgery considered?

Surgery is considered for tears that remain painful despite conservative care, and often for tendons that repeatedly dislocate.

Torn tendons are repaired or, if badly damaged, connected to the healthy neighboring tendon. Dislocating tendons are stabilized by deepening the groove and repairing the retaining tissue.

Related procedures

What is recovery like?

Several weeks in a boot, then physical therapy, with return to sports commonly around three to four months.

Frequently asked questions

Is a peroneal tendon tear the same as an ankle sprain?

No, though they often occur together. A sprain injures ligaments; a peroneal injury involves tendons. Persistent pain after a 'sprain' may be a missed tendon injury.