Peroneal Tendinopathy

What is peroneal tendinopathy?

The peroneal tendons run along the outside of the ankle and help stabilise the ankle and control movement of the foot.

They can become irritated or damaged because of overuse, altered foot mechanics or repeated ankle sprains.

What symptoms and signs might I experience?

• Pain along the outside of the ankle.
• Tenderness behind or below the outer ankle bone.
• Swelling.
• Pain during activity.
• Weakness when turning the foot outwards.
• Pain during resisted ankle movement.
• Snapping or instability in some cases.

How is it diagnosed?

Diagnosis is usually based on examination.

Ultrasound or MRI may be useful to assess tendon inflammation, tears or instability.

How is it treated without surgery?

Treatment may include:

• Activity modification.
• Physiotherapy.
• Progressive tendon strengthening.
• Balance exercises.
• Treatment of associated ankle instability.
• Supportive footwear.
• Orthotics where appropriate.
• Temporary bracing.

When might surgery be considered?

Surgery may be considered for persistent symptoms, significant tendon tears or associated ankle instability.

What might surgery involve?

Procedures may include:

• Tendon debridement.
• Tendon repair.
• Tendon reconstruction or grafting.
• Repair of the tendon sheath.
• Correction of an underlying bony abnormality.
• Lateral ligament reconstruction where instability  is contributing.

What is recovery like?

Tendon repairs generally require a period of protection followed by gradual movement, strengthening and rehabilitation.

Return to sport depends on the severity of the tendon injury and the procedure performed.